of TB IPC measures. The Guideline Development Group re-emphasized that the implementation of IPC measures must be adopted as a package of interventions based on a three-level hierarchy of controls. In line with international standards on occupational safety and health, it is imperative that national health care authorities make use of particulate respirators for health workers only when a respiratory protection programme can be put in place. Attempting to establish one without the other may lead to overreliance on respirators, and give a false sense of protection. When setting up respiratory protection programmes, health care authorities must also consider the provision of respiratory protection to include community health workers at risk of exposure to individuals with TB. The panel acknowledged that an important advantage of properly implemented respiratory protection programmes is the appropriate use of particulate respirators and increased compliance among health workers. Effective implementation involves employee education and training activities on the proper use and maintenance (including repair and disposal) of particulate respirators, and periodic audits of practice. The implementation of respiratory protection for health workers is recommended in health care facilities and other institutions where patients undergo treatment and care. Respiratory IPC measures, including the use of respirators, are also required for family members who are providing close care for patients with TB receiving palliative and end-of-life care. Resources Given that the use of particulate respirators is to be implemented within respiratory protection programmes, the necessary resources should be made available to ensure their proper functioning and sustainability. Although the panel emphasized that investment needs would depend on existing infrastructure and service demand, the allocation of resources seemed reasonable when compared with the estimated costs of treating TB in settings with a high risk of M. tuberculosis transmission. Subgroup considerations Health workers with impaired lung function (e.g. as a result of asthma or chronic obstructive pulmonary disease) may be physically unable to wear a particulate respirator. Respirators should be worn by all personnel entering high-risk areas, in particular by health workers living with HIV, given the increased risk of developing TB disease if exposed in the workplace. Settings and target population The recommendation to use particulate respirators by health workers applies to all health care settings, and to non-health care congregate settings such as correctional facilities. It also applies to other settings where health care services are provided to individuals with presumed and confirmed TB (e.g. refugee and asylum centres).