Risk of Tuberculin Skin Test Conversion among Health Care Workers: Occupational versus Community Exposure and Infection

Abstract

A prospective observational cohort study to assess rates of and risk factors for tuberculin skin test (TST) conversion among health care workers (HCWs) was conducted at an urban hospital located in a high tuberculosis-incidence area in 1994-1998. All hospital employees undergoing required testing every 6 months were included. A total of 69 (1.2%) of 5773 susceptible employees had a documented TST conversion (overall rate, 0.38 per 100 person-years worked). No significant difference existed in conversion rates among employees with frequent, limited, or no patient contact. HCWs with a TST conversion lived in zip codes with higher tuberculosis case rates (P< or =.05). In multivariate analysis, TST conversion was associated with history of bacille Calmette-Guérin vaccination (relative risk [RR], 11.63), annual salary <$20,000 (RR, 3.67), and increasing age. In the setting of an effective tuberculosis infection-control program, TST conversion rates were low, and risk of conversion among HCWs was associated most strongly with nonoccupational factors.

Job‐related risk of latent tuberculosis infection in a homogeneous population of hospital workers in a low incidence area

“…The older age (47-70 years) is strongly associated with the risk of LTBI in this survey with increasing odds for a positive TST for every year of age, according to other authors [Warren et al, 2001;Larsen et al, 2002;Kraut et al, 2004]. Only few studies, conversely, evaluated the contribution of household TB exposure to tuberculin reactivity [Tissot et al, 2005;Menzies et al, 2007].…”

Prevalência e fatores associados à infecção pelo Mycobacterium tuberculosis entre agentes comunitários de saúde no Brasil, usando-se a prova tuberculínica

“…Inúmeros estudos avaliaram o nível de exposição ocupacional à TB e a positividade à PT 43,44,45,46 . Aqueles que tiveram contato direto e indireto com pacientes com TB foram mais positivos à PT 8 , concluindo que os que assim trabalham têm o risco aumentado, significativamente associado à exposição.…”

Detecting a low prevalence of latent tuberculosis among health care workers in Denmark detected by M. tuberculosis specific IFN-γ whole-blood test

“…The prevalence of TB and risk of TST conversion among health care workers (HCW) in some countries is alarmingly high [2 Á6]. In a study from Atlanta, Georgia, including all branches of HCW, occupational infection with M. tuberculosis was documented, estimated on the basis of biannual TST conversion, to be around 0.38% per y [7]. In Denmark, no recent studies have been carried out in HCW, but in 2003, 1% (5/395) of all notified cases of active TB were suspected to be the result of occupational exposure [8].…”