Tuberculosis among Health Workers—A Secondary Data Analysis of German Social Accident Insurance Data from 2002–2017

Abstract

Tuberculosis (TB) is the most common cause of fatal infections worldwide. Recent TB figures in Europe indicate that 30 people were infected with tuberculosis each hour in 2017. Healthcare workers are at particular risk of being infected through patient contact. TB is the second most common occupational infectious disease among German healthcare workers. Routine data from the German Social Accident Insurance were used to examine trends in occupational TB diseases. We analyzed annual cross-sectional data for the years 2002 to 2017. The data underwent descriptive analysis. A total of 4653 TB cases were recognized as occupational diseases (OD) in the period under study. In 2002, 60 TB cases were recognized as OD No. 3101, i.e., transmissions from person to person. Since 2013, the level has settled at around 500 recognized cases per year. This is around eight times the number of cases compared to 2002. The following three groups collectively accounted for the largest share of TB cases (88.5%): nurses (including geriatric nurses), other healthcare employees, and physicians. The upward trend in the number of TB cases recognized as occupational diseases is probably due to improvements in diagnostic tests used to diagnose TB infections. TB in health and welfare workers remains an important issue in the health and welfare sector in Germany, partly due to the long latency period between potential exposure to infectious patients or materials and the recognition of the latent tuberculosis infection (LTBI) or active TB as OD.

COVID-19 among Health Workers in Germany and Malaysia

“…A disease, which causes only mild symptoms for a few days, might not be reported, because the insurance is unlikely to grant any compensation for this disease. In addition, only half of the work-related infections in Germany pertain to workers covered by the BGW [29]. Therefore, the numbers of claims of an occupational disease because of COVID-19 should roughly be multiplied by two for an estimate of the effected health and social workers in Germany.…”

COVID-19 among Health Workers in Germany—An Update

“…At the beginning of the pandemic, it was not clear under which terms COVID-19 would be accepted as an OD. This became clearer with a publication explaining the conditions under which COVID-19 is recognized as an OD [23]. Probably more importantly, only during the course of 2020 did it become evident that long-lasting illness can occur even after a light case of the acute infection [24].…”

“…A disease which causes only mild symptoms for a few days might not be reported because the insurance will not grant any compensation for this disease. In addition, only half of the work-related infections in Germany pertain to HW covered by the BGW [23]. Therefore, the numbers of claims of an OD because of COVID-19 should roughly be doubled for an estimate of the real number of affected health and social workers in Germany.…”

“…As a rule of thumb, it can be assumed that about half of the work-related infections in HW are covered by the BGW. The rest are covered by accident insurance providers in the various German states [23].…”

COVID-19 als Berufskrankheit oder Arbeitsunfall: Überlegungen zu Versicherungsschutz und Meldepflicht in der gesetzlichen Unfallversicherung

“…Der Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW), die u. a. auch für nichtstaatliche und kirchliche Unternehmen des Gesundheitsdienstes der zuständige Unfallversicherungsträger ist, wurden bis zum 11.12.2020 insgesamt 8.677 bestätigte SARS-CoV-2 Infektionen bei Beschäftigten aus (zahn-)ärztlichen Praxen und Kliniken gemeldet. Wird berücksichtigt, dass von den jährlich bei allen Unfallversicherungsträgern gemeldeten Infektionen etwa die Hälfte auf die BGW entfällt, ist zu vermuten, dass ein großer Teil der vom RKI erfassten Fälle bei Beschäftigten beruflich verursacht wurde 11 .…”