Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-16T11:32:11.562Z Has data issue: false hasContentIssue false
  • English
  • Français

Tuberculosis in Hospital Personnel

Published online by Cambridge University Press:  02 January 2015

Loraine E. Price ,
William A. Rutala  and
Gregory P. Samsa
Loraine E. Price*
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
William A. Rutala
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
Gregory P. Samsa
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
*
547 Clinical Sciences Building 229H, Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC 27514
Get access Rights & Permissions [Opens in a new window]

Abstract

Tuberculosis (TB) skin testing practices and the prevalence and inherent risk of TB infection among hospital employees in 167 North Carolina (NC) hospitals were determined from a 79% (132/167) response to a tuberculosis screening questionnaire. Preemployment TB skin testing was performed by 98% of responding hospitals, primarily (87%) by the Mantoux method. TB skin test reactions of ≥ 10 mm were interpreted as significant by 72% and at the appropriate time interval of 48 to 72 hours after administration by 80%. The booster test was routinely performed in 12% of the hospitals. TB infection prevalence among new employees during 1983 was 6.3% (260/4137) in 30 hospitals supplying these data. A positive correlation was noted between employee infection prevalence and county TB case rates (P = .014). Skin test conversion data from 56 hospitals across the state revealed a five year mean conversion rate of 1.14% among 71,253 personnel. There was an association between the incidence of TB in the general population and the frequency of conversions among hospital employees in corresponding geographical regions. Similarly, the incidence of TB among approximately 100,000 NC hospital employees in 1983 and 1984 was less than the incidence in the general population. These associations suggest that the incidence of TB infection among hospital personnel may reflect the prevalence of tuberculosis in the community rather than an occupational hazard. Annual TB skin testing of hospital employees may be justified in eastern North Carolina where the incidence of tuberculosis (22-30 cases/ 100,000) is greater than the national average and where the risk of new TB infection among hospital employees is relatively common (≥1.5%).

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 8 , Issue 3 , March 1987 , pp. 97 - 101
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1987

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Alpert, ME, Levison, ME: An epidemic of tuberculosis in a medical school. N Engl J Med 1965; 272:718–721.CrossRefGoogle ScholarPubMed
2.Barrett-Connor, E: The epidemiology of tuberculosis in physicians. JAMA 1979; 241:33–38.Google Scholar
3.Levine, I: Tuberculosis risk in students of nursing. Arch Intern Med 1968; 121:545–548.CrossRefGoogle Scholar
4.Ehrenkranz, NJ, Kicklighter, JL: Tuberculosis outbreak in a getterai hospital: Evidence for airborne spread of infection. Ann Intern Med 1972; 77:377–382.Google Scholar
5.Cantanzaro, A: Nosocomial tuberculosis. Am Rev Respir Dis 1982; 125:559–562.Google Scholar
6.Atuk, NO. Hunt, EH: Serial tuberculin testing and isoniazid therapy in general hospital employees. JAMA 1971; 218:1795–1798.Google Scholar
7.Gregg, DB, Gibson, MS: Employee tuberculosis control in a predominantly tuberculosis hospital. J SC Med Assoc 1975; 5:160–165.Google Scholar
8.Craven, RB, Wenzel, RP, Atuk, NO: Minimizing tuberculosis risk to hospital personnel and students exposed to unsuspected disease. Ann Intern Med 1975; 82:628–632.CrossRefGoogle ScholarPubMed
9.Ruben, FL, Norden, CW, Schuster, N: Analysis of a community hospital employee tuberculosis screening program 31 months after its inception. Am Rev Respir Dis 1977; 115:23–28.Google ScholarPubMed
10.Vogeler, DM, Burke, JP: Tuberculosis screening for hospital employees: A five year experience in a large community hospital. Am Rev Respir Dis 1978; 117:227–232.Google Scholar
11.Bolls, H, Duffy, KR, Hamory, BII: PPD conversion rates in an insurance company and a university hospital. Am J Infect Control 1984; 12:247.Google Scholar
12.Holly, MP, Bartzokas, CA: Tuberculin testing in hospital personnel, J Hyg 1977; 78:325–329.CrossRefGoogle Scholar
13.Berman, J, Levin, ML, Orr, ST, et al: Tuberculosis risk for hospital employees: Analysis of a five-year tuberculin skin testing program. Am J Public Health 1981; 71:1217–1222.Google Scholar
14.Lowenlhal, G, Keys, T: Tuberculosis surveillance in hospital employees: Are we doing too much? Infect Control 1986; 7:209–211.Google Scholar
15.American Thoracic Society: Infectiousness of tuberculosis: A statement by the ad hoc committee on treatment of tuberculosis patients in hospitals. Am Rev Respir Dis 1967; 96:836–837.Google Scholar
16. Guidelines for Prevention of Tuberculosis Transmission in Hospitals. Allanta, US Public Health Service, 1975.Google Scholar
17.Williams, WW: CDC guidelines for infection control in hospital personnel. Infect Control 1983; 4:326–349.Google Scholar
18.Thompson, NJ, Glassrolh, JL, Snider, DE, el al: The booster phenomenon in serial tuberculin testing. Am Rev Respir Dis 1979; 119:587–597.Google ScholarPubMed
19. Tuberculosis Control Policies and Procedures. North Carolina Department of Human Resources, 1984.Google Scholar
20.Snedecor, GW, Cochran, WG: Statistical Methods, ed 6. Ames, IA: Iowa State University Press, 1967.Google Scholar
21.Snider, DE: The tuberculin lest, in Green, GM. Daniel, TM, Ball, WC (eds): Koch Centennial Memorial. New York, American Lung Association, 1982; pp 108–118.Google Scholar
22.Lunn, JA: Administering and reading the Mantoux test, in Guidelines for the Diagnosis and Management of Tuberculosis Infection. New YorkAudio Visual Medical Marketing Inc, 1984, pp 20–25.Google Scholar
23.Comstock, GW: Interpretation of Mantoux lest results, in Guidelines for the Diagnosis and Management of Tuberculosis Infection. New York, Audio Visual Medical Marketing Inc. 1984, pp 30–38.Google Scholar
24.Bass, JB, Sanders, RV, Kirkpalrick, MB: Choosing an appropriate culling point for conversion in annual tuberculin skin testing. Am Rev Respir Dis 2985; 132:379–381.Google Scholar
25.Parer, LS: Incidence and epidemiology of tuberculosis in the 1980s, in Guidelines for the Diagnosis and Management of Tuberculosis Infection. New York, Audio Visual Medical Marketing Inc. 1984, pp 7–14.Google Scholar
26.Centers for Disease Control: Tuberculosis—United States, 1984. MMWR 1985; 34:299-302, 307.Google Scholar
27.Centers for Disease Control: Aplisol® tuberculin PPD. Memo to state and big city tuberculosis control officers, July/September 1982.Google Scholar