Wednesday, March 21, 2018

Occupational TB Exposure Risk: Time to Question the Current Screening Paradigm

Source: Hasting Prince Edward Public Health, Ontario, Canada
I really love it when a new study challenges current practice.

We screen US healthcare workers at regular intervals for tuberculosis (at least once yearly).  

This article, recently published in Clinical Infectious Diseases questions that practice.  After following over 40,000 healthcare workers for over 16 years, only 123 positive TB skin tests were reported of which only 7% had a suspected TB exposure in the workplace.  None developed active tuberculosis.

Do we need to screen so often?  Perhaps we could screen employees on initial hire and then only after a documented exposure to a tuberculosis case?  This would be easier, less costly and likely result in no harm.

Time to rethink the current healthcare worker tuberculosis screening paradigm.