Ask the expert: X-rays for TB screening

By: July 27th, 2010 Email This Post Print This Post

Q: How often do you need a chest x-ray if you test positive to TB? A staff physician believes he needs to have one every 4-5 years unless he becomes symptomatic. What is the recommendation?

A: CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005 provides advice and in this case recommends against repeat x-rays.

The guideline document on p. 30 says that healthcare workers:

“…with a baseline positive or newly positive TST or BAMT result should receive one chest radiograph to exclude a diagnosis of TB disease….After this baseline chest radiograph is performed and the result is documented, repeat radiographs are not needed unless symptoms or signs of TB disease develop or a clinician recommends a repeat chest radiograph.”

In place of serial testing, healthcare workers with positive test results should receive a symptom screening. The frequency of the screening should be determined by the risk classification of the healthcare facility, the guidelines add.

State health department regulations for TB prevention in healthcare facilities may differ from federal guidelines, so it is best to check that your state follows CDC recommendations.

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Thank you for that information. I am starting a new job and the owner is insisting that the xray has to be done yearly and I keeping telling her that it is not so. I take them every five years just to satisfy these jobs but I know it is not necessary. I do not have any symptoms, colds, fevers or anything. I wish that OSHA would make standard and make it known.

We are required every year to take a tb skin test during yearly physical. I cannot take tb skin test as I have had BCG and it shows false positive. The health department advised me not to take a tb skin test. My work sends me for an x-ray every year and insists I must do x-ray every year. Is this the right cause of action or is there any other method of determining my routine status without being subjected to x-ray every year? I live in the State of Alabama and I will be most grateful to know the answer.
Thank you.


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