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Ask the expert: X-rays for TB screening

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 [1] 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 [2] for TB prevention in healthcare facilities may differ from federal guidelines, so it is best to check that your state follows CDC recommendations.

[3] Get into compliance with HCPro’s Basic OSHA Compliance Manual Kits for medical [3] or dental [4] practices. Receive bimonthly electronic manual updates through your newsletter subscription [5] that keep your regulatory manual up to date and in compliance!