Ask the expert: Chest x-ray frequency with positive TB test

By: March 23rd, 2012 Email This Post Print This Post

Q: How often should a staff member in a doctor’s office with a positive tuberculin skin test be required to have a chest x-ray?

A: If the medical practice is assessed as low-risk for TB exposures, an employee with a new positive tuberculin skin test should have a chest x-ray. Once the x-ray rules out infectious status, additional chest x-rays are not needed unless symptoms of TB present or unless an infectious disease physician recommends one, according to CDC Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Settings, 2005.

In an FAQ to the Guidelines, questions 6 to 9 address chest x-rays for healthcare workers.

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What would be required for Paramedics and EMT’s?

We require an initial CXR any place I have done occupational health and infection prevention. Then, yearly we send out a questionaire to see if the person with +TST is perhaps developing active disease. If we have concerns about the information on the form, they are assessed in person and we would again order a CXR if we felt they might have active disease or send them to their PCP.

By Bruce Cunha on April 2nd, 2012 at 5:36 pm

Or if there is a new exposure to an active TB case. A chest x-ray at 8 weeks post exposure is indicated.

You can do a baseline QuantiFeron and an 8- week repeat. This is more sensitive than early changes in a CXR.

Can employees eat in the Lab when lab closed for lunch

Not if it is an area where specimens are processed. Don’t they have a break area? If not, I’d try to find one for them. Think of all the potential for food contamination even if there are currently no specimens actually there. It just doesn’t seem like a good practice to me.

By Rebecca L Sahlman, MD on February 19th, 2013 at 3:00 pm

Is there a requirement on how I must word a negative chest x-ray report in an individual with a positive PPD skin test?

In the State of Ohio can a Hospital Chest X-Ray done that states “lungs clear” just prior to admission to a long term care facility replace the 2 Step PPD for State Surveyor regulatory purpose?

By Barbie Landwehr on August 21st, 2014 at 4:00 pm

Can you please tell me how often a chest x-ray needs to be performed. I was always told 5 years and now I am hearing two.

By Teresa D'Costa on September 4th, 2014 at 3:40 am

Can an X-Ray replace the two-step PPD for a new hire if the facility (hospital) is out of Mantoux, or does the new hire need to get the two step done (after the X-ray) as soon as the mantoux comes in?

Once the PPD is positive and you’re hired at another company, should you go for chest x-ray again even though it was done at the former place. How often does it need to be done?

With a positive PPD, will you go for a chest x-ray again if hired in another place?

What are the OSHA requirements for chest x-rays for employees working around chemicals? We require a chest x-ray for new employees at their initial physical before hiring. We also require the appropriate PPE to be worn. Does OSHA requirea chest x-ray yearly?

By J. G. Stauffer, MD on March 6th, 2015 at 2:36 pm

Where are the responses to the above questions about the frequency for screening chest x-rays for those with positive TST?

By J. G. Stauffer, MD on March 6th, 2015 at 2:37 pm

Where are the responses to the above questions about chest x-ray screening for those with positive TST?

By Delilah Amerson on November 17th, 2015 at 9:56 am

How often are associates with a history of +PPD required to have CXR?

By Cheryl Brinson on March 14th, 2018 at 3:57 pm

How often must an employee who allergic to normal TB test have a chest xray done?

How often should a chest xray be done if the TB test is positive?

By Jocelyn Desuyo on February 23rd, 2019 at 4:39 am

Is it safe to undergo chest xray then 2 days after, a lumbar and thoracic xray had been performed?
Please let me know. Thank you.

By Jocelyn Desuyo on February 23rd, 2019 at 4:47 am

Is it safe to undergo lumbar and thoracic xray after 2 days performing the chest xray? Please let me know. Thank you.

We are a home health agency. If a new hire employee has positive TB skin test, we require a chest x-ray.

Is it acceptable for us to accept x-ray results that states “normal”? Or does the x-ray have to specify “negative for TB”?

Thank you very much.


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