Ask the expert: Healthcare worker TB exposure

By: July 16th, 2012 Email This Post Print This Post

Q: A patient seen by our practice has recently tested positive for tuberculosis and is undergoing treatment.  From an OSHA perspective, what follow-up treatment do we need to do for employees who were exposed to him?

A: Following the CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005, will keep you compliant with OSHA for a healthcare worker (HCW) with a TB exposure in your facility.

The CDC guidelines for HCWs exposed to a patient known to be infectious with TB in a setting that uses the tuberculin skin test (TST) for worker screening are:

  • Perform a symptom screen
  • Administer a TST to those who previously had negative TST results
  • Repeat the TST and symptom screen 8–10 weeks after the end of exposure, if the initial TST result is negative
  • Promptly evaluate the HCW for TB disease, including performing a chest radiograph, if the symptom screen or the initial or 8–10-week follow-up TST result is positive
  • Provide additional medical and diagnostic evaluation for LTBI, including determining the extent of exposure, if TB disease is excluded

Exposed HCWs with documented previously positive TSTs “do not require either repeat testing for M. tuberculosis infection or a chest radiograph (unless they are immunocompromised or otherwise at high risk for TB disease), but they should receive a symptom screen.” If TB symptoms are present:

  • Record the symptoms in the HCW’s medical chart or employee health record
  • Perform a chest radiograph
  • Perform a full medical evaluation
  • Obtain sputum samples for smear and culture, if indicated

 

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Comments

By Mary Ann Massa on July 19th, 2012 at 9:43 am

Is a biopsied proven TB in an encapsulated nodule possible to be spread to staff who took the exams?

By Miriam Barroso on September 10th, 2013 at 6:01 pm

After initial 2 step TB Test on admission in an Assisted Living facility, how often is it required to test the Resident again?

 

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