Journal Article

Risk of Tuberculin Skin Test Conversion among Health Care Workers: Occupational versus Community Exposure and Infection

Nina M. Larsen, Cara L. Biddle, Mark J. Sotir, Nancy White, Patricia Parrott and Henry M. Blumberg

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 7, pages 796-801
Published in print October 2002 | ISSN: 1058-4838
Published online October 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/342333
Risk of Tuberculin Skin Test Conversion among Health Care Workers: Occupational versus Community Exposure and Infection

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A prospective observational cohort study to assess rates of and risk factors for tuberculin skin test (TST) conversion among health care workers (HCWs) was conducted at an urban hospital located in a high tuberculosis—incidence area in 1994–1998. All hospital employees undergoing required testing every 6 months were included. A total of 69 (1.2%) of 5773 susceptible employees had a documented TST conversion (overall rate, 0.38 per 100 person-years worked). No significant difference existed in conversion rates among employees with frequent, limited, or no patient contact. HCWs with a TST conversion lived in zip codes with higher tuberculosis case rates (P ⩽ .05). In multivariate analysis, TST conversion was associated with history of bacille Calmette-Guérin vaccination (relative risk [RR], 11.63), annual salary <$20,000 (RR, 3.67), and increasing age. In the setting of an effective tuberculosis infection—control program, TST conversion rates were low, and risk of conversion among HCWs was associated most strongly with nonoccupational factors.

Journal Article.  4023 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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