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. 1996 Aug 31;313(7056):522–525. doi: 10.1136/bmj.313.7056.522

Are healthcare workers in England and Wales at increased risk of tuberculosis?

S Meredith 1, J M Watson 1, K M Citron 1, A Cockcroft 1, J H Darbyshire 1
PMCID: PMC2351896  PMID: 8789976

Abstract

OBJECTIVE: To determine whether healthcare workers in England and Wales are at increased risk of tuberculosis and to examine the frequency of drug resistance in this population. DESIGN: Comparison of notification rates by occupation obtained from national tuberculosis notification surveys in 1988 and 1993, with denominators from the 1991 census. SUBJECTS: People with notified tuberculosis in professional and associate professional occupations from the two surveys. MAIN OUTCOME MEASURES: Rates of notified tuberculosis in health professionals (mainly doctors) and health associate professionals (mainly nurses) compared with rates in other professional and associate professional occupations, adjusted for ethnic group, sex, and age. RESULTS: 119 cases of tuberculosis were identified in healthcare workers, including 61 nurses and 42 doctors. The crude notification rate in healthcare workers was 11.8 per 100,000 per year (95% confidence interval 9.8 to 14.1) compared with 3.3 per 100,000 per year (2.9 to 3.6) in other professional and associate professional occupations; rate ratios were higher (range 1.7 to 3.2) in all ethnic groups. The relative risk adjusted for ethnic group, sex, and age was 2.4 (95% confidence interval 2.0 to 3.0), slightly higher for health professionals (2.7 (1.9 to 3.8)) than for associate professionals (2.0 (1.5 to 2.6)). No multiple drug resistant strains of tuberculosis were identified in healthcare workers. CONCLUSIONS: Better detection and notification of cases of tuberculosis in healthcare workers may account for some of the apparent increased risk, but these findings imply that tuberculosis remains a hazard for healthcare workers and highlight the importance of ensuring that occupational health monitoring and protection workers are not neglected.

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Selected References

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  1. ABRUZZI W. A., Jr, HUMMEL R. J. Tuberculosis: incidence among American medical students, prevention and control and the use of BCG. N Engl J Med. 1953 Apr 23;248(17):722–729. doi: 10.1056/NEJM195304232481705. [DOI] [PubMed] [Google Scholar]
  2. Bloch A. B., Cauthen G. M., Onorato I. M., Dansbury K. G., Kelly G. D., Driver C. R., Snider D. E., Jr Nationwide survey of drug-resistant tuberculosis in the United States. JAMA. 1994 Mar 2;271(9):665–671. [PubMed] [Google Scholar]
  3. CHILDRESS W. G. Occupational tuberculosis in hospital and sanatorium personnel. J Am Med Assoc. 1951 Jul 28;146(13):1188–1190. doi: 10.1001/jama.1951.03670130010004. [DOI] [PubMed] [Google Scholar]
  4. Frost H., Klaber Moffett J. A., Moser J. S., Fairbank J. C. Randomised controlled trial for evaluation of fitness programme for patients with chronic low back pain. BMJ. 1995 Jan 21;310(6973):151–154. doi: 10.1136/bmj.310.6973.151. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Lunn J. A., Mayho V. Incidence of pulmonary tuberculosis by occupation of hospital employees in the National Health Service in England and Wales 1980-84. J Soc Occup Med. 1989 Spring;39(1):30–32. doi: 10.1093/occmed/39.1.30. [DOI] [PubMed] [Google Scholar]
  6. MIKOL E. X., HORTON R., LINCOLN N. S., STOKES A. M. Incidence of pulmonary tuberculosis among employees of tuberculosis hospitals. Am Rev Tuberc. 1952 Jul;66(1):16–27. doi: 10.1164/art.1952.66.1.16. [DOI] [PubMed] [Google Scholar]
  7. Menzies D., Fanning A., Yuan L., Fitzgerald M. Tuberculosis among health care workers. N Engl J Med. 1995 Jan 12;332(2):92–98. doi: 10.1056/NEJM199501123320206. [DOI] [PubMed] [Google Scholar]
  8. REID D. D. Incidence of tuberculosis among workers in medical laboratories. Br Med J. 1957 Jul 6;2(5035):10–14. doi: 10.1136/bmj.2.5035.10. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Sepkowitz K. A. Tuberculosis and the health care worker: a historical perspective. Ann Intern Med. 1994 Jan 1;120(1):71–79. doi: 10.7326/0003-4819-120-1-199401010-00012. [DOI] [PubMed] [Google Scholar]
  10. Sheldon C. D., King K., Cock H., Wilkinson P., Barnes N. C. Notification of tuberculosis: how many cases are never reported? Thorax. 1992 Dec;47(12):1015–1018. doi: 10.1136/thx.47.12.1015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Warburton A. R., Jenkins P. A., Waight P. A., Watson J. M. Drug resistance in initial isolates of Mycobacterium tuberculosis in England and Wales, 1982-1991. Commun Dis Rep CDR Rev. 1993 Dec 3;3(13):R175–R179. [PubMed] [Google Scholar]

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