Can Someone please tell me about TB testing

FLArn · Sep 12, 2009

because TB is on the rise and there is a high risk of being exposed to patients that may not be diagnosed and we could carry TB to our families and other patients without knowing it.

3rdcareerRN · Sep 12, 2009

Hi Can anyone tell me why nurses have to get a TB test every year?

The U.S. Occupational Safety & Health Administration mandates it:

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=DIRECTIVES&p_id=1586 , par. 1©1(e)2(b) "Medical Surveillance":

"TB skin testing shall be conducted every three (3) months for workers in high risk categories, every six (6) months for workers in intermediate risk categories, and annually for low risk personnel "

clc123 · Sep 12, 2009

Thanks, the reason I asked is because when I was employed in my hospital I was under the impression that I was being tested to know that if I started out with a negative test and then converted to a positive test it would be assumed that it was an work related exposure. I am near the border of mexico and I was told there was a high incidence of TB in this area and there were always many TB patients in my hospital. I was led to believe that the hospital was going to help me if I converted. Well, I just happened to check my TB results from last week and...you guessed it. I converted to positive on the new blood test. So what did my employer do? I am on call tonight and I asked if I needed to have a chest Xray or anything and I also said I was kind of upset etc. They basically told me I was over reacting, it is no big deal, I can be on call. I had no clue who was going to order the Xray. I happened to see the pulomonlogist in the hall and I told him about the conversion and also about an incident when I was dializing a patient in the ICU and the other pulmonologist said "Oh, I think we better test this guy for TB, I don't know why he was not tested before this" (I had been dializing him in his room with no mask 2 hrs that day and three hours two days before that) So I went and got an N95 mask. I don't remember the pt. name and I didn't think to do an incident report. Anyway the pulmonologist said " you can't prove you got it here, lots of people in the community have it too. and healthcare is a dangerous field."So now I am in a fix. I called my doctor and he gave me an RX for a chest Xray and I may need months worth of antibiotics even if the Xray is clear and I have a severe problem taking anti biotics they make me seriously ill. I guess all this is going to come out of my pocket.

Lacie, BSN, RN · Sep 12, 2009

Check with your local health dept. as when I converted they provided not only my cxr but also my INH and Pyridoxine for a year at no cost. Just because you converted to positive doesnt mean you will develop the disease only you may have been exposed. In my situation I didnt realize I had been immunized with the BCG immunization in the military in the early 70's when sent overseas therefore I would always show a postive ppd. My son also converted while living in Kentucky and had to undergo INH therapy also and the health dept covered everything for him. It's not something worker's comp would cover unless they have documentation you were directly working with an "active" tb pt. A ppd doesnt determine if active only "possible" exposure. Some people just have a localized reaction (allergic) and never was truly positive although it will appear as a severly positive reaction (my sons case). Also did they do a two step as if not they probably should have. It took 2 before they treated me or my son. hope this helps.

Sunflowerinsc, ADN, RN · Sep 12, 2009

Every place that I have worked ,I received my yearly PPD by employee health. They contact anyone who is positive and send you to the Health Department for medications and follow up. I have know employees who converted and took the medications. They did not have to pay for them. The Health Department provided the medications, did the follow up blood work and xrays per the Health Department Doctor's orders. I hope your employee health will put your mind at ease. I am sure you know that converting didn't mean you have TB, just have been exposed.