Category:
Infection Control
Number of Pages: 2
Distribution:
Infection Control Manual
Intranet
Origination Date: 6/20/89
Title:
Employee Health TB Screening
Approval:
Infection Control Committee
Chairman
Reviewed Date:
8/93, 9/95, 11/97, 7/99, 10/01, 7/02,
10/04
Revised Date:
8/93, 9/95, 11/97, 7/99, 10/01, 7/02,
10/04
Approval Signature:
POLICY
To determine past or present infection by tuberculosis bacillus in employees, volunteers, and dedicated onsite
personnel.
PROCEDURE
A baseline two-step MantouxTB skin test is required on all previously tuberculin negative applicants at the time
of their Pre Placement Examination (PPE), and in the case of volunteers and dedicated onsite personnel, as part
of their initial Immunization and Screening process. New applicants with a history of positive skin test will be
required to complete a TB Review of Symptoms Questionnaire and provide documentation of chest film within
one year of evaluation. The screening procedure for employees will also apply to volunteers and dedicated
onsite personnel, with frequency of TB Screening based upon YRMC’s annual risk assessment and OSHA
Standards.
I. Procedural Steps
A. Notify the employee when his/her TB screening is due. Those employees subject to two-step testing may
submit documentation of a negative skin test performed within 6 months of their PPE as first step. All
employees must complete second step within 2 weeks of their PPE.
B. Obtain medical history to determine any prior positive TB Skin test results. If a female employee is or
believes she might be pregnant, she may consult her physician before receiving a TB skin test.
C. An employee who has had a positive reaction should be counseled, reassured and given appropriate
literature to read and discuss with Employee Health nursing staff.
D. The employee (if not pregnant) will be sent for a chest x-ray, expense to be borne by YRMC and referred
to the Yuma County Health Department for evaluation for preventive therapy.
E. Employees who have previously had a positive TB skin test will complete a Review of Symptoms
Questionnaire at the time of designated periodic testing. See attached form. If the interview is
symptomatic and the employee is not pregnant, a single view chest x-ray will be ordered. The employee
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will be referred to the Yuma County Health Department for evaluation. The questionnaires will be
reviewed and signed by a physician.
F. Employees who may have been exposed to a potentially infectious tuberculosis patient will have a
baseline TB skin test unless they are previous positive reactors. If the initial skin test is negative, the test
is to be repeated 12 weeks after the exposure. Tuberculosis exposure incidents and results of TB skin test
conversions will be investigated.
1. Exposed persons with skin test reactions > 5 mm or with symptoms suggestive of tuberculosis will
receive chest x-ray.
2. Persons with previously known positive skin test reactions who have been exposed to an infectious
patient do not require a repeat skin test or chest x-ray unless they have symptoms suggestive of
tuberculosis. A TB interview will be done at the time of exposure and repeated at 3 months.
G. Employees with current pulmonary or laryngeal tuberculosis will be excluded from work until adequate
treatment is instituted, cough resolved, and sputum is free of bacilli on three consecutive smears. A
written release by their physician will be required. (Reference TB Control Plan)
II. Documentation
A. Date and results of testing.
B. Monthly reports to the Yuma County Health Department for new employees and ongoing screening of
employees according to the prescribed TB forms.
C. Report to Infection Control Committee if evidence of increases or trends are noted.
D. Obtain employees' previous skin testing results and give same when requested by another facility or by the
employee.
Reference: Core Curriculum on Tuberculosis: CDC, 4th Ed. 2000
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