Tuberculosis Screening
EHS provides a tuberculosis screening program that complies with Joint Commission and Michigan Safety and Occupational Health Administration requirements. The program includes testing for new employees, annual testing for specific employees and testing for employees who have been exposed to a patient who may be infectious.
New employees
New employees will receive information about TB testing at the new employee health assessment. All employees – except those with a documented history of a positive TB skin test or a documented TB skin test done within the previous six months – must have a TB screening at the new employee health assessment.
Employees who work in a patient care area must participate in annual TB screening. New employees that will be participating in the annual program and have not been TB tested in the past year will have their test done by the "two-step" method.
Employees will have their test read in EHS or, if their work area participates in the "unit read" program, will have it read by a designated professional on their unit.
Compliance with tuberculosis screening is considered complete when the test has been read from 48-72 hours after placement. Employees with a documented history of a positive TB skin test must have a chest X-ray and counseling regarding the signs and symptoms of tuberculosis and the benefit of prophylactic (preventive) treatment of a positive skin test. Annual skin testing will not be performed on employees with a history of a positive TB skin test.
Annual testing
Employees who will be working with patients or working in a patient care area must complete annual TB screening. Individuals with a history of a positive test will be exempt from the annual program. Each week, Employee Health Service contacts employees via e-mail telling them that their annual screening is due. It is expected that employees will report to EHS for testing during the month that the notice is received. Employees working in remote sites will have their annual testing performed at their worksite. For more information regarding off-site programs, please refer to off-site procedures.
Post-exposure testing
Despite efforts to protect employees from being exposed to potentially infectious diseases, employees may be exposed to tuberculosis. This may occur before a patient is placed in TB respiratory isolation. If you need to report an exposure to tuberculosis, please contact Infection Control Services at 734-936-6355. Infection Control assesses any potential exposure and provides EHS with a list of employees who may have been exposed.
EHS sends the employee a notice of the exposure. If the employee has completed TB screening in the previous 12 months, that test is considered their baseline test. If the employee has not completed a TB screening within the previous 12 months, a test is applied immediately following the exposure. Twelve weeks after the exposure, all employees (except those who are already known to test positive) are required to complete post-exposure TB screening. It is important to wait 12 weeks between exposure and follow-up testing because it takes time for a TB skin test to turn positive after infection with the tuberculosis bacteria. Employees who are already known to test positive are not required to complete post-exposure testing, however they are notified of the exposure and reminded of TB symptoms to watch for. Should they exhibit any TB symptoms, they are instructed to report to EHS immediately.
Most people who have been exposed to tuberculosis do not become infected (TB testing becoming positive) and of those few who do become infected, only 10 percent will ever get the actual disease.
However, it is very important for the Hospitals and Health Centers to monitor exposures to infectious diseases so we can ensure a safe environment for our employees and patients.
Alterntive to Skin Testing
In certain cases a blood test can be used for TB screening. EHS staff will evaluate the need for the blood test if PPD testing is not appropriate or possible.
General
For more information on tuberculosis, see our Tuberculosis Fact Sheet for Health Care Workers.
