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Prevalence of Tuberculin Skin Test Positivity and Conversions Among Healthcare Workers in New York City During 1994 to 2001

Published online by Cambridge University Press:  02 January 2015

Sharlette Cook ,
Khin Lay Maw ,
Sonal S. Munsiff ,
Paula I. Fujiwara  and
Thomas R. Frieden
Sharlette Cook
Affiliation:
New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control, New York City, New York
Khin Lay Maw
Affiliation:
New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control, New York City, New York
Sonal S. Munsiff*
Affiliation:
New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control, New York City, New York Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia
Paula I. Fujiwara
Affiliation:
New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control, New York City, New York Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia
Thomas R. Frieden
Affiliation:
New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control, New York City, New York Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, 125 Worth Street, Room 216, CN 74, New York, NY 10013
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Abstract

Objective:

To determine the prevalence of and risk factors for tuberculin skin test positivity and conversion among New York City Department of Health and Mental Hygiene employees.

Design:

Point-prevalence survey and prospective cohort analysis. Sentinel surveillance was conducted from March 1,1994, to December 31, 2001.

Participants:

HCWs in high-risk and low-risk settings for occupational TB exposure.

Results:

Baseline tuberculin positivity was 36.2% (600 of 1,658), 15.5% (143 of 922) among HCWs born in the United States, and 48.5% (182 of 375) among HCWs not born in the United States. There were 36 tuberculin conversions during 2,754 observation-years (rate, 1.3 per 100 person-years). For HCWs born in the United States, the risk for tuberculin conversion was greater in high-risk occupational settings compared with low-risk settings (OR 5.7; CI95, 1.7–19.2; P < .01). HCWs not born in the United States and those employed at the Office of the Chief Medical Examiner (OCME) were at high risk for baseline tuberculin positivity (OR, 3.2; CI95,1.7–5.8; P < .001); OCME HCWs (OR 4.7; CI95, 2.3–9.4; P < .001), those of Asian ethnicity (OR 4.3; CI95,1.4–13.5; P < .01), and older HCWs (OR, 1.0; CI95,1.0–1.1; p < .05) were at a higher risk for conversion.

Conclusions:

Although the prevalence of tuberculin positivity decreased after the peak of the recent TB epidemic in New York City, the conversion rate among HCWs in high-risk occupational settings for TB exposure was still greater than that among HCWs in low-risk settings. Continued surveillance of occupational TB infection is needed, especially among high-risk HCWs.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 11 , November 2003 , pp. 807 - 813
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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