Tuberculosis exposure and control in an urban emergency department.
To measure tuberculosis (TB) conversion rates among staff of an urban emergency department compared with other hospital employees (OHEs) and to evaldate the effectiveness of new TB control measures.
A prospective interventional cohort study was performed in an academic adult 1,000-bed urban hospital, with more than 6,000 employees, and an annúal ED census of 43,000.
As part of a hospital-wide program, all employees were screened for tuberculin reactivity (Siebert purified protein derivative [PPD] of tuberculin) annually during a 31/2-year period.
Additional information collected on each employee included country of birth, ethnicity, history of bacille Calmette-Gúerin (BCG) vaccination, length and site of employment, and age.
At the end of the second year, TB control measures including construction of a new ED facility with TB respiratory isolation rooms, nonrecirculated air, and droplet shields for registrars were implemented.
Relative risk (RR) and 95% confidence intervals (CIs) were calculated.
During the first screening cycle, PPD status was obtained on 5,697 hospital employees, 88 of whom worked primarily in the ED.
Baseline status was 81% PPD- (induration<5 mm), 9% PPD+ (induration>10 mm), and 10% refused skin testing.
ED staff did not differ from OHEs with regard to PPD status, age, ethnicity, BCG history, foreign birth, residing in a county with high TB prevalence, or length of employment. (...)
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Tuberculine, Test cutané, Personnel sanitaire, Service urgence, Exposition professionnelle, Zone urbaine, Epidémiologie, Diagnostic, Dépistage, Homme, Etats Unis, Amérique du Nord, Amérique, Etude comparative, Médecine travail, Service hospitalier
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Tuberculin, Skin test, Health staff, Emergency department, Occupational exposure, Urban area, Epidemiology, Diagnosis, Medical screening, Human, United States, North America, America, Comparative study, Occupational medicine, Hospital ward
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0424335
Code Inist : 002B05B02E. Création : 25/01/1999.