Tuberculosis infection among health care workers in Montreal.
We conducted a cross-sectional survey to estimate the prevalence of tuberculosis infection among health care workers at two downtown Montreal hospitals. Participants completed questionnaires, then underwent two-step tuberculin testing. Records of previous tuberculin tests and BCG vaccinations were reviewed. Charts of all tuberculosis patients admitted in 1992-93 were also reviewed. Air changes and direction of air flow in patient care areas were measured using tracer gas techniques and smoke tubes. Of 619 eligible workers, 522 participated (84%). 196 (38%) were tuberculin reactors; 23 (4%) had documented conversions. Inadequate ventilation and delays in diagnosis were identified at both hospitals. Comparing clinical with nonclinical personnel, the adjusted odds of a significant initial tuberculin reaction were 2.6 (95% confidence interval 1.3, 5.2), of a documented conversion 13.6 (1.4, 132), and of a booster reaction 0.9 (0.2, 3.6). Initial tuberculin reactivity was associated with male gender (p = 0.008), BCG vaccination (p = 0.0001), foreign birth (p = 0.007), age (p < 0.0001), and occupation (p = 0.02); conversion with male gender (p = 0.001) and occupation (p = 0.01); and boosting with older age (p = 0.02) and BCG vaccination (p = 0.001). Among clinical personnel at two hospitals, the prevalence of significant tuberculin reactions and of documented conversions was unexpectedly high.
Montreal Chest Institute, Royal Victoria Hospital, Montreal, Canada.
K
K
Schwartzman
V
V
Loo
J
J
Pasztor
D
D
Menzies
D000046:Academic Medical Centers; D000328:Adult; D001500:BCG Vaccine; D003430:Cross-Sectional Studies; D005260:Female; D006761:Hospitals; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology* / Q000517:prevention & control; D010564:Personnel, Hospital; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors; D014374:Tuberculin Test; D014376:Tuberculosis / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission
D001500:BCG Vaccine