Prevalence of tuberculin skin test positivity and conversions among healthcare workers in New York City during 1994 to 2001.
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.


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


METHODS
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.
Cook
Sharlette
S
New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control, New York City, New York 10013, USA.
Maw
Khin Lay
KL
Munsiff
Sonal S
SS
Fujiwara
Paula I
PI
Frieden
Thomas R
TR
D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control / Q000379:methods; D007407:Interviews as Topic; D008297:Male; D008397:Masks / Q000706:statistics & numerical data; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification / Q000472:pathogenicity; D009519:New York City / Q000453:epidemiology; D016273:Occupational Exposure / Q000517:prevention & control; D015995:Prevalence; D011446:Prospective Studies; D011635:Public Health Administration; D012307:Risk Factors; D014374:Tuberculin Test / Q000706:statistics & numerical data*; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology*; D000078329:Workforce