Tuberculosis among health care workers at King Chulalongkorn Memorial Hospital, 1988-2002.
METHODS
It is still not well determined whether health care workers (HCWs) in developing countries-where background tuberculosis (TB) prevalence in the general population is high-have a higher risk of TB than other occupations.


OBJECTIVE
To examine the risk of TB among HCWs in an area where TB prevalence is high.


METHODS
A cohort of 3959 HCWs at Chulalongkorn Memorial Hospital, Thailand, was observed from 1988 to 2002.


RESULTS
The overall TB incidence rate was 188 per 100 000 person-years (py), with specific incidence rates of 77, 48 and 63/100 000 py, respectively, for confirmed, possible and self-reported TB cases. The highest risk work site was the emergency room, with rate ratios (RRs) of 10.4 (95%CI 3.0-44.7), 22.6 (95%CI 2.7-1041.2) and 9.4 (95%CI 1.5-99.1) for overall, confirmed and possible TB cases, respectively. The 11 TB cases in this area were 9 registered nurses, 1 nursing auxiliary and 1 housekeeper. The occupation of highest risk was nurse, with RRs of 2.4 (95%CI 0.9-9.1) for overall TB cases. However, only the increased RRs for the emergency room were statistically significant.


CONCLUSIONS
The results of this study support the premise that certain groups of HCWs in developing countries are occupationally at increased risk of TB.
Jiamjarasrangsi
W
W
Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok 10330, Thailand. wjiamjar@hotmail.com
Hirunsuthikul
N
N
Kamolratanakul
P
P
D000328:Adult; D006801:Humans; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D010564:Personnel, Hospital; D013785:Thailand; D014376:Tuberculosis / Q000453:epidemiology*