Not all are singing from the same songsheet

Whilst reading comments made by various Occupational Health professionals in the US I came across this exchange;

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Tina: "At our EH department we require documentation of MMR, Hepatitis B vaccinations in exposure category 1 and 2, Tb skin test within 30 days of hire, if they are over 50 years old we require a 2 step ppd..."

Debra: "I'm very curious why you only require two step testing on staff over 50. I've never come across that recommendation..."

Tina: "Our TB prevalence in this area is low. We also require 2 step testing for those foreign born from high prevalence areas, significant past exposure to TB, underlying conditions such as immunosuppression, HIV/AIDS, undergoing corticosteroid therapy. But the majority of 2 step testing we do are for those over 50."

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The 2005 CDC guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings advise;

Baseline testing for M. tuberculosis infection is recommended for all newly hired HCWs, regardless of the risk classification of the setting...

...If TST is used for baseline testing, two-step testing is recommended for HCWs whose initial TST results are negative.

....BAMT (eg QuantiFERON) does not require two-step testing and is more specific than skin testing.

It couldn't be made more clear!



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