Tuberculosis Screening in Silica-Exposed Workers : Developing a Tool for Health Care Providers

Both the Occupational Safety and Health Administration and Washington State require safety and health protections for workers exposed to respirable crystalline silica, including tuberculosis (TB) screening as part of occupational medical surveillance. We describe the creation of a TB screening tool for silica-exposed workers receiving regulated medical surveillance examinations in Washington State. The tool provides relevant clinical recommendations to assist health care providers and public health practitioners who choose to use the tool when performing such examinations. A cross-disciplinary team at the Washington State Department of Labor and Industries created the TB screening tool to help health care providers identify silica-exposed workers who should receive a comprehensive evaluation for active TB disease and workers who should or must receive testing for latent TB infection. The Washington State Adult Tuberculosis Screening Tool for Workers Exposed to Respirable Crystalline Silica benefits occupational and respiratory clinicians and public health practitioners by aiding both the individual- and population-level delivery of occupational health and TB screening services to silica-exposed workers receiving required medical surveillance examinations.