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Tuberculosis in physicians: a continuing problem.

P J Geiseler, K E Nelson, R G Crispen

    The American Review of Respiratory Disease
    |May 1, 1986
    PubMed
    Summary
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    Physicians face a higher risk of active tuberculosis (TB) than the general population, particularly within six years of medical school graduation. Early detection and BCG vaccination are crucial for mitigating TB incidence in healthcare professionals.

    Area of Science:

    • Epidemiology
    • Infectious Diseases
    • Occupational Health

    Background:

    • Active tuberculosis (TB) poses a significant occupational health risk.
    • Understanding the long-term incidence of TB among physicians is crucial for public health.
    • Previous studies have indicated potential risks for healthcare workers.

    Purpose of the Study:

    • To evaluate the occurrence and risk factors of active tuberculosis among a cohort of physicians.
    • To assess the incidence of TB in physicians compared to the general population.
    • To determine the timing of TB diagnosis relative to medical school graduation.

    Main Methods:

    • A retrospective cohort study of 4,575 physicians who graduated between 1938 and 1981.
    • Analysis of TB case data, including age at diagnosis and time since graduation.

    Related Experiment Videos

  • Comparison of TB incidence rates between physicians and the general population.
  • Evaluation of tuberculin conversion rates during medical training and the impact of BCG vaccination.

    • Main Results:

    • 66 cases of active TB were identified among the 4,575 physicians.
    • TB incidence was higher in physicians than the general population for most years.
    • The majority of cases (73%) occurred in physicians aged 25-34 years at diagnosis.
    • Two-thirds of TB cases occurred within 6 years of graduation, with a risk of 140 per 100,000 person-years.
    • 63% of initially tuberculin-negative students converted during medical school or training.
    • BCG vaccination was associated with a 40% reduction in TB risk.

    Conclusions:

    • Physicians, particularly early in their careers, face a continuing elevated risk of active tuberculosis.
    • Tuberculin conversion during medical training highlights the importance of surveillance.
    • BCG vaccination may offer significant protection against tuberculosis in physicians.
    • Health authorities must remain vigilant regarding the ongoing risk of TB in medical students and physicians.