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Dramatic decrease in tuberculin skin test conversion rate among employees at a hospital in New York City

P Fella1, P Rivera, M Hale

  • 1Division of Infection Control, St. Clare's Hospital and Health Center, New York, NY, USA.

American Journal of Infection Control
|December 1, 1995
PubMed
Summary
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Implementing less costly tuberculosis control methods, such as isolation and UV light, significantly reduced employee skin test conversion rates before high-efficiency particulate air filter respirators were introduced.

Area of Science:

  • Healthcare epidemiology
  • Infectious disease control
  • Occupational health

Background:

  • Updated guidelines for preventing tuberculosis (TB) transmission in healthcare facilities were issued by the CDC.
  • Many recommended measures, like high-efficiency particulate air (HEPA) filter respirators, are costly and their efficacy is unproven.
  • A review of employee tuberculin skin test conversion rates was conducted prior to HEPA respirator implementation.

Purpose of the Study:

  • To evaluate the effectiveness of implemented tuberculosis control measures on employee tuberculin skin test conversion rates.
  • To assess if less costly methods could reduce nosocomial tuberculosis spread.

Main Methods:

  • Retrospective review of employee tuberculin skin test conversion rates.
  • Data collected at 6-month intervals from 1991 to 1993.

Related Experiment Videos

  • Analysis of implemented control measures including isolation, negative-pressure ventilation, UV light, and various respirators.

    • Main Results:

    • Tuberculosis control measures implemented included patient isolation, negative-pressure ventilation, UV light fixtures, and different types of respirators.
    • Employee tuberculin skin test conversion rates decreased from 20.7% in early 1991 to 5.8% in late 1993.
    • This decline occurred before the introduction of high-efficiency particulate air filter respirators.

    Conclusions:

    • The study demonstrates a significant decrease in employee skin test conversion rates.
    • Less costly, established methods for tuberculosis control were effective in reducing nosocomial spread.
    • These findings suggest that expensive interventions like HEPA respirators may not be necessary for effective TB control.