Prevalence of tuberculin skin test positivity and conversions among healthcare workers in New York City during 1994 to 2001
Prevalence of tuberculin skin test positivity and conversions among healthcare workers in New York City during 1994 to 2001
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DOI：
10.1086/502141
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发表时间：
2003-11-01
影响因子：
4.5
通讯作者：
Frieden, TR
中科院分区：
文献类型：
--
作者：
Cook, S;Maw, KL;Frieden, TR
目的：确定结核菌素皮试阳性和转换纽约市卫生和精神卫生部employees.Design的患病率和危险因素：点患病率调查和前瞻性队列分析。1994年3月1日至2001年12月31日进行哨点监测。对象：职业性结核病暴露高危和低危场所医务人员。基线结核菌素阳性率为36.2%（1，658人中的600人），15.5%（922人中的143人）在美国出生的HCW中，48.5%（375人中的182人）在美国以外出生的HCW中。在2，754个观察年中有36例结核菌素转换（率为1.3/100人年）。对于出生在美国的HCW，高风险职业环境中结核菌素转换的风险高于低风险环境（OR，5.7; CI 95，1.7-19.2; P <0.01）。非美国出生的医务工作者和在首席医学检查官办公室（OCME）工作的医务工作者基线结核菌素阳性的风险较高（OR，3.2; CI 95，1.7-5.8; P < .001）; OCME HCW（OR，4.7; CI 95，2.3-9.4; P <0.001），亚裔（OR，4.3; CI 95，1.4-13.5; P < .01），（OR，1.0; CI 95，1.0-1.1; P <0.05）有较高的转换风险。虽然结核菌素阳性的流行率在纽约市最近结核病流行高峰后有所下降，高危职业场所医务人员结核病暴露的转化率仍高于低危场所医务人员。需要继续监测职业性结核病感染，特别是在高危医务工作者中。
OBJECTIVE: To determine the prevalence of and risk factors for tuberculin skin test positivity and conversion among New York City Department of Health and Mental Hygiene employees.DESIGN: Point-prevalence survey and prospective cohort analysis. Sentinel surveillance was conducted from March 1, 1994, to December 31, 2001.PARTICIPANTS: HCWs in high-risk and low-risk settings for occupational TB exposure.RESULTS: Baseline tuberculin positivity was 36.2% (600 of 1,658), 15.5% (143 of 922) among HCWs born in the United States, and 48.5% (182 of 375) among HCWs not born in the United States. There were 36 tuberculin conversions during 2,754 observation-years (rate, 1.3 per 100 person-years). For HCWs born in the United States, the risk for tuberculin conversion was greater in high-fisk occupational settings compared with low-risk settings (OR, 5.7; CI95, 1.7-19.2; P < .01). HCWs not born in the United States and those employed at the Office of the Chief Medical Examiner (OCME) were at high risk for baseline tuberculin positivity (OR, 3.2; CI95, 1.7-5.8; P < .001); OCME HCWs (OR, 4.7; CI95, 2.3-9.4; P < .001), those of Asian ethnicity (OR, 4.3; CI95, 1.4-13.5; P < .01), and older HCWs (OR, 1.0; CI95, 1.0-1.1; P < .05) were at a higher risk for conversion.CONCLUSIONS: Although the prevalence of tuberculin positivity decreased after the peak of the recent TB epidemic in New York City, the conversion rate among HCWs in high-risk occupational settings for TB exposure was still greater than that among HCWs in low-risk settings. Continued surveillance of occupational TB infection is needed, especially among high-risk HCWs.