TABLE C-10. ARI with M. tuberculosis for Various Populations of Hospital-Based Health Care Workers (HCWs) as Calculated Directly from Reported Several Selected Surveillance Studies with Sufficient Data to Permit This Calculation

Health Care Worker Group (reference)

Year

Calculated ARI of HCWs (%/year)

Barnes Hospital, St. Louis (40)

1989–1991

0.4

Cabrini Medical Center, New York (32)

1991

Wards admitting tuberculosis patients

5.1

Other wards

4.0

St. Clare’s Hospital, New York (30,31)

1993–1994

3.3

Laboratory

2.3

Physicians and nurses

3.0

Social service

2.2

Housekeeping

6.7

Finance

1.9

Grady Memorial Hospital, Atlanta (33)

1994

0.9

House officers (35)

1993–1997

1.1

Military medical center, Bethesda (38)

1994–1995

1.2

Respiratory therapy

17.1

Maintenance, engineering

2.6

Food service

2.6

Nursing technicians

2.3

Laboratory

2.1

Custodial

1.8

Practical nurses

1.8

Physicians

0.9

Registered nurses

0.4

NOTE: When applicable, all risks were calculated for periods following the implementation of current infection control measures.

Recent Risk for Health Care Workers in Locations of Low Tuberculosis Incidence

Since the United States is not homogeneous with respect to the incidence of tuberculosis, it is reasonable to expect that the risk to health care workers in areas of low incidence will be lower than the risks cited above in areas of higher incidence. Bailey and colleagues studied tuberculous infection among employees at Barnes Hospital, a 1,000-bed hospital in St. Louis, between January 1989 and July 1991 (40). At that time the new case rate in Missouri was 5/100,000/year and in St. Louis it was 11/100,000/ year. A total of 11.3 percent of employees were initially skin test positive. During the study period 0.93 percent of the initially tuberculin skin test negative employees converted to positivity, for an calculated annual risk of infection of 0.37 percent. The risk of infection was not correlated with occupational exposure; it was correlated with minority group status, resi-



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