Can job titles be predictors for recent onset latent tuberculosis in health care workers?

Background: Tuberculosis is a common health problem in developing countries including Thailand. The association between occupation and recent onset of tuberculosis is unclear.

Objective: We studied the association of job types and tuberculin conversion or recent onset latent tuberculosis in healthcare workers in an endemic area of tuberculosis.

Design and Sample: A case-control study was done at Srinagarind Hospital, Thailand. Cases were subjects with tuberculin conversion, while controls were subjects with negative results of tuberculin skin test (TST) in two consecutive years.

Results: One thousand twenty five subjects completed two consecutive TST between 2001 and 2009. The rate of tuberculin conversion was 19.8% or 203 subjects. In a multivariate model, the only three significant factors for tuberculin conversion were male gender, having a BCG scar, and job type. Only nurses, nurse assistants, and ward workers were significantly associated with tuberculin conversion with adjusted odds ratio [95% confidence interval] of 2.3 [1.3-4.1], 2.3 [1.3-4.7], and 3.0 [1.8-5.0], respectively.

Conclusion: Being male, having a BCG scar, and certain job types increase the risk of latent tuberculosis in healthcare workers. Tuberculosis infection control program should emphasize job types for healthcare workers who are at increased risk.