That’s what we do. Annual education about the symptoms of TB disease and instructing them to report any such symptoms immediately.

Since you are unlikely to survey them during a symptomatic time, the key is to educate them to report at any time.

Melanie Swift, MD

Director, Vanderbilt Occupational Health Clinic

http://occupationalhealth.vanderbilt.edu

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of TePoel, Debra A
Sent: Thursday, July 10, 2014 9:02 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] (no subject)

This is what I found on CDC website:

Persons Whose Condition is at High Risk for Progression From LTBI to TB Disease

The following persons are at high risk for progressing from LTBI to TB disease:

· persons with a history of untreated or inadequately treated TB disease, including persons with chest radiograph findings consistent with previous TB disease.

HCWs with a baseline positive or newly positive test result for M. tuberculosis infection or documentation of previous treatment for LTBI or TB disease should receive one chest radiograph result to exclude TB disease. Instead of participating in serial testing, HCWs should receive a symptom screen annually. This screen should be accomplished by educating the HCW about symptoms of TB disease and instructing the HCW to report any such symptoms immediately to the occupational health unit. Treatment for LTBI should be considered in accordance with CDC guidelines (39).

That answers my question. Thank you,

Deb TePoel, BSN

RN Clinician • Employee Health Services • Abbott Northwestern Hospital

Phone: 612-863-0033 • Fax: 612-863-3674 • mailto:debra.tepoel@allina.com

Mail Route 15002 • 800 E. 28^th St. • Minneapolis, MN 55407

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Cunha, Bruce E.
Sent: Thursday, July 10, 2014 8:47 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] (no subject)

All employees that have a positive TB test. From what I remember from my TB training, even with treatment, there is a small chance that your TB can go active.

Bruce E. Cunha RN MS COHN-S

Manager, Employee Health and Safety

Marshfield Clinic

Marshfield WI.

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From: MCOH-EH [mailto:mcoh-eh-bounces+cunha.bruce=marshfieldclinic.org@mylist.net] On Behalf Of TePoel, Debra A
Sent: Thursday, July 10, 2014 8:21 AM
To: MCOH/EH; Abhijay Karandikar
Subject: Re: [MCOH-EH] (no subject)

Hello,

Are you doing the annual symptom questionnaire on all employee’s with history of positive TB or only those groups identified by your annual TB risk assessment?

Thanks for your assistance,

Deb TePoel, BSN

RN Clinician • Employee Health Services • Abbott Northwestern Hospital

Phone: 612-863-0033 • Fax: 612-863-3674 • mailto:debra.tepoel@allina.com

Mail Route 15002 • 800 E. 28^th St. • Minneapolis, MN 55407

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Cunha, Bruce E.
Sent: Wednesday, July 09, 2014 2:23 PM
To: Abhijay Karandikar; MCOH/EH
Subject: Re: [MCOH-EH] (no subject)

We do a symptom survey annually and unless there is indication on that, we do not do any repeat CXR.

Bruce E. Cunha RN MS COHN-S

Manager, Employee Health and Safety

Marshfield Clinic

Marshfield WI.

From: MCOH-EH [mailto:mcoh-eh-bounces+cunha.bruce=marshfieldclinic.org@mylist.net] On Behalf Of Abhijay Karandikar via MCOH-EH
Sent: Wednesday, July 09, 2014 2:21 PM
To: mcoh-eh@mylist.net
Subject: [MCOH-EH] (no subject)

List,

I know there was a brief discussion on this a few months ago, but asking everyone's opinion again:

How often are you sending employees with LTBI and no Rx for CXR screening (q 3 years, q 5 years, etc.) and what evidence/guidelines are you basing these intervals on?

Thanks,

Abhijay P. Karandikar, MD, MPH, MRO

Medical Director - Occupational Medicine

Company MD - Pines Health Services

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