[MCOH-EH] [EXTERNAL] Re: TB screening question

[Eisenhauer, Julie (TCRHCC)]

We require this to be completed prior to starting their first day at our facility. We also require anyone with a past or new positive test to have completed or start treatment before the first day.

If it is a current employee and they need one for school or due to post-exposure etc.… they may ask for one and we foot the bill. It is not costly for us as we obtain it at cost with a government rate.

Sincerely Your Employee Health Nurse.

Julie A. Eisenhauer BSN, RN, CCM
HR/Employee Health
Tuba City Regional Health Care Corporation
PO Box 600
Tuba City, AZ. 86045
PH#: 928-283-1437; or Mitel ext. 41544
Email: Julie.eisenhauer at tchealth.org<mailto:Julie.eisenhauer at tchealth.org>
HR Email: TCRHCCHR at Tchealth.org<mailto:TCRHCCHR at Tchealth.org>


  *   THREE W’s -  WEAR a mask, WASH your hands, WATCH your distance 😊


From: MCOH-EH <mcoh-eh-bounces at mylist.net> On Behalf Of ping gao via MCOH-EH
Sent: Thursday, February 16, 2023 4:54 PM
To: MCOH-EH <mcoh-eh at mylist.net>
Cc: ping gao <gaopg at yahoo.com>
Subject: Re: [MCOH-EH] [EXTERNAL] Re: TB screening question

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Our hospital covers the cost for its employee health services including TB testing and updating
/administering other immunizations.

Ping Gao, MD, MPH, FACOEM
Medical Director
Occupational Medicine & Employee Health
AnMed
Anderson, SC 29621
Please excuse typo


On Feb 16, 2023, at 1:19 PM, John Keogh <dr.jtkeogh at gmail.com<mailto:dr.jtkeogh at gmail.com>> wrote:

Hi ,
In the US who pays for IGRA? In Canada the employee has to pay.
Regards,
Dr.Tom Keogh

On Thu, Feb 9, 2023 at 1:11 PM Warner Hudson <hudson.warner at gmail.com<mailto:hudson.warner at gmail.com>> wrote:
Yes me too; couldn’t say it better.
Sent from my iPhone


On Feb 9, 2023, at 6:45 AM, wendy thanassi <wendy.thanassi at gmail.com<mailto:wendy.thanassi at gmail.com>> wrote:

Great summary by Dr. Swift and I also agree with Sally Foster-Chang’s baseline test.

So, I’m not adding anything to this conversation except support and endorsement!

Have a great day 😊,
Wendy

Wendy Todaro Thanassi MD, MA, MRO
Medical Director, Workforce Health and Wellness
Clinical Professor, Primary Care and Population Health Science

Stanford Medicine
300 Pasteur Dr., H0124
Stanford, CA 94303
Cell: 650-380-1131
thanassi at stanford.edu<mailto:thanassi at stanford.edu>

Veterans Affairs Palo Alto Health Care System
3801 Miranda Ave, MC 11-EH
Palo Alto, CA 94304
Wendy.thanassi at va.gov<mailto:Wendy.thanassi at va.gov>

From: MCOH-EH <mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>> on behalf of Swift, Melanie D., M.D., M.P.H. via MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Date: Wednesday, February 8, 2023 at 12:10 PM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: Swift, Melanie D., M.D., M.P.H. <Swift.Melanie at mayo.edu<mailto:Swift.Melanie at mayo.edu>>
Subject: Re: [MCOH-EH] [EXTERNAL] Re: TB screening question
Dr. Thrasher, attached is the NTCA-ACOEM collaborative guidance document on TB testing and treatment in healthcare personnel. The preplacement evaluation recommendations for HCP with a prior positive TB test begin at the bottom of page e358.

Recommendations are essentially the same for prior treated LTBI and prior treated active TB. Document the dates and confirmation of completed treatment. For active TB they should have a clearance document from their public health department at the completion of therapy. A symptom screen would be recommended, but as long as she is asymptomatic and you have documentation of her prior positive IGRA and/or TST at the time of her original diagnosis, documentation of complete treatment and clearance of the active infection, then there really is no testing or imaging recommended. The key will be obtaining that documentation. If she has none, then as Sally recommends you could get an IGRA now (likely would be positive) and follow your usual clearance process. You can do a single view CXR with abdominal shielding, should records be unavailable and you need to exclude active TB. If you have the records though, no need to image her unless she is symptomatic or her treatment wasn’t complete.

Melanie

Melanie Swift, MD, MPH
(she/her)
Vice Chair, Division of Public Health, Infectious Diseases and Occupational Medicine
Medical Director, Mayo Clinic Physician Health Center<https://nam02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.mayoclinic.org%2Fdepartments-centers%2Fpreventive-occupational-aerospace-medicine%2Fphysician-health-center%2Freferrals&data=05%7C01%7Cjulie.eisenhauer%40tchealth.org%7Cbcbbf330f31b452f713308db11fe8943%7C842b0edb2ac1492f85b7b48ec194bb8b%7C0%7C0%7C638123557177838823%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=5Q63zMqKedmY35xH%2FwxkIEIDCTVYRskiIGaxnDKoK3I%3D&reserved=0>
Associate Medical Director, Occupational Health Service
_______________________________
Mayo Clinic
200 First Street SW
Rochester, MN 55905

From: MCOH-EH <mcoh-eh-bounces+swift.melanie=mayo.edu at mylist.net<mailto:mayo.edu at mylist.net>> On Behalf Of Sally Foster-Chang
Sent: Wednesday, February 8, 2023 11:20 AM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: [EXTERNAL] Re: [MCOH-EH] TB screening question

I’d do an IGRA. At least you would have a baseline.

On Wed, Feb 8, 2023 at 12:02 PM dennis thrasher via MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>> wrote:
Any recommendations for a new-hire nurse applicant? She is pregnant and
has previously been treated for active TB.
Thanks.
Dennis Thrasher, MD, MPH
sunnyside at dakotacom.net<mailto:sunnyside at dakotacom.net>
520 247 1397

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B.Sc., M.D., C.C.F.P., F.C.F.P., LM., C.C.B.O.M.,F.C.B.O.M., C.I.M.E., C.A.M.E

Occupational Medicine Consultant
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