[MCOH-EH] [EXTERNAL] Re: TB policy

Lesoski, Darryl DLESOSKI at mhc.net
Thu Dec 14 06:46:23 PST 2023


TY and appreciate everyone’s help!!!! Merry Christmas and Happy Holidays to all.  Darryl

From: MCOH-EH <mcoh-eh-bounces at mylist.net> On Behalf Of wendy thanassi
Sent: Wednesday, December 13, 2023 9:00 PM
To: MCOH-EH <mcoh-eh at mylist.net>
Subject: [EXTERNAL] Re: [MCOH-EH] TB policy


You don't often get email from wendy.thanassi at gmail.com<mailto:wendy.thanassi at gmail.com>. Learn why this is important<https://aka.ms/LearnAboutSenderIdentification>

Hello Darryl,I agree with Melanie that MCOH is a great resource!Being familiar with the CDC guidance and ACOEM's more in-depth Guidance document can form the solid foundation for the background and policy knowledge needed, as well as the really practical nuances needed for wr ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌


<https://us.report.cybergraph.mimecast.com/alert-details/?dep=K0MLY9RURYG2A0P%2Bjn7qHg%3D%3DvziePC914O5qJ21WBU3vV3jjAPGwi7vMOZzpKsZxGpak2YwCJ3SueVUgM%2FabkeSBqTLcjS8EgMrWMlonYIH6n09Ng%2BrsfubkuvvjuZHgp0VAJoPUFDgc9qT7WLS5sOE8XuQyPNzWFVfFbp9qRpAo4WhluvLLE9lMlP2z7nzJt2AkraLx9pDgJAyEmXuSK7EtHqRHF%2B2HvqtR%2BkRYB1NC169OlFBgWIm0K7L7Ee3w1XItg23ImzrTk3cX5lVgJKBQjmymIoq7fuxm0pSUKdzRwn%2BVe7q1NELMk%2FLuisuGpIN53gCgHsKKndlgmX7uS1knZyhlHhPrJKiQ4xXRPvjd10I1dOuuHdENWN1oRr5KIbKBxrWhlcpDowPNv6HKfq19dQBvPTnZwZ%2FjCHsV150PU7dZRhPuf9VtjLr261q9mt6ciIyi1MG9UJS9SfR4kccupVudYKLXoX%2BYxgU5itOAazPVEc%2FZuqI70j6y17cyIAscgn9ZRB78U4cOm4t%2FK0C1X4BJXL4VRbbWnQ9rdK0xy4NgJ0x2aVCqbXWNIvx5%2BODGm8xo3epFuuPPhAhsV13GkOqRVrbDX99NtiuUqKc3xn0lj00Kb2LRU0F%2FzxJvVcH%2F1mw83RArK6XHBW9%2F6zIS4jnNIYfTxZUF1gt6QTb80wju6Um3cfSU6HaJxLEcU%2FJXi6NEdqy6k7fv7t6N9lB7JMT1VEH1GUX8f5r%2F%2BMCga4VIKBZJbFFxpk27cogYwgBnZDfQhwLDjZgDgxixkGTwo13EmK7cVNn26F0bedV%2FDw%3D%3D>

Hello Darryl,

I agree with Melanie that MCOH is a great resource!
Being familiar with the CDC guidance and ACOEM's more in-depth Guidance document can form the solid foundation for the background and policy knowledge needed, as well as the really practical nuances needed for writing a modern plan:

https://www.cdc.gov/mmwr/volumes/68/wr/mm6819a3.htm<https://www.cdc.gov/mmwr/volumes/68/wr/mm6819a3.htm>
"Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019"
and
https://acoem.org/acoem/media/PDF-Library/Publications/Tuberculosis_Screening,_Testing,_and_Treatment.pdf<https://acoem.org/acoem/media/PDF-Library/Publications/Tuberculosis_Screening,_Testing,_and_Treatment.pdf>
"Tuberculosis Screening, Testing, and Treatment of US Health Care Personnel ACOEM and NTCA Joint Task Force on Implementation of the 2019 MMWR Recommendations"

Importantly, the nearly invisible tiny links to the appendices are KEY elements of this document, with examples of declination forms and very helpful charts and tables.

I hope that helps,
Wendy

Wendy Thanassi MA, MD, MRO
Palo Alto VA HCS


On Wed, Dec 13, 2023 at 3:44 PM Swift, Melanie D., M.D., M.P.H. via MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>> wrote:
Darryl I recently shared the ACOEM/NTCA guideance document and several useful appendices, in a discussion on the ACOEM MCOH Section Community. Are you a member of the MCOH section? If so, here’s the link to that post: https://community.acoem.org/discussion/annual-tb-testing-based-on-annual-risk-assessment<https://community.acoem.org/discussion/annual-tb-testing-based-on-annual-risk-assessment>

(If not, please join!!! If you can’t access that detailed post please respond to me off list at swift.melanie at mayo.edu<mailto:swift.melanie at mayo.edu>)

We also cover this topic in depth at the MCOH Basics Course, which will be offered this year as a pre-course at AOHC in Orlando. May 17th is the MCOH course. (excuse the shameless plug)


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://www.mayoclinic.org/departments-centers/preventive-occupational-aerospace-medicine/physician-health-center/referrals>
Associate Medical Director, Occupational Health Service
_______________________________
Mayo Clinic
200 First Street SW
Rochester, MN 55905

From: MCOH-EH <mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>> On Behalf Of Lesoski, Darryl via MCOH-EH
Sent: Tuesday, December 12, 2023 6:47 AM
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: Lesoski, Darryl <DLESOSKI at mhc.net<mailto:DLESOSKI at mhc.net>>
Subject: [EXTERNAL] [MCOH-EH] TB policy

We are in the midst of updating our TB policy at our health care system within EH as well as within our Occ Med clinic.

Any guidance for best resources without re-inventing the wheel?  Do most use CDC guidance or your State Health Department?

Appreciate any feedback or suggestions.  THANK YOU.

Darryl


Darryl Lesoski, MD, MPH, FACOEM

System Medical Director – Occupational Health and Medicine, Employee Health
Munson Medical Center
Munson Occupational Health and Medicine
Email: dlesoski at mhc.net<mailto:dlesoski at mhc.net>

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