National Tuberculosis Advisory Committee Guideline: Management of Tuberculosis Risk in Healthcare Workers in Australia

Abstract

Tuberculosis (TB) is uncommon in Australia and not commonly managed by most healthcare workers (HCWs). However, even in a low incidence setting, occasional exposure of HCWs is inevitable and transmission of TB to HCWs leading to disease does occur. In addition, HCWs may have been recruited to Australia from countries with high TB incidence. These HCWs are more likely to be infected with TB before arrival and subsequently develop active disease while working in health settings in Australia. In 2001, there were 20 TB notifications in HCWs in Australia, of which 10 were born overseas, whereas in 2013, 70 of 77 notified cases (91%) were people born overseas.1, 2 Managing the risk of TB in HCWs is multifaceted. A combination of staff education, awareness, early diagnosis, appropriate use of personal protective equipment (PPE), environmental controls and screening procedures is required to minimise the risk of transmission to HCWs and from HCWs to patients. Prevention of nosocomial transmission from HCWs is particularly important in patients that are more vulnerable, for example children and the immunocompromised. This document aims to describe the components that are considered essential for all healthcare facilities in Australia to minimise this risk. It is not intended to be operational, and reference should be made to specific state and territory TB Control Program policies for this detail. Each facility should develop its own policy for the management of TB risk in HCWs according to this jurisdictional policy and the facility specific factors that determine risk, but it should include at least the following components.