Yale
New Haven Hospital
QISS
GB 325
New Haven, CT
06504 USA
Dr. Jeff Topal
688-4634
Work Restrictions for Personnel with Active TB
Healthcare workers with current active pulmonary or laryngeal tuberculosis pose a risk to patients and other personnel while they are infectious; therefore, stringent work restrictions for such individuals are
necessary. Such persons should be excluded from work until:
1)
clinical improvement is noted (i.e. resolution of cough
and fever)
2)
sputum is free of mycobacteria (AFB) on 3 consecutive
smears obtained on separate days
3)
the drugs chosen for treatment are evaluated as appropriate
(a minimum of 4 anti-TB drugs when initiating treatment
4)
the worker has demonstrated the ability to consisently take and
retain the required medications
5)
at least two weeks (14 days) of therapy has been completed with at least 2 drugs to which the isolate is sensitive
5)
a worker's particular duties which may place others at a
greater risk (i.e. a worker caring for immunosuppressed patients)
have been reviewed by OHS
Personnel with MDR-TB should not return to work until their
sputum culture is negative. Personnel with tuberculosis at a site
other than the lung or larynx usually do not need to be excluded
from work if concurrent pulmonary infection has been ruled out.
Personnel who discontinue treatment before the recommended course of therapy has been completed should not be allowed to work until treatment is resumed, an adequate response to therapy is documented, and 3 consecutive sputum smears obtained on separate days are negative for AFB.
Work Restrictions for Personnel with Positive Tuberculin Tests (i.e. PPD+ workers)
1)
Healthcare workers who are otherwise healthy and receiving
prophylactic chemotherapy (i.e. INH prophylaxis) for tuberculosis
infection (i.e. +PPD) should be allowed to continue their usual work
activities.
2)
Healthy tuberculin skin test positive workers who decline preventive chemotherapy will be
counseled about the risk of developing active disease and will be instructed to seek evaluation
promptly if symptoms develop that may be due to tuberculosis.
3)
Healthcare workers who cannot take or do not accept or complete a full course of preventive therapy should have their work situations evaluated by OHS or Winchester Chest Clinic to determine if work
restriction is required. Otherwise healthy persons who decline
chemoprophylaxis will be counseled about the risk of contracting disease and will be instructed to seek evaluation promptly if symptoms develop that may be due to tuberculosis, especially if they have contact with high-risk patients.
