TY - JOUR
T1 - Risk factors for a positive tuberculin skin test among employees of an urban, midwestern teaching hospital
AU - Bailey, Thomas C.
AU - Fraser, Victoria J.
AU - Spitznagel, Edward L.
AU - Dunagan, W. Claiborne
PY - 1995/4/15
Y1 - 1995/4/15
N2 - Objective: To determine the prevalence and incidence of and the relative risks for positive tuberculin skin tests among employees of a large, urban teaching hospital. Design: Retrospective cohort study. Setting: Barnes Hospital, St. Louis, Missouri. Participants: Hospital personnel employed at any time between January 1989 and July 1991. Results: 684 of 6070 employees screened (11.3% [95% CI, 10.4% to 12.1%]) had positive tuberculin skin tests. Factors associated with a positive result were age (odds ratio, 2.02 per decade [CI, 1.87 to 2.18]; P < 0.0001); black race (odds ratio, 1.58 [CI, 1.26 to 2.00]; P < 0.0001); Asian race (odds ratio, 16.7 [CI, 9.33 to 29.9]; P <0.0001); Hispanic ethnicity (odds ratio, 9.45 [CI, 3.58 to 25.0]; P <0.0001); and percentage of low-income persons within the employee's residential postal zone (odds ratio, 1.14 per 10% [CI, 1.05 to 1.23]; P = 0.001). Twenty-nine of 3106 employees who had at least two tests had skin- test conversions (0.93% [CI, 0.60% to 1.3%]); 15 of these conversions (52%) occurred among employees who had no direct contact with patients. Only the percentage of low-income persons within the employee's residential postal zone (odds ratio 1.39 [CI, 1.09 to 1.78]; P = 0.0075) was independently associated with conversion. Conclusions: The most important associations with a positive tuberculin skin test were older age, minority group status, and the proportion of low-income persons within the employee's residential postal zone. Skin-test conversion was independently associated only with the percentage of low-income persons in the employee's postal zone. Stratifying employees according to degree of contact with patients or according to departmental group was not useful in determining risk for a positive tuberculin skin test or for skin-test conversion. For certain groups of employees, an exposure to tuberculosis in the community probably poses a greater risk than exposure in the hospital setting.
AB - Objective: To determine the prevalence and incidence of and the relative risks for positive tuberculin skin tests among employees of a large, urban teaching hospital. Design: Retrospective cohort study. Setting: Barnes Hospital, St. Louis, Missouri. Participants: Hospital personnel employed at any time between January 1989 and July 1991. Results: 684 of 6070 employees screened (11.3% [95% CI, 10.4% to 12.1%]) had positive tuberculin skin tests. Factors associated with a positive result were age (odds ratio, 2.02 per decade [CI, 1.87 to 2.18]; P < 0.0001); black race (odds ratio, 1.58 [CI, 1.26 to 2.00]; P < 0.0001); Asian race (odds ratio, 16.7 [CI, 9.33 to 29.9]; P <0.0001); Hispanic ethnicity (odds ratio, 9.45 [CI, 3.58 to 25.0]; P <0.0001); and percentage of low-income persons within the employee's residential postal zone (odds ratio, 1.14 per 10% [CI, 1.05 to 1.23]; P = 0.001). Twenty-nine of 3106 employees who had at least two tests had skin- test conversions (0.93% [CI, 0.60% to 1.3%]); 15 of these conversions (52%) occurred among employees who had no direct contact with patients. Only the percentage of low-income persons within the employee's residential postal zone (odds ratio 1.39 [CI, 1.09 to 1.78]; P = 0.0075) was independently associated with conversion. Conclusions: The most important associations with a positive tuberculin skin test were older age, minority group status, and the proportion of low-income persons within the employee's residential postal zone. Skin-test conversion was independently associated only with the percentage of low-income persons in the employee's postal zone. Stratifying employees according to degree of contact with patients or according to departmental group was not useful in determining risk for a positive tuberculin skin test or for skin-test conversion. For certain groups of employees, an exposure to tuberculosis in the community probably poses a greater risk than exposure in the hospital setting.
UR - http://www.scopus.com/inward/record.url?scp=0028901411&partnerID=8YFLogxK
U2 - 10.7326/0003-4819-122-8-199504150-00004
DO - 10.7326/0003-4819-122-8-199504150-00004
M3 - Article
C2 - 7887551
AN - SCOPUS:0028901411
SN - 0003-4819
VL - 122
SP - 580
EP - 585
JO - Annals of Internal Medicine
JF - Annals of Internal Medicine
IS - 8
ER -