TUBERCULOSIS IN HEALTH-SERVICE EMPLOYEES IN NORTHERN-IRELAND

Tuberculosis can be transmitted from patients to health care workers. However, where the incidence of tuberculosis is low, and good infectio n control practices exist, the risk of health care workers acquiring t he disease is likely to be small. The objective of this study was to d etermine the rate of notification of tuberculosis in health care worke rs in Northern Ireland compared with the general population. Informati on from the statutory tuberculosis notification forms for the period 1 982-1991 was entered on to a computer database. Those patients involve d in health care occupations were identified and age and sex standardi zed incidence rates were calculated. The overall notification rate for tuberculosis was 7.4 cases per 100 000 of general population. There w as no significant increase in notification of tuberculosis among healt h care workers [standardized incidence ratio: 126% (95% CI 91-170)]. N o cases were diagnosed as a result of screening methods performed duri ng employment. It was concluded that health care workers in Northern I reland did not have a significantly increased incidence of tuberculosi s compared with the general population over the 10-year period studied . This suggests that the risk of transmission from patients to health care workers is negligible in the setting of a low general incidence o f tuberculosis and good infection control practice. Under these circum stances, the present findings support the cessation of routine screeni ng of health care workers.