THE ASSOCIATION BETWEEN OCCUPATION AND TUBERCULOSIS - A POPULATION-BASED SURVEY

There has been increasing interest in the potential association betwee n occupation and the risk of tuberculosis. Therefore, we analyzed occu pational information collected on all patients with clinically active tuberculosis in 29 states from 1984 to 1985. Census data were used to estimate the number of persons in each of the occupations. Information on employment and occupation was ascertained for 9,534 (99%) of the w orking age (16 through 64 yr) tuberculosis patients. The overall case rate of tuberculosis in this age group in the study areas was 8.4 per 100,000 persons, which was slightly lower than the national rate of 9. 3 per 100,000 persons, As a group, health care workers had rates of tu berculosis similar to the general population (standardized morbidity r atio [SMR]: 1.0; 95% CI: 0.9 to 1.1). However, elevated rates were obs erved for inhalation therapists (SMR: 2.9; 95% CI: 1.2 to 6.0), and lo wer-paid health care workers (SMR: 1.3; 95% CI: 1.1 to 1.5). Elevated rates were also noted for funeral directors (SMR: 3.9; 95% CI: 2.2 to 6.1) and farm workers (SMR: 3.7; 95% CI: 3.4 to 4.1). These data sugge st that even in communities with relatively low rates of tuberculosis certain occupations may be associated with an elevated risk.