Occupational risk of tuberculosis among health care workers at the Institute for Pulmonary Diseases of Serbia

SETTING: The Institute for Pulmonary Diseases of Serbia, which specialises in diagnosis and treatment of lung diseases in a region with approximately 550-600 TB admissions per year. OBJECTIVE: TO assess the occupational risk of tuberculosis (TB) among healt h care workers (HCWs) employed at this institution, DESIGN: Retrospective analysis of morbidity of TB among HCWs over a 12-year period (1986-1997). The incidence of TB among HCWs was estimated by the fr equency of bacteriologically or histologically confirmed active disease. Al l HCWs at our institution underwent routine pre-employment screening, consi sting of verification of BCC vaccination, PPD tuberculin reactivity, chest X-ray and laboratory evaluation, RESULTS: Of an average 267 employed HCWs, pulmonary TB occurred in nine (si x nurses and three laboratory technicians). Cumulative incidence for HCWs w as 3451/100 000, compared to 454/100 000 in the general population, for an incidence rate ratio of 7.6. CONCLUSION: The risk of TB among HCWs employed at the Institute for Pulmona ry Diseases of Serbia in Belgrade is 7.6 times higher than that observed in the general population, suggesting occupational acquisition of TB.