Employee and Employer Skin Testing Issues
An employer, as part of a pre-employment screening, may require a TB skin test. To verify any requirements that may affect your employment status, please refer to your employer.
There are, however, certain occupational settings that mandate TB skin testing as part of regular employment practice. The degree of a worker’s risk of occupational exposure to TB will vary based on a number of factors. More detailed occupational information can be obtained by visiting the Centers for Disease Control and Prevention (CDC) website as well as that of the Occupational Safety and Health Program (OSHA).
An employer's obligations regarding TB are those set forth in the Occupational Safety and Health Act (OSH Act) of 1970. Recommendations for preventing the transmission of TB for health care settings were originally established with the 1990 CDC Guidelines. In October, of 1994, those guidelines were revised and published. The 1994 guidelines emphasize the control of TB through an effective TB infection control program. Under these guidelines the control of TB is to be accomplished through the early identification, isolation, and treatment of persons with TB, use of engineering and administrative procedures to reduce the risk of exposure, and through the use of respiratory protection. OSHA believes these guidelines reflect an industry recognition of the hazard as well as appropriate, widely recognized, and accepted standards of practice to be followed by employers in carrying out their responsibilities under the OSH Act.
The CDC is presently updating the "Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Facilities, 1994." A draft of the updated guidelines can be viewed at: "Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005."
The Occupational Safety and Health Administration (OSHA) is currently reviewing workplace practices related to TB. Refer to (OSHA) for more information.
Based on a review of the data, OSHA has preliminarily concluded that workers in hospitals, nursing homes, hospices, correctional facilities, homeless shelters, and certain other work settings are at significant risk of incurring TB infection while caring for their patients and clients or performing certain procedures. To reduce this occupational risk, OSHA is proposing a standard that would require employers to protect TB-exposed employees by means of infection prevention and control measures that have been demonstrated to be highly effective in reducing or eliminating job related TB infections. These measures include the use of respirators when performing certain high risk procedures on infectious individuals, procedures for the early identification and treatment of TB infection, isolation of individuals with infectious TB in rooms designed to protect those in the vicinity of the room from contact with the microorganisms causing TB, and medical follow-up for occupationally exposed workers who become infected.
Specific workplaces have been the subject of reports issued by the CDC (www.cdc.gov). These workplaces are as follows:
Please check with your employee
health services about obtaining a TB skin test, if
necessary for employment.
- Residents and Employees of High-Risk Congregate Settings
- Residents and Employees of Prisons and Jails
- Residents and Employees of Nursing Homes/Facilities for the Elderly
- Residents and Workers at Homeless Shelters
- Health-Care Workers