Risk of tuberculin conversion among healthcare workers and the adoption of preventive measures

摘要: Background: In industrialised countries, occupational tuberculosis among healthcare workers (HCWs) is re-emerging as an important public health issue. To prevent and control transmission, several institutions have issued implemented recommendations practice guidelines. Objectives: estimate the annual rate of infection (ARTI; per 100 person-years) HCWs in Turin, capital Piedmont region Italy, to identify factors associated with variations ARTI evaluate efficacy regional guidelines tuberculosis. Methods: The study was conducted between 1997 2004 on a cohort HCWs. diagnosed through tuberculin skin testing (TST) conversion defined induration increase at least 10 mm from previous negative TST. hazard ratio for each at-risk subgroup, categorised according working activities settings, estimated using exponential survival models. by stratifying analysis moment implementation (before/after). Results: 2182 participants were drawn dynamic cohort. overall adjusted 1.6 (95% CI: 1.3 1.9)/100 person-years. Different workplaces (eg, administrative infectious diseases inpatient services) occupations clerical medical workers) significantly different ARTIs, ranging 0.62 2.62 0.61 1.71, respectively, whereas TST risk differed about 16–68% 30–60%, respectively. coincided reductions 1.3/100 person-years, concurrently ARTIs disappeared. Conclusions: categories targeting surveillance prevention transmission identified, introduction preventive measures observed be effective decreasing