Medical Center Occupational Health Basics-JOEM TB recommendations 2020

JOEM TB recommendations 2020

Pdf Summary

A collaborative effort by the American College of Occupational and Environmental Medicine (ACOEM) and the National Tuberculosis Controllers Association (NTCA) in 2020 focuses on updated guidelines for tuberculosis (TB) screening, testing, and treatment among US healthcare personnel. The document builds on the Centers for Disease Control and Prevention’s (CDC) and NTCA’s 2019 recommendations, aiming to reduce the routine annual TB testing of healthcare workers due to low conversion rates and emphasize treating latent tuberculosis infection (LTBI) to prevent progression to active TB disease.<br /><br />The updates replace the term "healthcare worker" with "healthcare personnel" (HCP) to encompass all individuals working in healthcare settings. Guidelines now recommend a baseline TB screening for all newly hired HCP, including risk assessments and symptom evaluations, without serial or annual testing unless there is known TB exposure.<br /><br />Key recommendations include discontinuing routine annual testing for HCP without known exposure and focusing on preventing TB by treating LTBI. TB education should be provided annually, covering TB risk factors, symptoms, and infection control.<br /><br />Occupational health practitioners are urged to implement these guidelines to prioritize the detection and treatment of LTBI. As many TB cases originate from reactivation of LTBI, expanding treatment can prevent future cases. An important part of this initiative is providing comprehensive TB education to employees, which can help encourage treatment adherence from those diagnosed with LTBI. Additionally, the transition away from routine testing to increased education and targeted testing aims to better allocate resources within healthcare settings.<br /><br />Supporting these changes, past data indicates that TB rates among healthcare workers are no higher than the general population, making the move towards focused risk assessment and treatment a strategy to further TB elimination efforts in the US healthcare system.

Keywords

tuberculosis

healthcare personnel

latent tuberculosis infection

TB screening

CDC guidelines

occupational health

TB education

risk assessment

LTBI treatment

TB elimination