National Tuberculosis Advisory Committee Guideline: Management of Tuberculosis Risk in Healthcare Workers in Australia.

[Disclaimer: The views expressed in this item are those of the individual authors, and do not necessarily represent the views of the Communicable Diseases Intelligence journal or the Australian Centre for Disease Control. While this Policy and Guidelines item was drafted with consideration to the then-available information on the condition(s) addressed within, it may not be complete and may not represent the currently understood best practice for the referenced condition(s). Readers are advised to refer to the most recent guidance on this matter, where such guidance exists and where its authoritativeness can be established. These guidelines do not replace the need for clinical judgment to be exercised for each individual circumstance, nor the necessity for expert advice to be obtained as appropriate.] Tuberculosis (TB) is uncommon in Australia and not commonly managed by most healthcare workers (HCWs). However, even in a low incidence setting, occasional exposure of HCWs is inevitable and transmission of TB to HCWs leading to disease does occur. In addition, HCWs may have been recruited to Australia from countries with high TB incidence. These HCWs are more likely to be infected with TB before arrival and subsequently develop active disease while working in health settings in Australia. In 2001, there were 20 TB notifications in HCWs in Australia, of which 10 were born overseas, whereas in 2013, 70 of 77 notified cases (91%) were people born overseas.1, 2 Managing the risk of TB in HCWs is multifaceted. A combination of staff education, awareness, early diagnosis, appropriate use of personal protective equipment (PPE), environmental controls and screening procedures is required to minimise the risk of transmission to HCWs and from HCWs to patients. Prevention of nosocomial transmission from HCWs is particularly important in patients that are more vulnerable, for example children and the immunocompromised. This document aims to describe the components that are considered essential for all healthcare facilities in Australia to minimise this risk. It is not intended to be operational, and reference should be made to specific state and territory TB Control Program policies for this detail. Each facility should develop its own policy for the management of TB risk in HCWs according to this jurisdictional policy and the facility specific factors that determine risk, but it should include at least the following components.