How Often Do Healthcare Workers Need Tuberculosis Testing?

CDC recommends TB screening for all U.S. healthcare personnel at hire, including a risk assessment, symptom evaluation and a TB blood test or skin test. Under the 2019 CDC and National Tuberculosis Controllers Association recommendations, routine annual testing is not recommended unless there is a known exposure or ongoing transmission. State or facility rules may require more.

The 2019 recommendations from the National Tuberculosis Controllers Association and CDC updated the 2005 CDC guidelines for healthcare personnel. They call for:

1. Baseline (preplacement) screening. An individual TB risk assessment, a symptom evaluation, and a TB test, either an interferon-gamma release assay (IGRA) blood test or a tuberculin skin test (TST), for personnel without documented prior TB disease or latent TB infection.
2. No routine serial testing. No routine TB testing at any interval after baseline, such as annually, in the absence of a known exposure or ongoing transmission. Facilities may consider serial screening for certain higher-risk groups or settings.
3. Post-exposure testing. After a known exposure without adequate protection, a timely symptom evaluation and testing. Personnel with a negative test should be retested 8 to 10 weeks after the last exposure, preferably with the same test type.
4. Latent TB infection. Encouragement of treatment for personnel with untreated latent TB infection, and annual symptom screening for those who are not treated.
5. Annual TB education for all healthcare personnel.

CDC notes that state and local TB regulations may differ. State, local or facility rules may require more frequent testing, so employers should check state health department rules.

OSHA does not set a TB testing schedule. A positive TB test from a preplacement exam is not recordable on the OSHA 300 Log because it does not reflect workplace exposure (29 CFR 1904.11(b)(1)).

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