Targeted Testing a) If the worker has produced a ‘Confirmed’ Positive Test, it is mandatory that the worker be included in the test group for the following random tests that is conducted.
Targeted Testing. Although diagnosis of LTBI can be an important TB control strategy, because only a small fraction of those with LTBI will ever develop active disease, and also because the positive-predictive value (PPV) of tests for LTBI decreases with decreasing prevalence, it is neither practical nor cost-effective to screen everybody for LTBI. For this reason, it is recommended by the CDC and American Thoracic Society that only persons that are at high risk of developing TB disease should be tested, a process referred to as “targeted testing” (American Thoracic Society & Centers for Disease Control and Prevention, 2000; Centers for Disease Control and Prevention, 2011a). Testing and treating those at highest risk for TB will have the greatest impact on TB elimination. The CDC has issued guidelines that identify high risk groups recommended for targeted LTBI testing (American Thoracic Society & Centers for Disease Control and Prevention, 2000; Centers for Disease Control and Prevention, 2011a). Persons at high risk for developing TB disease fall into two broad categories: 1) those who have an increased likelihood of exposure to persons with TB disease and 2) those with clinical conditions or other factors associated with an increased risk of progression from LTBI to TB disease (American Thoracic Society & Centers for Disease Control and Prevention, 2000; Centers for Disease Control and Prevention, 2011a). Those who have an increased likelihood of exposure to persons with TB disease include: • Known close contacts of a person with infectious TB disease • Persons who have immigrated from TB-endemic regions of the world • Persons who work or reside in facilities or institutions with people who are at high risk for TB, such as hospitals that care for TB patients, homeless shelters, correctional facilities, nursing homes, or residential facilities for patients with HIV infection/AIDS Those with clinical conditions or other factors associated with an increased risk of progression from LTBI to TB disease include those with: • HIV infection • Injection drug use • Radiographic evidence of prior healed TB • Low body weight (10% below ideal) • Other medical conditions such as silicosis, diabetes mellitus, chronic renal failure, receiving hemodialysis, and other conditions Immunologic Tests for Mycobacterium Tuberculosis Infection LTBI is diagnosed by responses to in vivo or in vitro MTB antigen stimulation using either the TST or IGRA (Xxxxxxx, Matteelli, Xxxxxxxx, & Xxxxxxxxxx, 2...
Targeted Testing. Where the worker holds a position in Vesuvius in which the use of drugs or alcohol by that worker in carrying out the duties and responsibilities of that position would pose a significant risk to the health, welfare or safety of that worker or others in the workplace.
