Latent tuberculosis infection in employees with long-Term exposure to hospital environment

• Author Details:   
• Tushar Ramesh Sahasrabudhe
• Brahmansh Singh ^*

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Background: Hospital employees catering for Tuberculosis (TB) patients are scared of catching TB. We therefore evaluated the prevalence of latent tuberculosis infection (LTBI) among individuals with varying degrees of job-related exposure to hospital environment to assess if the risk is significant.
Materials and Methods: This cross-sectional comparative study included 200 participants, categorized into three groups: hospital employees with long-term direct exposure to patients (Group-1, n=88), hospital employees with long-term indirect exposure to patients (Group-2, n=59) and individuals with no exposure to hospital environment (Group-3, n=53). LTBI was detected using Tuberculin Skin Test (TST) and Interferon-Gamma Release Assay (IGRA) and results were correlated with duration of exposure and use of masks.
Results: The LTBI prevalence was significantly higher in Group-1 (21.59%) compared to Group-2 (5.08%) and Group-3 (5.6%). Pulmonology nursing staff (46.7%) and ICU staff (35.7%) demonstrated the highest positivity rates. Consistent use of N95 masks was associated with a 58% reduction in the infection risk. LTBI prevalence increased with years of hospital employment, with rates of 0% for 1-5 years, 25.4% for 5-10 years, and 83.3% for those employed for >10 years. Extended working hours were associated with higher positivity rates of 36.9% vs 4.7%.
Conclusion: Healthcare workers with direct patient contact have significantly higher prevalence of LTBI. Duration of employment and extended working hours substantially increase this risk. Consistent use of N95 masks provides significant protection. Targeted screening and preventive interventions are recommended for high-risk departments.

Keywords: Latent tuberculosis infection (LTBI), Healthcare workers (HCWs), N95 masks, Tuberculin Skin Test, IGRA