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Risk Analysis of Latent Tuberculosis Infection among Health Workers Compared to Employees in Other Sectors

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  • Lisa Hermes

    (Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
    Co-first author, these authors contributed equally to this work.)

  • Jan Felix Kersten

    (Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
    Co-first author, these authors contributed equally to this work.)

  • Albert Nienhaus

    (Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
    Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany)

  • Anja Schablon

    (Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany)

Abstract

Latent tuberculosis infection (LTBI) represents a work-related risk for health workers (HWs). Tuberculosis remains the second most common occupational infectious disease among HWs in Germany. Comparative figures on LTBI prevalence in the general population are missing because testing is only carried out in the context of an outbreak situation. The objective of this study is to investigate whether HWs are at greater risk of LTBI than workers in other sectors. This study is based on two samples. The first sample is a database of HWs who were examined by the German Occupational Physicians Network using an interferon-gamma release assay (IGRA). The second sample consists of general employees (non-health workers, non-HWs) from Hamburg who had no professional contact with the health care system. Propensity score matching (PS matching) was performed to ensure better comparability of the groups. The differences in the prevalence of positive test results from IGRAs were examined using univariate and multivariate analyses. After the PS matching of 1:10, 100 test subjects in the non-HW group and 1000 HWs remained to form the analysis collective. The HWs tended to exhibit higher IGRA values than non-HWs. The univariate analysis showed an odds ratio (OR) of 3.86 for the HWs (95% confidence interval (CI): 0.99 to 32.5; p = 0.056) with respect to a positive test result. The multivariate analysis produced an OR of 4.92, (95% CI: 1.3 to 43.7; p = 0.013) for HWs born in Germany. Despite the declining tuberculosis incidence rates in Germany, a comparison with non-exposed professional groups showed that HWs are at greater risk of LTBI. Preventive medical check-ups still seem to be indicated.

Suggested Citation

  • Lisa Hermes & Jan Felix Kersten & Albert Nienhaus & Anja Schablon, 2020. "Risk Analysis of Latent Tuberculosis Infection among Health Workers Compared to Employees in Other Sectors," IJERPH, MDPI, vol. 17(13), pages 1-10, June.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:13:p:4643-:d:377333
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    References listed on IDEAS

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    1. Claudia Peters & Agnessa Kozak & Albert Nienhaus & Anja Schablon, 2020. "Risk of Occupational Latent Tuberculosis Infection among Health Personnel Measured by Interferon-Gamma Release Assays in Low Incidence Countries—A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 17(2), pages 1-16, January.
    2. Ho, Daniel & Imai, Kosuke & King, Gary & Stuart, Elizabeth A., 2011. "MatchIt: Nonparametric Preprocessing for Parametric Causal Inference," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 42(i08).
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    1. Rebecca Malsam & Albert Nienhaus, 2021. "Occupational Infections among Dental Health Workers in Germany—14-Year Time Trends," IJERPH, MDPI, vol. 18(19), pages 1-17, September.
    2. Luca Coppeta & Giuseppina Somma & Savino Baldi & Elisabetta Tursi & Iacopo D’Alessandro & Andrea Torrente & Stefano Perrone & Antonio Pietroiusti, 2020. "Cost-Effectiveness of Annual Screening for Tuberculosis among Italian Healthcare Workers: A Retrospective Study," IJERPH, MDPI, vol. 17(5), pages 1-7, March.
    3. Nika Zielinski & Johanna Stranzinger & Hajo Zeeb & Jan Felix Kersten & Albert Nienhaus, 2021. "Latent Tuberculosis Infection among Health Workers in Germany—A Retrospective Study on Progression Risk and Use of Preventive Therapy," IJERPH, MDPI, vol. 18(13), pages 1-9, July.

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