TB Education and Screening
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HUMAN RESOURCES MANUAL
POLICY
TB EDUCATION AND SCREENING
INFORMATION ABOUT TUBERCULOSIS (TB)
- TB has been on the rise in North America since 1985.
- Active TB is contagious through the air.
- Active TB is preventable and curable in most cases.
- If infected with TB bacteria, people with HIV are more vulnerable to getting active TB.
- TB testing provides baseline information on a person's infection with TB. It does not indicate active TB. By identifying those who have been infected, individuals can receive follow up testing and treatment thus protecting themselves from developing active TB and protecting others from transmission.
PURPOSE
The AIDS Committee of Toronto (ACT) has developed the following TB policy to make the workplace safer for employees, volunteers and clients by reducing and/or preventing the spread of workplace TB. Consideration has been given both to the public health requirement for TB prevention, treatment and care, and to the needs of individuals at ACT who may have TB.
EDUCATION
Information on clinical aspects of TB including brochures and this policy are provided to all new employees and volunteers as part of their orientation to ACT (see Orientation, HR #'s 3-10 and 3-11; Agency Orientation, HR # 9-80), and to all new clients.
ACT provides regular information updates on TB in conjunction with HIV Health Promotion programming.
Brochures and other information about TB are available in the Access Centre.
Aspects of the TB policy that are applicable to public areas and counselling rooms are posted publicly.
KNOWN EXPOSURE
If an employee, volunteer or client learns that he/she has been exposed to active TB, that person should contact a physician for information and follow-up screening.
Note: Conclusive test results can take up to eight weeks following exposure.
If a person is exposed to active TB:
- This does not mean that the exposed person has active TB.
- This does not mean the exposed person is contagious.
- There is no requirement to stay away from work. However, if the person feels ill with possible symptoms of active TB, the person may be contagious and should stay away from work.
TB SCREENING/TESTING
TB testing is recommended:
- for all employees and volunteers upon commencing work at ACT and annually thereafter, and
- for all clients.
Note: A negative skin test is not always accurate for people with a weakened immune system. Employees, volunteers and clients are encouraged to confer with their physicians and follow up on other TB tests and symptom screening to rule out active TB.
On a regular basis, ACT arranges for an on-site public health nurse to conduct TB testing and symptom screening.
All TB test results and other subsequent medical test results are confidential.
Employees and Volunteers
Employees/volunteers who have a positive TB skin test must also have TB symptom screening and a chest x-ray to ensure they do not have active TB. Those who have had a positive TB skin test in the past should have annual medical check ups including TB symptom screening, and if necessary, a chest x-ray.
Diagnosis of Active TB:
New employees/volunteers are not refused their position based on the TB test results. If the tests show active TB, they may commence work when the immediate supervisor/Volunteer Coordinator is provided with written confirmation from their physician that they are no longer contagious.
Existing employees/volunteers who are diagnosed with active TB are to notify the Executive Director and/or the local public health department. The Executive Director is to meet with/notify affected co-workers and clients, keeping specifics of the case confidential where possible. The Executive Director is also to arrange a public health nurse visit for follow-up TB testing for exposed individuals.
Employees/volunteers diagnosed with active TB are not to return to work until providing their immediate supervisor/Volunteer Coordinator with written confirmation from their physician that they are no longer contagious.
Clients
Clients are not refused services based on TB test results but where test results show active TB, clients receive alternate services and support, e.g., by phone or outside of the building, until providing written confirmation from their physician that they are no longer contagious.
PRECAUTIONARY MEASURES
Since coughing increases risk of TB transmission:
1. Signs are to be posted in appropriate locations regarding covering mouth and nose when coughing or sneezing, and about alternate client services being available if needed.
2. Individually wrapped candies and tissues are to be available in all locations. The Director of Support Services is responsible for ensuring these are available at the reception desk.
3. If clients/employees/volunteers are coughing, they are to be offered a candy and tissue. If the coughing persists, the individual's health should be enquired about. If there are any concerns about spread of air borne TB bacteria, respond as follows depending on the situation:
a) Client - ask client to leave and offer alternate services (by phone or outdoor meeting).
b) In individual or group session - end session and open doors to the room to increase air circulation.
c) Employee/volunteer - notify person's supervisor.
EMPLOYEE LEAVES RESULTING FROM ACTIVE TB
Employees with active TB receive up to 60 working days of paid leave which is not deducted from the employee's regularly accumulated sick leave.
The employee may not return to work until the supervisor is provided with written confirmation from a physician that the employee is no longer contagious.
Employees are allowed time off for medical appointments while recuperating from active TB. (See Collective Agreement, Letter of Understanding #2.)
Where possible, ACT is flexible about allowing employees to return to work gradually after having active TB.
When returning to work after active TB, ACT attempts to provide alternative work if necessary and possible so there is reduced risk to the employee's and other people's health (i.e., not directly in contact with other people until completely recovered).
Revised 1999
