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P282: Health care exposure prevention of tuberculosis by successful implementation of employee safety policy- our experience


India accounts for one-fifth of the global Tuberculosis (TB) incident cases. It is estimated that annually around 330,000 Indians die due to TB.[1] The risk of exposure to Health care workers (HCW) is often overlooked and the hospitals also underplay it. In one of the data published in Lung India 11.2 new cases per 1000 person-years of exposure was reported.[2, 3] It is an important challenge everywhere, particularly in low and low to middle income countries. [4]


A TB infection control plan that outlines a protocol for the prompt recognition, separation and investigation for suspected or confirmed TB disease was formulated as part of employee safety policy.


Our TB infection control program was based on a three-level hierarchy of control measures based on CDC recommendations 2012. Triage of Suspected TB patients on hospital admission was strictly implemented. We used smear-negative algorithms. Structural modifications- Emergency department was provided with a negative pressure room to keep these patients. Behavioral change - Till the patient is proved negative, the staff attending the patient wear N95 mask to reduce the risk for exposure.


Before implementation open TB cases admitted annually without screening were 15, 14, and 15 in 2007, 2008 and 2009 respectively and after Implementation 5,0,2 in 2010,2011 and 2012 respectively.


Implementation of policies to prevent exposure of health care workers to Tuberculosis is imperative to prevent Nosocomial TB Infection. Through a effective employee safety policy and a active Infection Control team, nosocomial TB spread can be prevented.


  1. WHO Policy on TB Infection Control in Health –care Facilities, Congregate Settings and Households. Geneva; WHO. 2009

  2. Aggarwal AN: Tuberculosis transmission at healthcare facilities in India. Lung India. 2009, 26: 33-4. 10.4103/0970-2113.48893.

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  3. Prevention of hospital-acquired infections WHO Department of Communicable Disease, Surveillance and Response. 2

  4. Robert J‘erome, Affolabi D, Awokou F, Nolna D, Manouan B, Acho Y, Gninafon M, Terbucq A, et al: Assessment of organizational Measures to prevent nosocomial Tuberculosis in health facilities of 4 sub-saharan countries in 2010. Infect Control Hosp Epidemiology. 2013, 34 (2): 190-194. 10.1086/669085.

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Sri Ratnamani, M., Rao, R. P282: Health care exposure prevention of tuberculosis by successful implementation of employee safety policy- our experience. Antimicrob Resist Infect Control 2 (Suppl 1), P282 (2013).

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