Tuberculosis: preventing occupational transmission to health care workers.

1. The anticipated reduction in the incidence of tuberculosis (TB) failed to consider four major factors: the advent of human immunodeficiency virus (HIV); the development of multi-drug resistant TB; the decline in public health services and limited access to health care for those in congregative facilities; and the increase in immigration of persons from countries with high prevalence of TB. 2. Some strains of multi-drug resistant TB are resistant to all anti-TB medications and seriously hamper infection control strategies. Unfortunately, MDR-TB is transmitted in the same manner as drug susceptible organisms and studies show comparable infection rates. 3. The role of the occupational health nurse in preventing workplace exposure to TB combines education, disease prevention, early detection, and treatment modalities to maximize the opportunity for a healthy work environment for health care workers.