Walls C
Auckland Health Services Ltd, Gree-Lane, Auckland, New Zealand.
N Z Med J. 1996 Jan 26;109(1014):12-3.
This review assessed the effectiveness and results of a programme implementing the 1992 Tuberculosis Control Guidelines to hospital staff at Green Lane and National Women's hospitals.
All staff tuberculosis surveillance and patient contact tracing contacts carried out by the occupational health unit and the resultant outcomes were assessed.
A higher risk of Mantoux conversion does exist in hospital staff. These conversions occur in nonhigh risk occupational groups as well as the more recognized at risk groups.
The 1992 guidelines proved impracticable to administer effectively and were resource intensive. Hospital staff form a distinct, well educated occupational group who are able to make their own risk assessments about the lifetime risks of tuberculosis infection. The British Thoracic Society Guidelines for screening healthcare workers make a practical surveillance programme. Tuberculosis remains a risk for healthcare workers and the emphasis of any staff programme should broaden from surveillance aimed at identifying primary infection having occurred to include improved environmental measures, work practices and the use of personal protection to reduce the work related exposure to the mycobacterium.
本综述评估了一项向格林巷医院和国家妇女医院工作人员实施1992年结核病控制指南的计划的有效性和结果。
对职业健康部门开展的所有工作人员结核病监测和患者接触者追踪情况及其结果进行评估。
医院工作人员中确实存在更高的结核菌素试验阳转风险。这些阳转发生在非高危职业群体以及更公认的高危群体中。
事实证明，1992年的指南难以有效实施且资源密集。医院工作人员构成了一个独特的、受过良好教育的职业群体，他们能够就结核病感染的终身风险自行进行风险评估。英国胸科学会的医护人员筛查指南构成了一个切实可行的监测计划。结核病对医护人员来说仍然是一种风险，任何工作人员计划的重点都应从旨在识别已发生的原发性感染的监测扩大到包括改善环境措施、工作实践以及使用个人防护用品，以减少与工作相关的结核分枝杆菌接触。
