Setting: The Institute for Pulmonary Diseases of Serbia, which specialises in diagnosis and treatment of lung diseases in a region with approximately 550-600 TB admissions per year.
Objective: To assess the occupational risk of tuberculosis (TB) among health care workers (HCWs) employed at this institution.
Design: Retrospective analysis of morbidity of TB among HCWs over a 12-year period (1986-1997). The incidence of TB among HCWs was estimated by the frequency of bacteriologically or histologically confirmed active disease. All HCWs at our institution underwent routine pre-employment screening, consisting of verification of BCG vaccination, PPD tuberculin reactivity, chest X-ray and laboratory evaluation.
Results: Of an average 267 employed HCWs, pulmonary TB occurred in nine (six nurses and three laboratory technicians). Cumulative incidence for HCWs was 3451/100,000, compared to 454/100,000 in the general population, for an incidence rate ratio of 7.6.
Conclusion: The risk of TB among HCWs employed at the Institute for Pulmonary Diseases of Serbia in Belgrade is 7.6 times higher than that observed in the general population, suggesting occupational acquisition of TB.