Incidence of tuberculosis among nurses and healthcare assistants in France.

BACKGROUND: Health care workers (HCWs) are considered to be at higher risk of tuberculosis (TB) than the general population. However, a decreasing incidence in the general population as well as improvement in preventive measures in hospitals has reduced the risk for HCWs.

AIMS: To quantify the actual incidence of TB in nurses and health care assistants in a low-incidence country.

METHODS: We performed a retrospective study of 80 hospitals throughout France, employing 233389 health care staff (physicians excluded). We calculated the number of pulmonary TB cases over 3 years (700166 person-years) and the total number of staff members in each job category (nurses, health care assistants, administrative staff) in each hospital, to calculate the incidence.

RESULTS: Overall, the incidence rate varied between 1.27 and 6/100000 for administrative staff and nurses, respectively (non-significant difference). The incidence varied according to the geographical area. However, the incidence in nurses and health care assistants was not different from the general population (7.5/100000).

CONCLUSIONS: In a low-incidence country, such as France, the implementation of measures to prevent occupational TB among HCWs has been effective. These preventive measures should be maintained but medical follow-up could be revised.