Tuberculosis (TB) in the Workplace

Frequently Asked Questions


What is Tuberculosis?

Tuberculosis (TB) is a disease caused by a bacterium, (a germ). It usually affects the lungs but can develop in any part of the body. TB is a curable disease. There are over 400 cases of TB notified in Ireland annually. This has gone from a high of around 7000 cases annually in the 1950’s. However, there has been an increase in cases in the past few years.

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What are the symptoms of Tuberculosis?

  • Weight loss for no obvious reason
  • Fever and night sweats
  • A cough that lasts more than three weeks
  • Loss of appetite
  • Coughing up blood, sometimes in later stages

Anyone with these symptoms should contact their local doctor or occupational health department (if there is one in the workplace).

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How is TB diagnosed?

Tuberculosis on the lungs usually causes characteristic changes on a chest x ray which will suggest but not confirm the disease. Once a chest x ray has been taken which may suggest that tuberculosis is present, the diagnosis may be confirmed by obtaining phlegm for bacteriological analysis. Because this bacterium can be particularly difficult to grow this process may take some weeks. Other tests may be required depending on where the infection is including urine tests or a biopsy.

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Can TB be cured?

Yes, almost every case but only if the full course of treatment is taken as prescribed, or else the disease can return in a drug resistant form.

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How is TB spread?

Tuberculosis is an airborne disease. Only people with TB in the lungs called Pulmonary TB can spread the disease. They can cough up the bacteria and another person can breathe it in. A bit like a cold is caught but not as easily. To get TB you usually need to have a very close, daily contact with someone who has the disease. Most people get it from a family member, friend, partner or co worker. You’re not likely to get TB from someone coughing on the bus or at a restaurant. It is not spread by dishes, drinking glasses, sheets or mattresses.

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Can the TB treatment cause side effects?

Rifampicin will turn urine and other body secretions such as tears orange/red. It also interacts with other medicines, in particular it reduces the effectiveness of the contraceptive pill. It is therefore important to warn your doctor when prescribing other medicines that you are on TB treatment. Other side effects can occur including rash, giddiness, sickness, pins and needles, and jaundice (liver problems)

If any of these occur patients should contact their TB nurse or doctor.

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How is TB treated?

The treatment regimen recommended by the World Health Organisation includes at least three and sometimes four specific antibiotics. These are isoniazid, rifampicin, pyrazinamide and ethambutol. For convenience they may be given as a single tablet. Treatment continues for at least six months. There has been a recent change of drug - resistant tuberculosis worldwide. The main cause of resistant disease is patients failing to take their treatment as prescribed.

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Do patients with TB have to go into hospital or do they have to stay off work while they are being treated?

No, although they may be admitted into hospital very briefly to confirm the diagnosis. Patients taking treatment very quickly become non infectious and therefore can go about there daily business as usual and do not have to be isolated in sanatoria as used to happen before a cure was developed.

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Can TB reoccur?

Yes, it is possible. Like any bacterial infection, it can be caught and cured more than once. So if you have any doubts, please consult your local doctor or your occupational health department (if there is one in the workplace).

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Can TB in the workplace be prevented?

There are numerous solutions to reduce or eliminate the risks of contracting TB, particularly in the health-care sector these include:

  • Early identification of infectious cases
  • Isolation and treatment of people with TB
  • Engineering and administrative procedures
  • Respiratory Protection

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Health-care Facilities

Treatment of Tuberculosis. Centres for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Reports (MMWR) 52(RR11); 1-77, (2003, June 20). Provides recommendations intended to guide the treatment of tuberculosis in settings where mycobacterial cultures, drug susceptibility testing, radiographic facilities, and second-line drugs are routinely available.

Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health Care Facilities. Centres for Disease Control and Prevention (CDC), (1994, October 28). Emphasises the importance of screening, training, and educating health-care workers to eliminate nosocomial transmission of M. tuberculosis.

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Further Information?

  • TB Guidelines. Centres for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination (DTBE). Provides a listing of major TB guidelines.
  • Trends in Tuberculosis Morbidity. Centres for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Reports (MMWR) 52(11);217-222, (2003, March 21).
  • Treatment of Tuberculosis. American Thoracic Society, Centres for Disease Control (CDC), and Infectious Diseases Society of America, (2003, June 20). Provides recommendations intended to guide the treatment of tuberculosis in settings where mycobacterial cultures, drug susceptibility testing, radiographic facilities, and second-line drugs are routinely available.
  • Protect Yourself Against Tuberculosis - A Respiratory Protection Guide for Health Care Workers. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication 96-102, (1995, December).
  • Health Protection Surveillance Centre, HSE, Ireland: www.hpsc.ie
  • Occupational Safety and Health Administration, US: www.osha.gov
  • World Health Organisation: www.who.int

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