Tuberculosis specialist Alistair Story claims guidance on TB is misleading

A tuberculosis expert has warned NHS OH professionals that while the overall risk of infection was low for most employees, it was higher in groups such as healthcare workers, voluntary staff, prison staff, and staff in care homes for the elderly and hostels for the homeless.

Clinical nurse specialist Alistair Story advised delegates to the annual conference of the Association of NHS Occupational Health Nurses that a sensible period for screening staff would be once a year and that BCG (Bacillus Calmette-Guerin) vaccination was not recommended for healthcare workers aged over 35.

Story said guidelines from the National Institute for Clinical Excellence [http://guidance.nice.org.uk/CG33/guidance/pdf/English] and the Department of Health’s Health Clearance for new Health Care Workers and Policy and Guidance Green Book were”slightly conflicting and by no means simple”, but there were “some reassuring messages” about the level of risk.

TB rates have increased annually nationally since 1987 and rose by 11% to 8,113 case between 2004 and 2005, with 43% in London. The causes include deprivation, delays in presentation and treatment, drug resistance (the last new drug was launched in in 1963), drug abuse, the high prison population and homelessness.

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