Are healthcare workers in England and Wales at increased risk of tuberculosis?
Objective: To determine whether healthcare workers in England and Wales are at increased risk of tuberculosis and to examine the frequency of drug resistance in this population. Design: Comparison of notification rates by occupation obtained from national tuberculosis notification surveys in 1988 and 1993, with denominators from the 1991 census. Subjects: People with notified tuberculosis in professional and associate professional occupations from the two surveys. Main outcome measures: Rates of notified tuberculosis in health professionals (mainly doctors) and health associate professionals (mainly nurses) compared with rates in other professional and associate professional occupations, adjusted for ethnic group, sex, and age. Results: 119 cases of tuberculosis were identified in healthcare workers, including 61 nurses and 42 doctors. The crude notification rate in healthcare workers was 11.8 per 100 000 per year (95% confidence interval 9.8 to 14.1) compared with 3.3 per 100 000 per