Tuberculosis among Health Workers—A Secondary Data Analysis of German Social Accident Insurance Data from 2002–2017

Jan Felix Kersten,Anja Schablon,Stephanie Schneider,Albert Nienhaus

doi:10.3390/ijerph17051564

Abstract

Tuberculosis (TB) is the most common cause of fatal infections worldwide. Recent TB figures in Europe indicate that 30 people were infected with tuberculosis each hour in 2017. Healthcare workers are at particular risk of being infected through patient contact. TB is the second most common occupational infectious disease among German healthcare workers. Routine data from the German Social Accident Insurance were used to examine trends in occupational TB diseases. We analyzed annual cross-sectional data for the years 2002 to 2017. The data underwent descriptive analysis. A total of 4653 TB cases were recognized as occupational diseases (OD) in the period under study. In 2002, 60 TB cases were recognized as OD No. 3101, i.e., transmissions from person to person. Since 2013, the level has settled at around 500 recognized cases per year. This is around eight times the number of cases compared to 2002. The following three groups collectively accounted for the largest share of TB cases (88.5%): nurses (including geriatric nurses), other healthcare employees, and physicians. The upward trend in the number of TB cases recognized as occupational diseases is probably due to improvements in diagnostic tests used to diagnose TB infections. TB in health and welfare workers remains an important issue in the health and welfare sector in Germany, partly due to the long latency period between potential exposure to infectious patients or materials and the recognition of the latent tuberculosis infection (LTBI) or active TB as OD.

Highlights

A range of Western European countries have been considered low-incidence countries for tuberculosis (TB) for several years
TB in health and welfare workers remains an important issue in the health and welfare sector in Germany, partly due to the long latency period between potential exposure to infectious patients or materials and the recognition of the latent tuberculosis infection (LTBI) or active TB as occupational diseases (OD)
4653 TB cases were recognized as occupational diseases in the overall period

Summary

Introduction

A range of Western European countries have been considered low-incidence countries for tuberculosis (TB) for several years. Tuberculosis is the infectious disease with the highest mortality figures worldwide [1,2,3]. Recent figures from Europe indicate that around 30 people an hour contract TB today. A global decline in TB incidence rates has been reported. The European WHO Region has reported stronger annual declines than those observed for the world as a whole (5.2% vs 1.8%). This decline does not meet the target necessary to achieve the milestones of the End TB Strategy by 2025 [4]

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