Abstract
Objective: To determine the prevalence of positive tuberculin skin test (TST) reactions (10 mm or greater) among full-time employees of a provincial prison for women in Montreal.
Methods: Participants underwent tuberculin skin testing and completed a self-administered questionnaire.
Results: Among 129 employees identified, 118 (91%) underwent tuberculin testing. Among 102 born in Quebec who completed the questionnaire, 33 (32%) had positive TST reactions, including 12 (23%) of 52 subjects who had never been vaccinated. Positive TST reactions were significantly associated in multivariate analysis with BCG vaccination after infancy (OR = 4.5, 95% CI = 1.5–13.5), years of work at other provincial prisons (OR = 2.5 for each 5 years of work, 95% CI = 1.2–5.2), travel to tuberculosis endemic countries (OR = 7.7, 95% CI = 1.4–43), although not with work in the prison for women (OR = 1.3, 95% CI = 0.9–1.9)
Conclusion: The prevalence of positive TST reactions was greater among workers at a provincial prison for women than among a sample of students, suggesting increased occupational risk of tuberculosis infection.
Résumé
Objectif: Déterminer la prévalence des cuti-réactions positives à la tuberculine (10 mm ou plus) parmi les employés à temps plein d’une prison provinciale pour les femmes à Montréal.
Méthodologie: Les participants ont passé un test cutané à la tuberculine et ont répondu eux-mêmes à un questionnaire.
Résultats: Sur 129 employés identifiés, 118 (91%) ont subi un test cutané à la tuberculine. Sur les 102 d’entre eux nés au Québec qui ont rempli le questionnaire, 33 (32%) ont eu une cuti-réaction positive, dont 12 parmi les 52 individus qui n’avaient jamais été vaccinés. Dans l’analyse multivariable, les cuti-réactions positives sont apparues nettement associées à la vaccination au BCG après l’enfance (risque relatif [RR] = 4.5, 95% intervalle de confiance [IC] = 1.5–13.5), à des années de travail dans d’autres prisons provinciales (RR = 2.5 pour 5 années de travail, 95% IC = 1.2–5.2), à des voyages dans des pays où la tuberculose est endémique (RR = 7.7, 95% IC = 1.4–43), mais pas avec le travail dans la prison pour femmes (RR = 1.3, 95% IC = 0.9–1.9).
Conclusions: La prévalence des cuti-réactions positives est plus importante parmi les employés d’une prison provinciale pour femmes que parmi un échantillon d’étudiants, ce qui tend à indiquer une augmentation du risque professionnel de contraction de la tuberculose.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Wilkins K. Tuberculosis incidence in Canada in 1992. Health Reports 1994;6(2).
Enarson D, Ashley MJ, Grzybowski S. Tuberculosis in immigrants to Canada: A study of present-day patterns in relation to immigration trends and birthplace. Am Rev Respir Dis 1979;119:11–7.
Orr PH, Manfreda J, Hershfield ES. Tuberculosis surveillance in immigrants to Manitoba. Can Med Assoc J 1990;142:453–58.
Enarson D, Grzybowski S. Incidence of active tuberculosis in the native population of Canada. Can Med Assoc J 1986;134:1149–52.
Enarson DA, Wang J, Dirks JM. The incidence of active tuberculosis in a large urban area. Am J Epidemiol 1989;126:268–76.
Selwyn PA, Hartel D, Lewis VA, Schoenbaum EE, Vermund SH, Klein RS, et al. A prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection. N Engl J Med 1989;320:545–50.
Barnes PF, Bloch AB, Davidson PT, Snider DE. Tuberculosis in patients with human immunodeficiency virus infection. N Engl J Med 1991;324:1644–50.
Chevalley B, De Hauer R, Bernheim J. Epidemiologie de la tuberculose pulmonaire en milieu carceral. Schweiz Med Wschr 1983;113:261–65.
Drobniewski F. Tuberculosis in prisons — forgotten plague. Lancet 1995;346:948–49.
Abeles H, Feibes H, Mandel E. The large city prison — a reservoir of tuberculosis. Am Rev Respir Dis 1970;101:706–9.
Braun M, Truman B, Maguire B, DiFerdinando G, Wormser G, Broaddus R, et al. Increasing incidence of tuberculosis in a prison inmate population. JAMA 1989;261:393–97.
Centers for Disease Control (CDC). Prevention and control of tuberculosis in correctional institutions: Recommendations, advisory committee for elimination of tuberculosis. JAMA 1989;262:3258–62.
Centers for Disease Control (CDC). Tuberculosis in a state correctional institution — California, 1990–1991. MMWR 1992;41:927–29.
Valway SE Richards S, Kovacovich J. Outbreak of multi-drug-resistant tuberculosis in a New York State prison, 1991. Am J Epidemiol 1994;140:113–22.
Sokal JE. Measurement of delayed skin-test responses. N Engl J Med 1975;293:501–2.
Canadian Thoracic Society (Fitzgerald JM, ed). Canadian Tuberculosis Standards. Ottawa: Canadian Lung Association, 1996
Frappier A, Cantin M, Davignon L. BCG vaccination and pulmonary tuberculosis in Quebec. Can Med Assoc J 1971;105:707–10.
Ministere de Sante et Services Sociaux. Tuberculose, Rapport Annuel — 1992. Quebec City: Government of Quebec, 1993.
Menzies RI, Vissandjee B. Effect of bacille Calmette-Guerin vaccination on tuberculin reactivity. Am Rev Resp Dis 1992;145:621–25.
Dawson-Saunders B, Trapp RG. Basic and Clinical Biostatistics. Norwalk: Appleton & Lange, 1990.
Feinstein AR. Clinical Epidemiology: the Architecture of Clinical Research. Toronto: WB Saunders Co., 1985.
Kleinbaum DG, Kupper LL. Applied Regression Analysis and Other Multi-Variate Methods. North Scituate, Mass.: Duxbury Press, 1978.
Menzies RI, Vissandjee B, Rocher I, St.Germain Y. The booster effect in two-step tuberculin testing among young adults in Montreal. Ann Intern Med 1994;120:190–98.
Rivest P, Tannenbaum T. Épidémiologie de la tuberculose région de Montréal-Centre 1992–1995. Montréal, Québec: Régie Régionale de la Santé et des Services Sociaux., 1996;1–65.
Salive ME, Brewer TF. Coinfection with tuberculosis and HIV-1 in male prison inmates. Public Health Rep 1990;105:307–10.
Jeanes CWL. HIV-1 infections among incarcerated men in Quebec. Can Dis Wkly Rep 1991;17:233–35.
Hankins C, Laberge C. HIV-1 in a medium security prison for women in Quebec. Can Dis Wkly Rep 1989;15:168–70.
Ford PM, White C, Kaufmann H. Voluntary anonymous linked study of the prevalence of HIV infection and hepatitis C among inmates in a Canadian federal penitentiary for women. Can Med Assoc J 1995;153:1605–9.
Voluntary screening for hepatitis C in a Canadian federal penitentiary for men. Can Commun Dis Rep 1995;21:134–36.
Bruneau J, Lamothe F. Increased HIV sero-prevalence and seroincidence associated with participation in needle exchange program: unexpected findings from the Saint-Luc cohort study in Montreal. Proceedings of XI International conference on Aids, Vancouver 1996; 244 Abstract.
Hankins C, Gendron S. Early indications of declining HIV incidence among Montreal needle exchange attenders. Proceedings of Xl International Conference on Aids, Vancouver 1996; 36, Abstract.
Archibald C. HIV infection among injection drug users: Summary of December meeting. The Clarion 1995;2:5–6.
Pelletier A, DiFerdinando G, Greenberg A, Sosin D, Jones W, Bloch A, et al. Tuberculosis in a correctional facility. Arch Intern Med 1993;153:2692–95.
Bellin E, Fletcher D, Safyer S. Association of tuberculosis infection with increased time in or admission to the New York City jail system. JAMA 1993;269:2228–31.
King L, Geis G. Tuberculosis transmission in a large urban jail. JAMA 1996;237:791–92.
Martin Sanchez V, Alvarez-Guisasola F, Cayla JA, Alvarez JL. Predictive factors of mycobacteri-um tuberculosis infection and pulmonary tuberculosis in prisoners. Int J Epidem 1995;24:630–36.
Stead W. Undetected tuberculosis in prison. JAMA 1978;240:2544–47.
Corrections Canada. Tuberculosis prevention and control program. Ottawa: Government of Canada, 1995:1–33.
Author information
Authors and Affiliations
Additional information
(on leave from the Infectious Disease Unit, Direction de la santé publique de Montréal-Centre)
Dr. Menzies is supported by a scholarship of the Fonds de la Recherche en Santé du Québec.
Rights and permissions
About this article
Cite this article
Jochem, K., Tannenbaum, T.N. & Menzies, D. Prevalence of Tuberculin Skin Test Reactions Among Prison Workers. Can J Public Health 88, 202–206 (1997). https://doi.org/10.1007/BF03403888
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03403888