The Results of Tuberculin Skin Test and the Risk of Tuberculosis in Autopsy Workers

Ozsoy S., AKAR T., Gumus S., Dinc A. H., DEMİREL B., Safali M.

TURKIYE KLINIKLERI TIP BILIMLERI DERGISI, vol.30, no.6, pp.1876-1883, 2010 (SCI-Expanded) identifier identifier


Objective: Tuberculosis (TB) is a disease that arises due to M. tuberculosis complex and usually involves the lungs but can also affect other organs or organ systems. The number of people who died in Turkey was 210146 in 2006 and 0.11% (n=249) of them died because of pulmonary tuberculosis. During autopsy, many microparticles (aerosols) can be generated while taking the organ out of the body, washing the body, or using the oscillating saw. If these aerosols may contain bacilli that can easily infect the health workers. Tuberculin skin test (TST) determines delayed type hypersensitivity reactions to some antigenic components of microorganism. The only sign of latent tuberculosis infection is positive TST. In our study, we aimed to calculate the exposure rate of the autopsy workers to TB bacillus by evaluating TST measurements and chest radiograms. Material and Methods: The study group was composed of 25 physicians and five autopsy technicians. The control group was composed of 30 physicians, residents and specialists of basic medical sciences except of Microbiology. Both groups were evaluated by TST and chest X-rays from TB point of view. We used TST reaction evaluation criteria that was suggested by Ministry of Health of Republic of Turkey while evaluating TST measurements. All measurements were analyzed statistically. Results: TST positivity ratio is determined as 83.3% in the study group and 33.3% in the control group. The mean of TST measurement value is determined as 13.8 +/- 4.7 mm in the study group and 8.6 +/- 2.2 mm in the control group. There were no statistically significant differences between two groups concerning age, height, marital status, occupational experience or smoking habits (p>0.05). There was a statistically significant difference between study and control groups for the TST values were (F=11.786; p=0.001). There were no statistically significant differences for gender, smoking and interaction between gender-group and smoking-group (p>0.05). Established ANOVA model (univariate ANOVA); explained the =0.903 of TST change and it was statistically significant (F=71.159; p<0.001). There was a statistically significant correlation between TST results and time spent in the autopsy room (r=0553; p=0.002). Conclusion: Our study shows that autopsy workers have a high risk of TB exposure. We suggest that autopsy workers should be examined for occupational TB exposure. Furthermore, morgue buildings and autopsy rooms of our country should be designed in accordance with the international standards, and measures should be taken in this regard without delay.