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Occupational Health Clinic
1211 21st Ave. South
Suite 640 Medical Arts Building
Nashville, TN 37212
National Tubersol Shortage Affects TB Skin Testing at Vanderbilt
UPDATE: The shortage that prompted Vanderbilt to suspend routine TB testing has ended and Occupational Health has resumed TB testing for employees. If you need a TB skin test, you can walk-in anytime Monday-Friday, 7:30 A.M. to 5:30 P.M. to Occupational Health located at 640 Medical Arts Bldg. or check to see when OHC Comes to You.
Due to a shortage of the TB skin test solution Tubersol across the nation, the Tennessee Department of Health has directed all hospitals and clinics in Tennessee to temporarily suspend routine skin testing of healthcare workers. Vanderbilt’s Occupational Health Clinic will postpone TB skin testing, effective as of April 10th, 2013. Testing will resume as soon as the national shortage has eased, which is anticipated to be Summer 2013.
How does this impact employees? If you are a VUMC employee required to have a TB skin test, either as a new employee or for an annual requirement, Occupational Health will not be able to provide the TB skin test. Occupational Health has made adjustments to the TB compliance reporting so that individuals who are unable to be tested will not be penalized during the suspension of testing. Performance evaluations for staff/faculty and re-credentialing for providers will not be adversely affected by this temporary suspension of TB testing.
FAQs about the Tubersol (TB skin test solution) shortage:
Q: What about the compliance requirement for performance evaluations and credentialing?
A: The Occupational Health Clinic will adjust the compliance monitoring system so that no employee will be penalized for being unable to get TB testing.
Q: I have been exposed to a patient with TB and I’m supposed to have follow-up testing. Can I still get that?
A: Yes, people who have been exposed to someone with active TB are considered high risk and can still get tested.
Q: What will be done to screen new incoming staff, house staff and faculty?
A: Occupational Health will screen all new faculty/staff for symptoms of TB. Anyone with symptoms for active TB will receive a prompt medical evaluation to ensure they do not have a contagious illness.
Q: What will happen when the shortage is over?
A: When the shortage is over, testing will resume as usual. OHC will notify employees who need testing and provide convenient ways for them to get tested.
Q: I need a TB test for school – or another employer – what should I do?
A: The shortage is a national issue, so schools and other employers will implement the same restrictions. If the institution insists you be tested, refer them to the TN State TB Elimination Program at (615) 741-7247.
Q: Could we switch to another brand of TB solution?
A: There is an alternative solution, Aplisol, which is used in some settings. It is not recommended for healthcare worker testing and other settings with serial surveillance programs because of a higher rate of false positive results. Switching from our usual solution, Tubersol, to Aplisol is not recommended because of the high number of people who would have a false positive reaction in the same year. Also, Aplisol is now on backorder due to the national Tubersol shortage.
Q: What about blood tests instead of skin tests?
A: For ongoing screening programs in low risk individuals, the Health Department does not recommend switching to a blood test at this time. In low risk populations, there is a high frequency of test results that are barely above the cutoff level between positive and negative, and in serial testing programs people can go from positive to negative and back again; this can cause diagnostic uncertainty. Blood tests for TB infections may be useful to evaluate patients with TB symptoms or to guide treatment recommendations for people with a positive TB skin test.
Q: Who do I contact for help?
A: If you have any questions about the shortage or our testing program, contact the Occupational Health Clinic at firstname.lastname@example.org, or call OHC at 936-0955.