See explanatory notes on page 2 for additional information

Applicant answered NO to all Part A and NO to all Part B questions 3-7

Urgent referral to a TBCU or a doctor with experience in TB management

Applicant answered YES to any of Part B Questions 3, 4 or 5

IGRA ordered and reviewed by doctor/sta� health/infection control

TST - follow up as per TBCU protocol

IGRA TEST NEGATIVE

Applicant answered YES to any of Part B Questions *6-7

*Q6-if YES-prioritise if diagnosed wihin the past two years

REFER TO A TB CONTROL UNIT OR A DOCTOR WITH EXPERIENCE IN TB MANAGEMENT

Tuberculosis (TB) Risk Assessment Matrix - For Hospital and Health Service administration and / or clinician use Applicant completes the TB Risk Assessment form for Workers in Health Facilities. If further assessment is indicated, refer as per HHS protocol and forward TB risk assessment form and any supporting documentation to assessing clinician or TB Control Unit

Applicant answered YES to any question in Part A-symptoms of active TB

Clearance required from the assessing clinician (Dr or TBCU) for worker to commence employment

OR

Applicant has completed assessment previously and has:• NO to all symptoms in Part A and• NO new exposure or risk factors that were not investigated by hospital or public health authorities and has provided documentary evidence of previous appropriate assessment• If no documentary evidence of previous appropriate assessment, complete further assessment as indicated

NO FURTHER ASSESSMENT REQUIRED

Test for latent TB (IGRA or TST) (see explanatory notes)

IGRA TEST POSITIVE OR INDETERMINANT

Queensland Health

Tuberculosis Risk Assessment Matrix–Explanatory notes for administration and/or clinician use

• Interferon Gamma Release Assay (IGRA) may be available form staff health; tuberculin skin test (TST) requires referral to a TBCU.

• IGRA test includes any version of the Quantiferon test and the T-spot test.

• If a subject qualifies for a test for latent TB (LTB) but has a documented previous TST ≥ 10mm, repeat TST is not indicated but an IGRA test is useful if there is a history of past BCG vaccination.

• Serial testing for LTB is not usually indicated in the absence of a documented TB exposure incident. Annual testing may be adopted by individual work units if the risk of undetected exposure is considered high. In this scenario, serial TST is preferred to IGRA testing unless BCG is administered after 12 months of age (NTAC Guidelines: Management of Tuberculosis risk in healthcare workers in Australia. CDI Sept 2017).

• Persons who have previously completed this assessment and complied with any follow-up indicated under a different employer do not need to have repeat diagnostic testing or medical / TBCU assessment unless they have a new exposure risk or new symptoms (see TB risk Assessment Form).

• Applicants with NO positive risk factors identified in Part A and for whom testing for LTB is indicated as per risk factors identified in Part B may commence employment and complete any recommended additional assessment after commencement of employment. Clearance to commence employment is only required if the applicant answers YES to any symptoms in Part A.

Health Worker/Student Tuberculosis Risk Assessment Outcome Record template for client and Hospital and Health Service (HHS) record keeping is available from https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/diseases/tuberculosis/guidance/guidelines

TB Incidence resources

NSW Health List of Countries with a Tuberculosis Incidence of 40 cases per 100,000 Persons or Greater https://www.health.nsw.gov.au/Infectious/tuberculosis/Pages/high-incidence-countries.aspx

World Health Organisation (WHO)-Country pro�les TB Incidence https://www.who.int/tb/country/data/pro�les/en/

Queensland Health