Increased risk of tuberculosis in health care workers: a retrospective survey at a teaching hospital in Istanbul, Turkey

BACKGROUND: Tuberculosis (TB) is an established occupational disease affecting health care workers (HCWs). Determining the risk of TB among HCWs is important to enable authorites to take preventative measures in health care facilities and protect HCWs. This study was designed to assess the incidence of TB in a teaching hospital in Istanbul, Turkey. This study is retrospective study of health records of HCWs in our hospital from 1991 to 2000. RESULTS: The mean workforce of the hospital was 3359 + 33.2 between 1991 and 2000. There were 31 cases (15 male) meeting the diagnostic criteria for TB, comprising eight doctors, one nurse and 22 other health professionals. Mean incidence of TB was 96 per 100,000 for all HCWs (relative risk: 2.71), 79 per 100,000 for doctors (relative risk: 2.2), 14 per 100,000 for nurses and 121 per 100,000 (relative risk: 3.4) for other professionals. The mean incidence of TB in Turkey between 1991 and 2000 was 35.4 per 100,000. Incidence of TB was similar in the Departments of Chest Diseases and Clinical Medicine but there were no TB cases in the Basic Science and Managerial Departments. CONCLUSION: HCWs in Turkey who work in clinics have an increased risk for TB. Post-graduate education and prevention programs reduce the risk of TB. Control programs to prevent nosocomial transmission of TB should be established in hospitals to reduce risk for HCWs

Demographic characteristics of bronchial asthma in Turkey

The overlap of symptoms traditionally associated with both chronic obstructive lung disease and asthma seriously compromises identification of asthmatic subjects by symptoms alone. Furthermore, the relationship of cigarette smoking, the major cause of chronic obstructive lung disease to asthma, is unclear but is potentially important. Thus, the traditional clinical view that attaches the diagnostic label asthma to the young, atopic, wheezing patient and chronic obstructive lung disease to the middle aged, smoking, coughing patient may obscure rather than enhance our understanding of the potential risk factors involved in the production of these unique diseases and the natural history of their development. In the present study demographic characteristics of asthmatic patients who attended to the asthma outpatient clinics of three Chest Diseases Departments in Istanbul were determined. 349 patients were asked about their illness. Functional and laboratory investigations were done to the patients. The patients were asked about their sex, profession, educational status, place and date of birth, symptoms, relationship with provoking factors and medications, family history, smoking status, onest and duration of symptoms and the time period over which the symptoms are increasing. Respiratory function tests with early and late reversibility, total and in some patients specific IgE levels, skin prick tests, radiographic determinations were analyzed. Clinical and functional staging; relationship between prick tests, total IgE and eosinophilia and provoking factors were investigated