Bringing Awareness of TB by Celebrating World Tuberculosis Day at Your Workplace

Tuberculosis (TB) is a communicable respiratory disease caused by a highly contagious pathogen. It generally affects the lungs and is only passed on from one person to another through the air. In the workplace, the risk of the spread of this contagious disease is quite high, as the workforce operates in a close-knit community. March 24 is celebrated as World Tuberculosis Day. Employers can celebrate the day to create awareness among the employees about its danger in the workplace.

The World Health Organization (WHO) estimates 1.5 million people died of TB in 2020. At the global level, TB ranks 13th in terms of the number of deaths annually. It is the second most deadly infectious disease after COVID-19.

According to the National Tuberculosis Surveillance System (NTSS), 7,163 cases of tuberculosis were reported by 50 states of the United States in 2020. Approximately 66 million lives were saved between 2000 and 2020 by TB diagnosis and treatment. TB elimination by 2030 is one of the UN Sustainable Development Goals (SDGs).

What is Tuberculosis? (TB)

The infectious disease of Tuberculosis (TB) is caused by the bacteria Mycobacterium Tuberculosis. It is transmitted through the air and found in nearly every country in the world.

Globally, ten million people contracted the disease last year. The bacteria comes out into the air when a person with active TB disease coughs or sneezes. People nearby get infected by breathing the bacterial air.

After the person Inhales the TB bacteria, it settles in the lungs and starts growing there. By moving through the blood, the bacteria can spread to other parts of the body, like the kidney, spine, and brain. While TB in the lungs or throat can be infectious, it is usually non-infectious in other parts of the body. The risk of falling ill is higher for those with compromised immune systems, such as those living with HIV, malnutrition, or diabetes.

Symptoms of TB

There are various visible signs which help in the preliminary diagnosis of TB in a person. Some of them are -

• A persistent nagging cough that lasts for three weeks or more
• Coughing up blood or sputum (phlegm from deep inside the lungs)
• Sharp chest pain
• Fever or high body temperature
• Sweating at night
• Loss of appetite
• Unexplained weight loss
• Unusual sense of tiredness

Although there may be a few cases where the person shows no symptoms at all. In such a scenario, it becomes even more challenging to identify the patient and isolate them.

Who are Mostly at Risk?

Although tuberculosis poses threat to people from all age groups, it substantially affects grownups in their most productive times. Over 80% of cases and deaths are in developing countries. People who are infected with HIV are 18 times more likely to develop active TB.

Alcohol use and tobacco smoking increase the threat of TB by 3.3 and 1.6 times respectively. According to the World Health Organization, TB cases worldwide are estimated to have increased by 0.74 million due to alcohol use disorders, and 0.73 million due to smoking respectively.

In US, the Advisory Committee for Elimination of Tuberculosis (ACET) recommends that the following groups be screened for tuberculosis-

• People working in an enclosed community environment like employees.
• People with chronic health issues like diabetes and HIV.
• People who are dependent on alcohol and drugs.
• People arriving from a country where the TB infection rate is high.
• Those who had contact with a recent TB patient (within the last two years).

Diagnosis

TB specialists can refer suspected patients for a series of tests. It may include testing the suspected patient's sputum for TB or obtaining a chest X-ray.

Sputum Test

The first step is to take an X-ray of the chest. If it shows signs of tuberculosis, the doctor will take sputum samples (mucus from coughing). These samples are tested for TB bacteria.

Skin Test

The most commonly used diagnostic tool for tuberculosis is a skin test. The inside of the forearm is injected with a substance called tuberculin.

The doctor will check the area around the injection for swelling within 48 to 72 hours. If there is a hard, raised red bump, it is likely that the person is probably infected with TB. A large bump indicates a significant infection.

Treatment and Prescribed Drugs

It is possible to treat and cure TB. For diagnosing and curing the disease, the doctors usually prescribe a standard 6-month standard course of 4 antimicrobial drugs. They are-

• Pyrazinamide
• Isoniazid
• Ethambutol (Myambutol)
• Rifampin (Rifadin, Rimactane)

People suffering from latent tuberculosis might need to take only a few types of TB drugs. For treatment of active tuberculosis, all 4 drugs are prescribed as the bacteria usually shows a drug-resistant behavior.

Some of the drugs added to the course of therapy to counter drug resistance during TB medication include:

• Linezolid
• Bedaquiline

Usually, within a few weeks, the person will no more remain contagious and starts to feel better. Doctors mostly suggest finishing the course of prescribed TB drugs for effective control of the disease. Skipping doses too early can allow the bacteria still alive to develop resistance. In such a case, TB is much more dangerous and difficult to treat.
People can adhere to their treatment regimen by taking part in directly observed therapy (DOT).

Suggested read: A Definitive Guide On Employee Drug Testing

Tuberculosis- A Threat to Workplace Wellness

"50 percent of cases of some infectious diseases originate in the workplace and TB can be a chief contributor to the figure." - Shelly Batra, Operation ASHA, World Economic Forum summit Davos 2020

It is very important to identify and screen employees to prevent the workplace from drifting into a health crisis.

The ways in which TB can threaten the normal conduct of business in an organization are-

• It can spread in the workplace and infect multiple employees, who will be required to isolate themselves and get tested. This may have serious consequences on the smooth running of the business.

• From creating absenteeism in the workplace, lowering productivity, to increased expenditure on medical care, there is both direct and indirect impact of TB for a business.

• It can lead to mental health issues like depression and anxiety due to a lack of support or confusion about the next course of action.

• It can cause paranoia in the work environment, which can lead to the alienation of the affected employees.

TB prevention at the Workplace

When an employee is suspected to have TB, you should make them aware of the possible diagnosis. Advise them to contact appropriate health providers for prompt medical attention. Following are some of the responsibilities of employers to deal with a possible outbreak of TB in the workplace-

Provide Preliminary Screening and Treatment Facilities at the Workplace.

It could be anything from having first aid, masks, and an arrangement to safely isolate the affected employee. Providing preliminary screening and treatment at work saves workers from having to spend significant amounts of time and money traveling to health facilities that may be overcrowded, distant, or under-resourced.

Suggested read: Essential Self-Care For Employees In Frontline During The Covid Pandemic

Incorporate a Dedicated Policy for Communicable Diseases

The outbreak of covid-19 and the impact it had on the businesses showed how vulnerable our world is to such health threats. The risk of another health-related interruption is too big a threat to make businesses plan better.

Thus, as an employer, you can look to Incorporate a "Communicable Disease Policy" in the existing wellness program of the organization. It will ensure the organization is well prepared to safeguard employees from TB. It also takes care of other dangers from a future outbreak of contagious diseases in the workplace.

Suggested read: COVID-19 Has Changed the Future of Corporate Wellness Programs

Support Your Employees and Maintain the Confidentiality of Sensitive Medical Information.

Encourage employees to come forward and report any such diagnosis and assure the employee of the Company's commitment to providing leave benefits, medical coverage, and wholesome support and guidance to the affected employees.

The employer must maintain the confidentiality of employees’ sensitive medical information. By doing so the employee will feel respected and will develop a greater bond with the management and hence will lead to enhanced commitment and employee loyalty in return.

Improve the Work Environment and Ergonomics

Make sure your employees are protected from dust and have enough fresh air, light, and are not working in overcrowded conditions. You must also adhere to the legal obligations and provide a healthy work environment, under the Occupational Health and Safety guidelines.

Suggested read: Importance Of Managing Hazardous Health Risk In The Modern Workplace

Coordinate With the Local Public Health Authority

Ensure any investigation and response needed are coordinated with the local or state public health department. An investigator from the public health authority will interview the diagnosed employee and gather relevant medical information promptly. The employer would no longer be responsible for such fact gathering and the duty to protect such information.

Depending on the physical proximity of employees in the workplace, the public health authority may recommend testing additional employees as well. The information collected by the local health authorities will also help them to raise public awareness about TB.

Suggested read: 6 Steps Of Wellness Assessment For A Healthy Workplace In 2022

Collaborate TB and HIV Policies in Your Wellness Program

TB and HIV are closely linked and one of the highest-risk groups for TB infection in people is those living with HIV/AIDS. Addressing TB will boost the fight against HIV, to which many organizations are already committed.

Therefore as an employer, look to collaborate the TB and HIV policies of your organization. It will also save the business some extra expenditure on employee health.

Suggested read: HR Budgeting: Meaning, Importance, and Process

Conclusion

TB has been effectively managed by advances in drugs and diagnostics. But the outbreak of covid-19 caught most of the businesses off-guard. Employers must reconsider their approach to the management of communicable diseases so that they are ready to deal with any future outbreak of an epidemic without compromising the business.

As part of its effort to scale up the TB response, WHO works with partners, governments, and civil society. Businesses must look to incorporate the advances made in medical research. They must make them accessible to employees. Both employees and employers have much to contribute as a coordinated effort for preventing the global TB epidemic.