TB screening is a standard requirement for employment in professions involving close contact with vulnerable populations, such as healthcare, education, and childcare. This screening identifies individuals who may have been exposed to the bacteria, ensuring a safe work environment. Understanding the types of tests and where to get them can help you complete this pre-employment step efficiently.
Types of TB Tests for Employment Screening
The two primary methods for employment-related TB screening are the Tuberculin Skin Test (TST) and the Interferon-Gamma Release Assay (IGRA) blood test. Employers may specify which test is required, or they may allow the applicant to choose based on personal history or convenience.
The Tuberculin Skin Test, also known as the PPD (Purified Protein Derivative) test, is the older and generally less expensive option. This procedure involves injecting a small amount of tuberculin under the skin on the forearm during the first visit. The applicant must return 48 to 72 hours later to have a healthcare professional assess the injection site for a raised, hardened area (induration) to determine the result.
The IGRA blood test, sold under brand names like QuantiFERON-TB Gold or T-SPOT, is a more modern alternative. This test requires a single blood draw and avoids the need for a second visit for a reading. Crucially, the IGRA test is not affected by the Bacille Calmette-Guérin (BCG) vaccine, which can cause a false-positive result with the PPD skin test.
Primary Locations for Obtaining a TB Test
Urgent care centers and walk-in clinics, including those affiliated with major pharmacies, are highly accessible options for both PPD and IGRA tests. These clinics often accommodate walk-in appointments, making them a fast choice. Out-of-pocket costs for a single PPD test may range from approximately $50 to $175, and IGRA tests can be higher.
Occupational health clinics specialize in employment compliance and are frequently utilized by large employers to manage screening programs. These facilities are well-versed in the specific forms and documentation required for work clearance. Checking in advance ensures they offer the specific test type, PPD or IGRA, mandated by your prospective employer.
Local health departments, or public health clinics, often provide TB testing as part of their community health services. These are generally the most affordable option, sometimes offering tests at a low or subsidized cost. However, they may primarily offer the PPD skin test and might require an appointment, potentially leading to a longer process due to scheduling and the required two-day return visit.
Your established primary care physician’s office can also administer the test, especially if you prefer to have the procedure covered under your health insurance. It is important to confirm whether they perform the test in-house or require a referral to an external lab, and if the test is considered preventative care or a compliance-related screening.
Understanding the Testing Process and Results
Before visiting a testing location, bring any specific forms provided by your employer to ensure the results are documented correctly for work clearance. The cost varies significantly; a PPD test may cost between $35 and $175, while the IGRA blood test often ranges from $30 to $350 without insurance. Insurance plans may cover the cost if the test is medically necessary, but coverage for employment compliance screenings should always be verified with the insurer beforehand.
A negative result on either the TST or IGRA test indicates you do not have a TB infection and are cleared for employment. A positive result means you have been exposed to the bacteria, often signifying a latent TB infection (LTBI). People with LTBI are not contagious and do not have active disease, meaning they can typically continue working.
A positive result requires immediate follow-up to rule out active TB disease, which is contagious. The standard next step is usually a chest X-ray to check for physical signs of active disease in the lungs. If the chest X-ray is negative, you are confirmed to have latent TB; while treatment is often recommended, it generally does not prevent you from starting your job.