TB in the Workplace: Let's Talk About It

World TB Day, observed annually on March 24th, serves as a reminder of the urgent need to eliminate tuberculosis (TB), a serious yet curable disease. To achieve this, collective action is paramount. We must work together within our homes, communities, and workplaces to raise awareness, recognise early symptoms, and ensure prompt diagnosis. This year’s theme, ‘Unite to End Tuberculosis,‘ is a global call to action, emphasising the importance of public education, preventive measures, and access to early diagnosis and effective treatment to combat the ongoing TB epidemic.

What is TB?

TB is caused by bacteria that attack your lungs. It is spread from person to person through the air. When people with lung TB cough, sneeze, or spit, they release the TB germs into the air. A person needs to inhale only a few of these germs to become infected.

If not detected early, the bacteria can move through the blood to other parts of the body, such as the kidney, spine, and brain.

Why is TB such a big problem still?

The bacterium or germ responsible for TB was discovered by Dr. Robert Koch in the 1880s and announced on 24 March 1882. This was a pivotal moment in the medical field, leading to the development of effective tests and treatments.

Although we can usually cure TB with the existing treatments, there are several reasons why the disease remains a problem more than 140 years after its discovery. These include:

Some people can be infectious for a long time before they start treatment because of ignorance about their symptoms. This can be months or even years during which they may pass it on to other people.¹
The majority of TB tests and treatments are delivered within South Africa’s overburdened public health system, which can sometimes hinder access. However, these services are available at various other points of care, including clinics, through nurses and community health workers, via community outreach programmes, and even within some private health facilities. Many companies also offer free TB screening to their employees.²
Initial treatment takes around six months which can be tough to stick to. Defaulting on treatment can make the TB germs stronger and harder to kill with the usual medicines.
Many people are afraid to get help because of the stigma around TB. They worry about how others might judge them.
There are a lot of myths and misunderstandings about TB. This can lead to people getting tested late, which means they might unknowingly spread the disease to others.
Lack of knowledge: Many people don’t know what TB is or how to protect themselves.
Not completing the full course of treatment: TB medication regimens typically last for six months or longer. If a person stops taking their medication too early, the remaining TB bacteria may not be killed, and some of them may develop resistance to the drugs.

Not taking medication as prescribed: Missing doses, taking the wrong dose, or taking the medication at the wrong time could mean that the TB bacteria may not be exposed to enough of the drug to be killed. This can lead to drug resistance.

Some types of TB are now resistant to the usual drugs, making them harder to treat and more expensive to fight.
Not all workplaces have clear policies in place for dealing with TB.

What factors determine TB disease progression?³

Not everyone who gets exposed to TB bacteria will get sick. It all depends on how well your body’s defenses, like your immune system, can fight them off. When your immune system is strong, it can surround and inactivate the TB bacteria, preventing them from causing harm. This is called inactive TB, and you won’t feel sick or spread the germs to others.

However, if your immune system weakens due to illnesses such as HIV or diabetes, or other factors such as malnutrition, crowded living spaces with poor ventilation, smoking, and age, the TB bacteria can become active and start multiplying. This is called active TB disease at which point you may experience symptoms and can spread the disease to others. Children are also vulnerable because of their weaker immune systems. This is why you should be tested for TB if you’re at risk or have any concerns.

Signs you might have TB:

A cough that won’t go away (lasting more than 3 weeks)
Fever and night sweats
Losing weight for no reason
Feeling tired all the time
Having no appetite
Feeling generally unwell

Why is it important to talk about TB at work?

Diagnosing TB early, getting immediate treatment, and completing the full treatment course are vital to making a full recovery and stopping it from spreading. Without proper treatment up to two-thirds of people ill with TB will eventually die of the disease. Therefore, individuals must educate themselves and share their knowledge with their families, friends, and colleagues.

What can you do?

Pay attention to your health: If you have any TB symptoms, especially a cough that won’t go away, get tested right away.
Talk to your manager: If you are diagnosed with TB, let your manager or line manager know. They can help you get the right care and support.
If you suspect you have been exposed to someone with active TB, get tested.
Get tested for TB if you are at increased risk, such as if you have HIV or are in contact with people who have TB in your household or workplace.
Practice good hygiene: Cover your mouth when you cough or sneeze and wash your hands often.

What can your workplace do?

Create awareness: Share information about TB with everyone during health awareness days and through wellness programmes such as Employee Assistance Programmes (EAPs).
Make testing easy: Offer on-site testing or help employees find a treating doctor or facility.
Adapt working conditions and provide support to ensure employees with TB receive treatment and can safely return to work without risking the health of others.
Develop and implement clear management policies on issues such as confidentiality and the prevention of discrimination.⁴
Implement environmental control measures such as ensuring that the workplace has good ventilation to minimise the risk of transmission in the workplace.

Remember:

TB is treatable!
Early detection saves lives.
By working together, we can create a TB-free workplace.

If you need assistance don’t hesitate to reach out to LifeAssist.

References:

TB in the Workplace: Let’s Talk About It