Canada has one of the lowest TB rates in the world. Toronto Public Health provides information on TB and recommendations for TB screening in various workplace settings within the City of Toronto. The TB program also offers consultation around TB policies and procedures.
Ensure that employee confidentiality is maintained. Call Toronto Public Health (TPH) at 416-338-7600 to report. It is important to remember that only a person with active TB disease can spread the TB germs to others. People who have only a positive skin test (i.e. LTBI) are not sick and cannot spread TB germs. Toronto Public Health will follow up with anyone who has had a contact with someone who has active TB disease.
A person with LTBI should not be banned from work. People who have LTBI are not sick, and cannot spread TB germs to others.
Because people with active TB disease in the lungs or throat can spread the TB germs, it may be necessary for them to take time off work until they have been on treatment long enough that they can no longer spread the TB germs. Support from the employer is important during this time. Toronto Public Health and the employee’s physician will work closely to determine if the individual can safely report to work.
The Long-Term Care Homes Act, 2007 and Retirement Homes Act, 2010 require that all residents admitted to a long-term care or retirement home be screened for tuberculosis.
Toronto Public Health has updated its recommendations for TB screening for residents of both long-term care and retirement homes. A screening checklist for clinicians is also available.
Toronto Public Health highly recommends that all staff and volunteers provide documentation of TB testing prior to employment. Daycare/nursery school staff and volunteers need TB skin testing to protect themselves, other staff, volunteers and children. (Volunteers include those who expect to work regularly during the next year – approximately a half day per week or more.)
**The TB skin test should be done anytime within 6 months before the start of employment**
A TB skin test can be done by your family physician, a walk-in clinic or at a neighborhood community health centre. For employment purposes, you generally will have to pay for the TB skin test.
Employees/volunteers are not required to have annual or periodic skin tests or chest x-rays for TB. Repeat testing is required only if there is an infectious case of TB in the daycare/nursery school. Should this occur, follow-up of the TB case and contacts will be coordinated by Toronto Public Health. Skin testing will be free if you are identified as a contact of a TB case.
Some daycare/nursery schools participate in Early Childhood Education (ECE) field placements. Many ECE programs require their students to have a TB skin test. If you have ECE students, confirm with their program that they have had their TB skin tests done prior to starting their placement.
Routine TB testing for children is not recommended.
CCEYA Act: Subsection 7.4: Ontario Regulation 137/15:
57(1) Every licensee of a child care centre shall ensure that, before commencing employment, each person employed in each child care centre it operates has a health assessment and immunization as recommended by the local medical officer of health.
Revised February 2017