Current through Register Vol. 54, No. 45, November 9, 2024
Section 23.44 - Tuberculin testing of school personnel(a) School personnel shall receive a tuberculin skin test under this section.(b) School personnel to be tested include employes and independent contractors who provide direct services to students on behalf of a school, including but not limited to teachers, nurses, administrators, physicians, dentists, dental hygienists, custodians, janitors, cooks, cafeteria workers, bus drivers, librarians, psychologists, audiologists and counselors, and student teachers and volunteers who provide direct services to students on behalf of a school.(c) This section applies to public, private, parochial, residential or nonresidential schools or intermediate units in this Commonwealth that enroll students in grades K-12 and ungraded classes.(d) The tuberculin skin test shall be administered by either the intracutaneous Mantoux test method with the two-step tuberculin skin test procedure or the percutaneous multiple puncture test method. Purified Protein Derivative (PPD) shall be the tuberculin used for the intracutaneous Mantoux skin test. PPD or Old Tuberculin-OT-shall be the tuberculin used when administering the percutaneous multiple puncture skin test. The Department of Health may issue guidelines setting forth recommended procedures for the performance of the tuberculin skin tests.(e) The tuberculin skin test shall be performed by the school physician, or by a physician of the employe's choice legally qualified to practice medicine and surgery or osteopathy or osteopathic surgery in this Commonwealth, or the physician's legally qualified designee.(f) Prior to working for the school, the person tested for tuberculosis shall provide to the school a form, completed and signed by the physician responsible for the performance of the test, that indicates either of the following: (1) A nonsignificant Mantoux test reaction using the two-step skin test procedure, or a nonsignificant multiple puncture test reaction.(2) A significant tuberculin skin test reaction, with a negative chest x-ray for current tuberculosis disease.(g) The form shall state that the applicant is free of active infectious tuberculosis disease and shall indicate that the applicant was or was not referred for preventive antituberculosis chemotherapy.(h) If the intracutaneous Mantoux test method is used, the following information shall be provided on the form: (1) A nonsignificant or negative reaction shall be filed when the test reveals an induration of 9 mm or less 48 to 72 hours after the test is administered.(2) A significant or a positive reaction shall be filed when the test reveals either of the following: (i) Ten mm or larger induration 48 to 72 hours after the test is administered in a person with no known exposure to a case of active tuberculosis.(ii) Five mm or larger induration 48 to 72 hours after the test is administered in a person recently exposed to a case of active tuberculosis.(iii) Five mm or larger induration 48 to 72 hours after the test is administered in a person suspected of having active tuberculosis.(i) If the percutaneous multiple puncture test method is used, the following information shall be provided on the form: (1) A nonsignificant or negative reaction shall be filed when the test reveals no induration or vesiculation-blistering-48 to 72 hours after the test is administered.(2) A significant or positive reaction shall be filed when the test reveals vesiculation 48 to 72 hours after the test is administered.(3) When the test reveals another reaction-discrete papules, coalescence of papules or induration-the administration of the intracutaneous Mantoux tuberculin skin test is required, and results shall be filed as specified in subsection (g)(1) or (2).(j) The tuberculin skin test shall be administered within 3 months prior to the date the school receives the form.(k) School personnel who have a documented nonsignificant tuberculin skin test are not required to have further tuberculin tests unless they are exposed to a case of active tuberculosis or are directed otherwise by the Secretary of the Department of Health to have an additional test. If the conditions in paragraphs (1) or (2) occur, the individual is required to have a chest X-ray and an evaluation by a physician for the presence of infectious tuberculosis. School personnel who have a significant tuberculin skin test reaction, a negative chest X-ray and a statement from the physician indicating that they are free from infectious tuberculosis are not required to have further tuberculosis tests unless one of the following occurs:(1) They are exposed to an active case of tuberculosis.(2) They develop a productive cough which does not respond to usual medical treatment within 14 days.(l) The school shall submit requested data regarding the School Personnel Tuberculin Testing Program to the local health department on forms supplied by the Department of Health.The provisions of this §23.44 amended July 3, 1986, effective 7/5/1986, 16 Pa.B. 2412.