Latent tuberculosis infection in healthcare trainees: the need for structured occupational health surveillance in low-incidence countries

Background and aim: Latent tuberculosis infection (LTBI) remains a significant occupational health concern, even in low-incidence countries. Healthcare students and medical residents are exposed to Myco-bacterium tuberculosis (MT) during clinical training, emphasizing the need for structured health surveillance. This study analyzes data from a health surveillance program for tuberculosis-related biological risk among healthcare trainees at a university hospital in Northern Italy (2018–2022), aiming to demonstrate the neces-sity of implementing systematic TB surveillance protocols. Methods: A total of 2,087 healthcare students and medical residents underwent routine tuberculin skin test (TST) screening; interferon-gamma release assays (IGRA) were performed to confirm positive TST results. Demographic characteristics, professional role, and vaccination history were analyzed. A multiple logistic regression model was used to assess factors associated with TST positivity. Results: Among the participants, 710 (34%) were male and 1,377 (66%) were female, with a mean age of 23.6 ± 4.5 years. TST was performed in 2,053 individuals (98.4%), and 52 (2.5%) tested positive. IGRA confirmed LTBI in 6 cases (11.5%). Foreign nationality and older age were significantly associated with TST positivity, while no association was found for sex or professional role. Conclusions: LTBI surveillance is essential for healthcare trainees, ensuring early detection, risk mitigation, and infection control. These findings emphasize the importance of maintaining targeted LTBI surveillance among healthcare train-ees, even in low-incidence settings. Systematic screening programs contribute to early detection and infection control, reinforcing the role of occupational health services in safeguarding both trainees and patients. (www.actabiomedica.it).