The challenges posed by TB have changed, especially with the threat of drug-resistant TB. Also, the growing mobility of people including workers is a main factor for disseminating TB faster and farther, thus rending its control even more difficult. While the main objective of occupational health services is to control the risk of TB contamination on the workplace, it should be also to reach out the local communities and thus leveraging the impact of the DOTS activities outside the workplace.
In high TB prevalence countries (HTBPC), TB is a hazard on the workplace, and should be integrated in HIRAC procedures, for having in place the necessary control measures. Cross-sectoral approach involving Ministries of Health and Labour contributes to achieve this objective, following the collaboration that ILO and WHO have already implemented. In HTBPC, there is an urgent need to put in place measures on the workplace to scale up early diagnosis, adequate treatment, and better individual risk assessment based on personal history of mobility. Better coordination at intra-national, regional, and global levels is required to properly managed mobile workers infected with TB, whether it is latent TB infection or active TB. Occupational Health Services have an important role to play to move this forward.
In low prevalence TB countries, there is an operational program towards TB elimination, where occupational health services have a role to play. In addition to social determinants, mobility plays an important role in these countries, and the wider availability of tests combined with powerful data management and utilisation of e-Health allows to fast track an outbreak and take the adequate control measures. Illegal foreign workers – usually migrants from HTBC – suffer lack of access to TB diagnosis and treatment, and may expose their families, local communities and coworkers in the workplace.