Routine chest radiograph in pre-employment medical examination for healthcare workers: Time for a review of the protocol

Abstract

Background: Pre-employment medical examination (PEME) sought to evaluate the ability of workers to work without risk to their own or others' health and safety. This is important especially in a hospital environment where the patients may be at risk in case of employees harbouring infectious lung conditions or as a result of occupational exposure. Although not all healthcare workers are at risk or pose risk, they are expected to undergo chest X-ray (CXR) as part of PEME. Aims: The aim of this study is to determine the number of prospective employees with abnormal findings on routine CXR, describe their characteristics and reassess the value of CXR in PEME. Settings and Design: This was a retrospective study of all the staffs employed into the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria, from January 2004 to December 2013. Subjects and Methods: Of the 633 personnel employed during this period, medical records of 416 staffs were available for analysis. Data extracted included age, gender, and CXR report. Descriptive statistics was used for analysis and presentation. Results: The mean age of the prospective employees was 26.6 years ± 5 with a range of 20–49 years. Three hundred and ninety-six (95.2%) employees had normal CXR report while 20 (4.8%) had abnormal CXR. The only abnormality reported was cardiomegaly which was found in 66% of those aged ≥41 years. Cardiomegaly was significantly associated with increasing age (P = 0.003). Conclusions: Routine CXR as part of PEME for prospective employees into this healthcare institution is no longer necessary. It is suggested that its routine use should be limited to older job seekers.

Keywords

• healthcare workers
• pre-employment medical examination
• routine chest x-ray