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[Tuberculosis and exposed personnel: prevention and surveillance].

Tuberculosis is defined as an occupational disease for healthcare and laboratory personnel for the Social security (table no 40). This table was modified in 1998 in order to deal with, not only pulmonary and extra-pulmonary tuberculosis-disease, but also with primary infections. Coverage is specific for hospital personnel; the disease is imputable to the service, imputability acknowledged by the departmental reform commissions, after expertise. For private institutions, the total number of cases for healthcare personnel is reported to the CNAM (national insurance system), that is to say 30 to 50 cases per year including 90% of pleuro-pulmonary cases (1989-2000). Tuberculosis-infection (primary infections) has been reported since 1998 (1998: 2 cases; 1999: 10 cases; 2000: 23 case). There is no centralized collection of cases for public hospitals. In the Assistance Publique-Hôpitaux de Paris (approximately 60,000 paramedics), 30 cases of pleuropulmonary tuberculosis and four primary infections were reported as occupational diseases from 1997 to 2001, that is to say approximately six cases per year among hospital personnel, not including physicians. A census made at the time of the previous report in 1995 showed higher figures: 94 reported cases of tuberculosis declared from 1987 to 1992 (an average of slightly more than 15 cases per year).