Do you need a tb and an x-ray as part of your physical?

Hello,
My best friend has a B.A. already but she would love to be an R.N. She is very smart; received her B.A. with high honors and was on the dean's list all 4 years while at college. But most importantly, she is super caring not only with people, but also with animals, and even insects (literally she would never hurt a bee or a beetle!) She has been volunteering at our Nursing Home where I work. She truly feels for some of our residents who either don't have any relatives or are not visited often. She would talk to them and is sincerely interested in their stories and lives before they entered the facility. I just see her as one of the best nurses out there who would really make a difference! I spoke with her about it and there is just one problem that prevents her from starting working towards an RN degree, and that is she is EXTREMELY allergic to immunizations including TB test and strongly opposes to unnecessary x-ray exposure. She has always had a positive TB test because she is allergic to it. Her chest X-rays are of course crystal clear. She's been told by a doctor that it is an allergic reaction. She also strongly disagrees with the fact that as an R.N. or even to enroll into any nursing program she has to undergo a chest x-ray just because she is allergic to TB test. It doesn't make sense to her why she has to undergo unnecessary radiation exposure (that is cumulative) just to be proving that she doesn't have tuberculosis. I wonder if there are any other methods besides outdated TB test (that often gives false results), and yearly cancer-promoting x-rays?? Is there anything else that she, and anybody in similar situation, can do in order to show that they in fact are healthy and tuberculosis free? Anyways, any suggestions, experiences and insights about this subject would be appreciated! She will be reading your answers; I told her I'm posting a thread about her dilemma. Thank you all and best wishes! Last edit by WE~DO~CARE on Apr 17
Quote from WE~DO~CAREHello, It doesn't make sense to her why she has to undergo unnecessary radiation exposure (that is cumulative) just to be proving that she doesn't have tuberculosis. . Thank you all and best wishes!

They can do a Quantefuron Gold blood test for Tb antibodies. Some schools require it over a skin test. My sister (negative Mantoux) was required to get the blood test prior to her SLP clinicals in a pediatric regional hospital because of high risk kids and an area with heavy immigration and high incidence of latent and subclinical Tb. Not always covered by insurance though.

I would suggest to your friend that she do some research on x-ray exposure from reputable sources. Yes, the exposure is cumulative but, the amount she gets from a single yearly x-ray would be minimal. Frequent airplane travelers will get more exposure to radiation than she would. (And at my facility, the policy is CXR every 5 years unless exposed). And the previous poster is correct, she is going to come into contact with far worse things as a nurse than the occasional CXR.

She's allergic to immunizations? Never heard of such a thing. Most places will not hire someone who is not fully immunized. Most nursing schools will not allow entry into their program if you're not fully immunized. Does your friend have a physician's note exempting her from all immunizations due to "allergy"?And yes, a Quantiferon is a simple blood test to rule out TB.

A ten hour plane flight has the same amount of radiation as a chest X-ray. Hope she doesn't fly overseas more than once a decade...

^^^Good point.Here's a great chart. You're getting about 4x the amount of radiation on an annual basis just from the food you eat, compared to a CXR.Radiation Dosage Chart | Information Is Beautiful

What do they do for people that area allergic to vaccines? I have heard of many people allergic to TB test materials. Glad they have the blood test now.

Quote from mmc51264What do they do for people that area allergic to vaccines? I have heard of many people allergic to TB test materials. Glad they have the blood test now.

Part of this problem may be the belief she is "allergic" but in reality has sensitive skin, and not a systemic allergy. Unless someone is very practiced in giving the PPD correctly, and then READING it correctly, errors in interpretation are often made. I've had people come for a reading, convinced they were 'positive', but they were NOT. A red mark, even a very small induration, is NOT indicative of a 'positive' result. A large red mark, and something that looks like a hive, is ALSO not a positive result. It's pretty specific, and frequently misinterpretted.A skin sensitiviity (you can even call it an allergy, if you like) is not a reason that disqualifies someone from having PPDs. If it is localized to just the area where the PPD was given, the presence of a hive doesn't mean it should be resulted as positive. It can also change from year to year, based on batch and manufacturer, so a hive one year can mean no hive the next, and so on.If your friend has anything more pervasive, systemic, then obviously she shouldn't do it. But if it's what I've described.....nothing precludes her from taking---and passing---the test (provided the person reading it has a clue!).Nurses --and doctors--who never see a true positive can and do mistake a negative for a positive in this situation.Beyond that, if the situation warrants it, there's no reason she can't have the Quantiferon test. It's more expensive, but OTOH if it's required.....it's required.

Flyersfan88, Thanks for your insights! Of course it's important to rule out TB, but there gotta be a better way to do it without endangering herself with something her body is allergic to or something that is proven to increase chances of getting cancer in a lifetime. That's the point. She has no problems spitting in a cup to check for a TB that way or to get her blood drawn to do any other tests. But getting x-ray exposure, even though small still cumulative, I just don't think it's logical and practical in our age where we are trying as hard as we can to bring overall cancer rates down.

Quote from CelticGoddessI would suggest to your friend that she do some research on x-ray exposure from reputable sources. Yes, the exposure is cumulative but, the amount she gets from a single yearly x-ray would be minimal. Frequent airplane travelers will get more exposure to radiation than she would. (And at my facility, the policy is CXR every 5 years unless exposed). And the previous poster is correct, she is going to come into contact with far worse things as a nurse than the occasional CXR.

Quote from kloneShe's allergic to immunizations? Never heard of such a thing. Most places will not hire someone who is not fully immunized. Most nursing schools will not allow entry into their program if you're not fully immunized. Does your friend have a physician's note exempting her from all immunizations due to "allergy"?