How often can an employer require a nurse to get a chest X-ray to rule out TB?

By | 2022-02-18T14:31:47-05:00 August 31st, 2012|4 Comments


Dear Nancy,

Last summer I chose to work as a travel nurse. Because I have had positive PPD reactions in the past, I was required to submit a current chest X-ray to show I’m free of tuberculosis. Because I had not had one done in approximately seven years, I was not concerned about providing this. (I did undergo six months of prophylactic isoniazid therapy at the start of nursing school at the advice of my primary care provider.)

Now, six months later at another hospital, I am required to have a clear chest X-ray done within 90 days of my new assignment. How often can my employer require chest X-rays, which are not without risk? While at my last permanent hospital, I was not required to have even annual chest X-rays; I simply had to fill out a form that checked for symptoms. I don’t wish to overexpose myself to radiation.


Nancy Brent replies:

Dear Jennifer,

Employers are concerned not only about the health and safety of patients who seek treatment in their facilities, but also about the health and safety of their healthcare workers. Healthcare staff posing a risk to patients because of their own illnesses or conditions, such as TB, is a legitimate concern. The employer must ensure a staff member does not have an active case of TB and until that is established, the staff member cannot work until he or she no longer is contagious.

In regard to your concern about being exposed to another chest X-ray, only your physician can advise you about that risk. He or she also may have information as to other options to determine if you are not contagious or do not currently have an active case of TB. You can get some preliminary information about TB and healthcare workers on the following websites: the Centers for Disease Control and Prevention (, the Occupational Safety and Health Administration ( and the National Institute of Occupational Safety and Health ( Type something like “Mandatory chest X-rays for health care workers to rule out active TB” in the search bar.



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  1. Avatar
    Sheba December 5, 2018 at 9:46 pm - Reply

    That’s defly didn’t answer the question. It was every 3 years an employee with a prior POS result. I was searching Google to confirm if that time as in fact been increased to five years. However employers don’t decide in my State. The State Dept of Health does.

  2. Avatar
    Jaime Frand August 18, 2020 at 6:29 pm - Reply

    I spoke with the CDC and they told me there is no requirement to get another chest xray if it showed negative. You just need to have a questionnaire done signed by doctor stating you are cleared for work and asymptomatic. Do not take my word for it, just call the cdc and they will tell you the same thing.

  3. Avatar
    Hans June 25, 2021 at 8:03 am - Reply


    We understand the risk TB post to an individual. You definitely failed to answer the question asked.

  4. Avatar
    Russell October 1, 2021 at 3:44 pm - Reply

    Why would someone (especially a fertile female) need to have yet another chest radiograph for an asymptomatic + PPD?

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