Employee TB Testing Requirements
If you are managing hiring for a school, childcare center, healthcare facility, or other organization in California, understanding tuberculosis (TB) testing requirements is essential. TB testing protects employees, students, patients, and the public — and it’s often a legal obligation. This guide will walk you through who needs a TB test, what the process involves, and how WellnessMart can make compliance easy.
Who is Required to Get a TB Test in California?
California law requires certain employees to undergo TB testing before they start work. These include:
- Teachers and instructional staff at public and private K-12 schools
- Daycare and childcare facility employees
- Healthcare workers, including hospital and clinic staff
- Employees at public colleges, universities, and community colleges
Some private institutions may also require TB testing as a condition of employment, even if not explicitly mandated by the state.
According to the California Education Code (Section 49406), all newly hired public school employees must show proof of being free from active tuberculosis prior to starting work.
What Does a TB Test Involve?
TB screening generally falls into one of two categories:
- Tuberculin Skin Test (TST)
Also called the Mantoux test, this method involves injecting a small amount of purified protein derivative (PPD) under the skin of the forearm. The employee must return within 48 to 72 hours for the healthcare provider to check for a reaction. - TB Blood Test (IGRA Test)
A blood test, known as an Interferon-Gamma Release Assay (IGRA), measures how the immune system reacts to TB bacteria.
The most commonly used blood test is the QuantiFERON®-TB Gold Plus (QFT-Plus) test.
What is the QuantiFERON-TB Gold Plus Test?
The QuantiFERON-TB Gold Plus (QFT-Plus) is an advanced blood test used to detect TB infection.
It offers several advantages:
- One visit only: Unlike the skin test, there’s no need to return for a reading.
- Greater accuracy: Especially useful for individuals who have received the BCG vaccine (common outside the U.S.), reducing false positives.
- Fast turnaround: Most results are available within 1–2 business days.
- High sensitivity and specificity: Making it an excellent choice for employment TB screening in California.
At WellnessMart, we provide QuantiFERON-TB Gold Plus testing at all our locations for your convenience.
What Happens If an Employee Tests Positive?
- Positive skin or blood test: The employee must undergo a chest X-ray to determine whether they have active TB disease or latent TB infection (LTBI).
- Active TB disease: Must be treated and medically cleared before the employee can start working.
- Latent TB infection: Employees with LTBI may still be eligible to work after evaluation and documentation by a healthcare provider, depending on employer policies.
How Often is TB Testing Required?
California requires:
- Initial Testing: Completed prior to the start of employment.
- Follow-up Screening: A TB risk assessment must be completed every four years. Retesting is only necessary if the risk assessment identifies continued risk.
Healthcare workers and other high-risk employees may require annual TB testing or additional medical evaluation.
Why is TB Testing Important?
Tuberculosis can spread easily in environments where people are in close contact for extended periods. Even though TB is less common in the United States today, outbreaks still occur — especially in schools, daycare centers, and healthcare facilities.
Benefits of employee TB testing include:
- Protecting students, patients, coworkers, and the community
- Ensuring compliance with California Education Code and Public Health regulations
- Reducing liability and promoting a safe workplace environment
TB Testing Methods Comparison: Skin Test vs. QuantiFERON Blood Test
| Feature | Skin Test (TST) | QuantiFERON Blood Test (IGRA) |
| Number of visits | Two (test and read result) | One |
| Speed of results | 2–3 days | 1–2 days |
| BCG vaccine interference | More likely | Less likely |
| Cost | Typically lower | Slightly higher, but more reliable |
| Suitable for: | General screening | Healthcare, international employees, schools |
For most employers, using the QuantiFERON blood test reduces follow-up issues, missed appointments, and incorrect readings.
How Long Should TB Test Records Be Kept?
Employee TB test documentation should be securely stored for at least three years after employment ends. These records should include:
- Initial clearance documentation
- Risk assessment forms
- Chest X-ray reports if applicable
- Follow-up evaluation and treatment records (if needed)
Proper recordkeeping ensures readiness for audits and protects against future liability.
How WellnessMart Can Help With TB Testing
At WellnessMart, we specialize in fast, reliable TB testing tailored for California employers. Our services include:
- QuantiFERON-TB Gold Plus blood testing at over 50 convenient locations
- Traditional Tuberculin Skin Testing (TST)
- Same-day appointments and quick results
- Employer accounts with no out-of-pocket costs for applicants
- Easy online scheduling and consolidated billing for groups
We help make TB testing compliance simple, fast, and affordable — allowing you to focus on hiring and onboarding with confidence.
✅ Schedule your employees’ TB tests today at wellnessmart.com.
Conclusion
TB testing is a critical step in protecting your workplace and complying with California health regulations. Whether you choose a traditional skin test or a faster, more reliable QuantiFERON-TB Gold Plus blood test, WellnessMart has you covered.
Ensure the health of your employees and the safety of your organization with professional, hassle-free TB screening services from WellnessMart.
