Tuberculosis (TB) Test for Employment

A TB test for a job lasts as long as employer and state rules allow; 2023 CDC guidance sets no expiry. CDC guidance from 2023 tells health care facilities to follow their state TB regulations. A skin test documented in the last 12 months can count as the first step of a two-step test². Under 2024 CDC guidance, a person with a documented positive blood test is not tested again⁶.

The full rules on how long a result stays good are set out separately. The guide to how long a TB test is good for covers work, school and immigration.

A TB test for a job is a skin or blood test that shows TB infection before you start work. For health care workers, CDC guidance from 2019 pairs it with a risk assessment and a symptom check. Under 2025 CDC guidance, a skin test places 0.1 mL of tuberculin under the skin of the inner forearm⁵. A trained provider reads it 48 to 72 hours later⁵. A blood test mixes a blood sample with TB proteins and measures the immune response, under 2024 CDC guidance⁶. A positive result is followed by a chest X-ray to rule out active TB, as the tuberculosis (TB) test guide explains⁴.

Employers require a TB test because TB spreads through shared air, and a test at hire finds infection before work starts. The first test also sets a baseline, so a later positive result can show a new infection. Under 2025 CDC guidance, TB germs spread when a person with active TB of the lungs or throat coughs, speaks or sings. By a 2025 CDC estimate, about 80% of US TB cases come from latent infection that was never treated⁹. Treatment of latent TB is 90% effective at preventing TB disease⁹. A test at hire can find tuberculosis (TB) infection before it turns into active disease.

Health care jobs are the ones 2019 CDC guidance covers, with TB testing at hire. CDC guidance from 2025 lists hospital, shelter, prison and nursing home workers among people at higher risk of exposure. The 2005 CDC guideline counts all paid and unpaid health care staff, including students, volunteers and contract workers⁷. Its settings include clinics, dental offices, home care, nursing homes and homeless shelters⁷. For other jobs, the rules come from states and employers, and testing for healthcare workers has the full health care detail.

Either a TB blood test or a skin test is accepted for health care workers at hire, under CDC guidance from 2019. A blood test needs one visit, while a skin test needs two: one to place it and one to read it. Past BCG vaccination does not affect a blood test, so CDC guidance from 2025 prefers it for people who had BCG. Under 2024 CDC guidance, a blood test may cost more than a skin test⁶. The comparison of PPD or QuantiFERON weighs the two tests side by side.

Some jobs ask for a two-step TB test because one skin test alone sometimes misses an old infection. A second skin test follows 1 to 3 weeks after the first one is read, under 2023 CDC guidance. If the second test is positive, it is a boosted reaction to an infection from long ago². The worker is then treated as infected and checked for TB disease². The two-step tuberculosis (TB) skin test page walks through each step.

You get a TB test for a job at the health department, your doctor or a clinic that offers TB testing. Ask your employer first which test it accepts and whether it pays. If you choose a skin test, plan a second visit to have it read. Under 2025 CDC guidance, a skin test not read within 72 hours has to be placed again⁵. CDC guidance from 2024 says to contact your state or local TB program about testing⁴. The page on where to get a tuberculosis (TB) test lists the options.

A TB test form for employment records the test, its date and its result. For a skin test the result is written in millimeters of firm swelling, not only as positive or negative. Under 2025 CDC guidance, a trained provider places and reads the skin test⁵. Minnesota health department guidance from 2026 has the reader write the exact millimeters, or 0 if there is no firm swelling. Keep a written copy of any positive result, as CDC advised in 2025, since later tests can stay positive⁵. Blank forms and what each line means are on the TB test form page.

No, you cannot refuse a required TB test where your employer or state makes it a condition of the job. CDC guidance from 2019 starts with a risk assessment, and for health care workers a baseline test is part of it. Under 2025 CDC guidance, anyone with a severe reaction to a past skin test should not get another⁵. Under 2019 CDC guidance, a worker with a documented positive result is not tested again and gets a symptom check instead¹. Your answers on the tuberculosis risk assessment shape what testing follows.

No, health care workers do not need a TB test every year under CDC guidance from 2019. Routine yearly testing is not recommended unless there is a known exposure or ongoing spread in the workplace. Every worker still gets TB education each year¹. A worker exposed on the job who tests negative is tested once more, 8 to 10 weeks after the last contact¹. Under 2023 CDC guidance, workers who keep untreated latent TB answer a symptom check once a year instead of retesting³. State rules can still ask for yearly tests. California skilled nursing facilities, for example, include a TB test in the annual health exam under Title 22, section 72535. The guide to how often you need a tuberculosis test covers other groups.

These short answers cover positive results, whether every job needs a test, and school staff.