# TB Test Exemption



## KaesMom (Apr 16, 2006)

Hi everyone,
I searched the forums but can't find what I'm looking for.

My daughter is starting a preschool coop and DH and I are required to get a TB test because we will work in the school. DH doesn't mind but I don't want to take the test because I am nursing. I can find the form so that DD doesn't have to get the test but I can't find an exemption for me. All the links I can find aren't working and I searched the Department of Health and can't find it there.

Any ideas? I am going to the doctor's today at 3 (I know - nothing like waiting to the last minute!) and they said they would sign an exemption for me but I can't find one. Help!!

Thanks so much!
Andrea


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## nextcommercial (Nov 8, 2005)

I'm not being snarky..

But, why can't you have a TB test while you are nursing?


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## KaesMom (Apr 16, 2006)

I'm just not that comfortable with it. I did some limited research on it a couple of years ago when DD was tiny and I did not like the chemicals and junk (for lack of a better word) that I would be exposed to and therefore she would be exposed to. According to my doctor and my kids' pediatrician we have no risk factors and I did have a TB test roughly 10 years ago so I feel okay with skipping the test. I just don't know how to do that "officially".


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## Marnica (Oct 4, 2008)

As far as I am aware there are no exemptions for adults. The legal exemption forms that exists are for schools...

I am supposed to have a TB test for work, but I refused (also nursing) and submitted this letter:

Dear Sir or Madam:

I hereby declare that, I withhold my consent on Tuberculosis screening on the grounds that such testing is in violation of my United States of America Constitutional 1st Amendment Right to religious freedom. It would be a violation of my religious beliefs to knowingly contaminate the body with inorganic and/or organic substances that can cause injury, illness, or other harm to human well-being. (Corinthians 6:19-20); (Acts 5:29)

I further assert the following:

·There is no Tuberculosis epidemic in to warrant the mandate of such testing

·There is no Tuberculosis crisis at the to warrant the mandate of such testing

·Symptoms commensurate with Tuberculosis are known to be:

1.Coughing up blood/ Chest infection
2.Severe weight loss
3.Night sweats
4.Constant exhaustion
5.Loss of appetite

I have not exhibited any of these of symptoms. There is no reason to suspect that I may be infected with Tuberculosis. Furthermore testing is suggested for the following populations:

1.Persons with signs (e.g., radiographic abnormality) and/or symptoms (cough, hemoptysis, weight loss, etc.) suggestive of current tuberculosis disease.
2.Recent contacts with known tuberculosis cases or persons suspected of having tuberculosis.
3.Persons with abnormal chest roentgenograms compatible with past tuberculosis.
4.Persons with medical conditions that increase the risk of tuberculosis (silicosis, gastrectomy, diabetes, immunosuppressive therapy, lymphomas, etc.).
5.Groups at high risk of recent infection with M. tuberculosis, such as immigrants from Asia, Africa, Latin America, and Oceania; personnel and long-term residents in some hospitals, nursing homes, and prisons.

I, do not fall into any of these categories.

Furthermore,

·The Tuberculin Purified Protein Derivative (Mantoux skin test) Tubersol is used to find out whether a person is infected with the Tuberculosis germs (or allergic to the test). It cannot tell whether a person has Tuberculosis disease. It is also capable of producing a false positive (which it does with regularity)

·Tubersol contains a human strain of Mycobacterium tuberculosis grown on a protein-free synthetic medium and Phenol, which is carbolic acid. Carbolic acid is a corrosive poisonous crystalline acidic compound C6H5OH present in coal tar and is composed of a substance that is toxic and poisonous to the body.

·Tubersol also contains Tween 80, also known as polysorbate 80, which according to a study can cause anaphylactic reactions, difficulties breathing, and hives. REF: Coors, Esther A, et al "Polysorbate 80 in medical products and nonimmunologic anaphylactoid reactions." Annals of Allergy, Ashtma and Immunology. 95 (2005): 593-599

I also object to this test because I am currently breastfeeding and there are NO KNOWN published studies that demonstrate that tuberculin PPD or the toxic chemicals contained as preservatives listed above do not pass to breastmilk. Also Tubersol has not been evaluated for its carcinogenic or mutagenic potentials for impairment of fertility.

Overall, I am a healthy adult who poses no serious, infectious health threat to others. The only ailments that I have been afflicted with are colds. My overall good health has been confirmed during visits to my primary physician and other healthcare givers.

I have included these assertions to show that not being tested for Tuberculosis, poses no threat to the health and well-being of others here at .

Sincerely,

______________________

Notary Public:

__________________________ _______________________
Signature Date

__________________________ _______________________
City, State My Commission expires


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## KaesMom (Apr 16, 2006)

WOW! Marnica that is a great letter! Thank you so much for sharing.


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## sarahr (Mar 29, 2007)

Quote:


Originally Posted by *KaesMom* 
so I feel okay with skipping the test.

I also don't mean to be snarky, but while *you* might feel okay skipping the test, the other parents -- for whose kids the test offers protection -- might not feel okay. I would certainly want to know for sure that none of the adults to whom my child was being exposed on a regular basis could infect them with TB.

I've looked around, and I can't find anything that suggests that a TB test is contraindicated while nursing.


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## gsd1amommy (Apr 6, 2007)

Your child's school can also refuse to allow you to volunteer.


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## KaesMom (Apr 16, 2006)

Sarahr - thank you for your reply and I understand where you are coming from.

I discussed that with the board of the school and with my doctor. Both seemed to think the risk was very low. I do meet with the other moms from the school weekly and most are of a similar mindset to me and I haven't received any complaints.

But, to be honest, my children must come first. I won't compromise my beliefs for someone else's child. I think this falls along the same lines as not vaccinating. Some parents may feel that by doing so I am putting their children at risk. I do not agree but there is a chance that I am wrong. I would never purposely harm another child but again, my children must be my priority.


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## KaesMom (Apr 16, 2006)

Quote:

Your child's school can also refuse to allow you to volunteer.
Yes, they could. But, they said they had no problem with me not getting a TB test as long as I had a doctor's note. They have had other parents in the past not get the TB test so it wasn't a big deal to them. It is a very small co-op that is parent run. Most (if not all) of the parents are probably considered a bit "alternative" so this isn't really an issue to the school.


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## 4evermom (Feb 3, 2005)

Quote:


Originally Posted by *KaesMom* 
Yes, they could. But, they said they had no problem with me not getting a TB test as long as I had a doctor's note. They have had other parents in the past not get the TB test so it wasn't a big deal to them. It is a very small co-op that is parent run. Most (if not all) of the parents are probably considered a bit "alternative" so this isn't really an issue to the school.

It sounds like you just need to ask your doctor to write a note that says you are at a low risk for tb and that he doesn't feel a tb test is indicated at this time.

It's kind of hard to catch, only if you are exposed to someone with active tb who coughs in your face. And you probably have to be inhaling at the time. My mom had it and neither of her sisters with whom she shared a bathroom cup got it. You don't catch it from touching something infected, the way you catch a cold. So not only are you at low risk of having it, but if you aren't coughing from it, you are at low risk of passing it to someone even if you did have it. I think it is something pretty high like 10% of older adults who do have antibodies (which does NOT mean they have active tb).


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## nextcommercial (Nov 8, 2005)

Quote:


Originally Posted by *KaesMom* 
Yes, they could. But, they said they had no problem with me not getting a TB test as long as I had a doctor's note. .

I would just have the doctor write out a note quickly. I wouldn't go as far as the letter above (which I LOVE) because it might make you look like a difficult parent. Just a simple note that they can keep on file.


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## KaesMom (Apr 16, 2006)

4evermom - thanks for the reply and for the information. I agree that is what I need from my doctor but I am afraid he may not do it. He has told me that I am low risk but I'm not sure if he will put it in writing if you KWIM. That is why I was looking for an exemption form. We shall see what happens this afternoon!


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## KaesMom (Apr 16, 2006)

Quote:

I would just have the doctor write out a note quickly. I wouldn't go as far as the letter above (which I LOVE) because it might make you look like a difficult parent. Just a simple note that they can keep on file.
I think I am going to try this. Thanks!!


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## Shera971 (Nov 26, 2008)

Quote:


Originally Posted by *KaesMom* 
*But, to be honest, my children must come first.* I won't compromise my beliefs for someone else's child. I think this falls along the same lines as not vaccinating. Some parents may feel that by doing so I am putting their children at risk. I do not agree but there is a chance that I am wrong. I would never purposely harm another child but again, my children must be my priority.

And for me, my child comes first. Sorry if that came out snarky but that sort of thinking always gets my back up. Of course your kids come first but at the risk of others just doesn't seem fair. Every child is precious and important to those that love them.

If the test is required in order to volunteer, why not just opt out of volunteering? That way you don't have to compromise your beliefs and the other parents don't have to risk their kid's health (in their opinion).

ETA: I haven't done any research on TB tests. You could be completely fine to volunteer. My post is in the general sense I guess.


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## KaesMom (Apr 16, 2006)

Shera971 - I don't think you are being snarky. I think you are being a concerned parent and I would expect nothing else on this forum.

I can't opt out of volunteering. It is parent run - we are the teachers.


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## Marnica (Oct 4, 2008)

Quote:


Originally Posted by *sarahr* 
I also don't mean to be snarky, but while *you* might feel okay skipping the test, the other parents -- for whose kids the test offers protection -- might not feel okay. I would certainly want to know for sure that none of the adults to whom my child was being exposed on a regular basis could infect them with TB.

I've looked around, and I can't find anything that suggests that a TB test is contraindicated while nursing.


There have been no published studies about the TB test and nursing mothers or at least that I could find and I did a rather exhaustive search. The test itself offers no protection to anyone. It is used to find out whether a person is infected with the Tuberculosis germs. It cannot tell whether a person has Tuberculosis disease. Many people have been exposed to the TB germ but are not ill with TB. . This is why anyone from another country who has been given the BCG will test positive. This doesn't mean they have TB. This is the same reason that people often have antibodies to various diseases, but have never been actively sick with the disease. It is also capable of producing a false positive (which it does with regularity). When there are much better options for testing out there (more accurate, no exposure to chemicals), this test should be obsolete. The better test is much more $$$ which is the only reason it is not routinely used. It is called the Quantiferon Gold test. It is a simple blood test.


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## maryeliz (Oct 27, 2005)

Marnica, Do you know how widely available the TB blood test is? It does seem like the blood test would be the simplest option for anyone who isn't comfortable with the skin test.


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## Cascadian (Jan 28, 2009)

As a parent, I would not feel comfortable with having you volunteer with my kids, sorry. Where I live, there are lots of immigrants from countries that have higher rates of TB, and there is a high rate of TB in the downtown core due to unhealthy and unsafe lifestyles. I would feel better knowing that the adults who are in contact with my kids in the scenario you described, are safe and aren't carriers or infected. It seems selfish to me that you would try to opt out of the test rather than try to opt out of volunteering. Then again, I do put my kids first. This is not meant as a personal affront. I don't know you. Which is why I would want the test.


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## 4evermom (Feb 3, 2005)

Quote:


Originally Posted by *KaesMom* 
4evermom - thanks for the reply and for the information. I agree that is what I need from my doctor but I am afraid he may not do it. He has told me that I am low risk but I'm not sure if he will put it in writing if you KWIM. That is why I was looking for an exemption form. We shall see what happens this afternoon!

It could be that if your dh goes ahead with the test and gets a negative that your doctor will feel even more secure in putting your low risk in writing. Good luck!

I was just looking into TB tests, myself, because it seems like it might be required for ds...


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## 4evermom (Feb 3, 2005)

Quote:


Originally Posted by *Cascadian* 
As a parent, I would not feel comfortable with having you volunteer with my kids, sorry.

But the other parents ARE comfortable in the OP's situation. She's talking about a small parent run co-op, not teaching in a public school.


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## Marnica (Oct 4, 2008)

Quote:


Originally Posted by *maryeliz* 
Marnica, Do you know how widely available the TB blood test is? It does seem like the blood test would be the simplest option for anyone who isn't comfortable with the skin test.

http://www.cdc.gov/tb/publications/f...esting/QFT.htm

Unfortunaelt it is not widely avaliable but you can ask your reg doc about it. Here is a list of labs that do it as well.

http://www.quantiferon.com/contacts_usca.php


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## fairymom (Sep 15, 2008)

Quote:


Originally Posted by *Cascadian* 
As a parent, I would not feel comfortable with having you volunteer with my kids, sorry. Where I live, there are lots of immigrants from countries that have higher rates of TB, and there is a high rate of TB in the downtown core due to unhealthy and unsafe lifestyles. I would feel better knowing that the adults who are in contact with my kids in the scenario you described, are safe and aren't carriers or infected. It seems selfish to me that you would try to opt out of the test rather than try to opt out of volunteering. Then again, I do put my kids first. This is not meant as a personal affront. I don't know you. Which is why I would want the test.


And what about the other kids in the coop? Are they all to be tested for TB too? there may be a child out there that could pass it to others. I'd honestly be a lot more afraid of the other children than the adults- adults knowhow to cover their months/wash hands- KIDS DO NOT and are a lot more likely to pass it to others.

One of my oldest dc had to have the TB test for something- cant remember what- but it was not comfortable at all- I'd never to it to a child again or myself.


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## pinksprklybarefoot (Jan 18, 2007)

I have to be honest, I am confused as to the point of the test. In theory, couldn't you have the test done, then get infected with TB the next week?


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## RunnerDuck (Sep 12, 2003)

Quote:


Originally Posted by *pinksprklybarefoot* 
I have to be honest, I am confused as to the point of the test. In theory, couldn't you have the test done, then get infected with TB the next week?

It is a very strange test/requirement IMO.

Seems like a year or two ago I read they hardly ever catch TB in a kid when they test them for school and yet the tests are required. Total waste of time and resources.

Now if you take the test and are + don't they then have to do a chest x-ray to confirm?

If you were really opposed to the test but wanted to follow the rules anyway couldn't you just have an x-ray? Of course I am sure some people will have issues with x-rays and it might cost a lot to go that route but it might be an option.


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## KaesMom (Apr 16, 2006)

Quote:

And what about the other kids in the coop? Are they all to be tested for TB too? there may be a child out there that could pass it to others. I'd honestly be a lot more afraid of the other children than the adults- adults knowhow to cover their months/wash hands- KIDS DO NOT and are a lot more likely to pass it to others.

One of my oldest dc had to have the TB test for something- cant remember what- but it was not comfortable at all- I'd never to it to a child again or myself.
The kids do not have to take a TB test unless their pediatrician thinks they are high risk.

Sorry everyone - I didn't think this would be a touchy subject. I'm not trying to start a fight - I'm just trying to do what I feel is best. I have no problem with the blood test but it is not available to me. The co-op is parent run and while I haven't talked to every single parent I have discussed this with the board and they did not act like it was a problem. Parents have opted out in the past without incident. I meet with the other parents weekly for playdates and planning and have brought this up in the past. No one seemed concerned that I wasn't planning on taking the test.


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## KaesMom (Apr 16, 2006)

Quote:

If you were really opposed to the test but wanted to follow the rules anyway couldn't you just have an x-ray? Of course I am sure some people will have issues with x-rays and it might cost a lot to go that route but it might be an option.
I don't know - if my doctor won't sign anything then maybe I will ask if he will send me to get an x-ray. But, is an x-ray safe when you are breastfeeding? I've never had to get one so I haven't looked into that yet.


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## Cascadian (Jan 28, 2009)

Quote:


Originally Posted by *fairymom* 
And what about the other kids in the coop? Are they all to be tested for TB too? there may be a child out there that could pass it to others. I'd honestly be a lot more afraid of the other children than the adults- adults knowhow to cover their months/wash hands- KIDS DO NOT and are a lot more likely to pass it to others.

One of my oldest dc had to have the TB test for something- cant remember what- but it was not comfortable at all- I'd never to it to a child again or myself.

Precautionary measures are there for a reason, whether proactively or because of a horrible precedent. Doesn't make me feel good about an organization that lets people cherry-pick their safety measures.

Wha'ever. Not my issue. I personally would not stand for it if it affected me/my kids and would kick up a fuss. But that's obviously not the case here.


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## EVC (Jan 29, 2006)

Quote:

And what about the other kids in the coop? Are they all to be tested for TB too? there may be a child out there that could pass it to others. I'd honestly be a lot more afraid of the other children than the adults- adults knowhow to cover their months/wash hands- KIDS DO NOT and are a lot more likely to pass it to others.
The OP is in California and, if I recall the vax exemption correctly, the TB test is covered there as well. Meaning, even if the school recommended the TB test for kids, anyone could opt out of it based on personal belief, just as they can opt out of vaxes.

(Again, I am going on memory here, so I do not recall the exact wording. Please correct me if I am wrong about this.)

OP, there is also the sputum test for TB, I believe, which is totally non-invasive. Perhaps you could ask your doctor about that?


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## Shahbazin (Aug 3, 2006)

I am in San Diego, & did the Quantiferon Gold (blood draw) test when I was required to take the TB test while pregnant - I had to look high & low for somewhere to get it done though, & I think I finally ended up getting it done at the county health dept.


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## KaesMom (Apr 16, 2006)

Shahbazin - I'm just up the freeway from you.

I went to my doctor's yesterday and he was fine with signing a note. I wrote up a little letter and will send that in with the note and we will see how it goes. I have no problem getting a blood test (or sputom) if I can find someone to administer it. My doctor said he can send me for an x-ray but he didn't know of a lab that offered the blood test. I included that information in my note and now we will just wait and see.

Thanks everyone for all of your insight.


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## Evergreen (Nov 6, 2002)

I would be fine with it too. In fact, where I live TB tests are not required for volunteering in our schools.


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## tracy young (Jul 21, 2009)

there is a blood draw test you can have drawn to check instead of the skin injection.
it is more expensive and you might have to search for a lab that does it, but that way you aren't putting anything into you,
good luck, Tracy


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## emilysmama (Jun 22, 2005)

Quote:


Originally Posted by *KaesMom* 
I don't know - if my doctor won't sign anything then maybe I will ask if he will send me to get an x-ray. But, is an x-ray safe when you are breastfeeding? I've never had to get one so I haven't looked into that yet.

Hello KaesMom,

I can address the x-ray issue. I have a Ph.D. in physics. My dd is no longer breastfeeding, but when she breastfeeding, I had a mammogram, which is an x-ray of the breast. It is perfectly harmless and does not affect the milk or the breasts. No pumping and dumping necessary. My baby latched on as soon as I was done, no hint of hazard to the baby.


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## suabel (May 24, 2005)

Just to chime in here: are you sure you need any sort of injection for a TB test in your state? When I became employed by our public school system last year, I needed a TB test. Because I had no risk factors, for instance, being out of the country in the past XX years, etc. I did not require any needle stick at all, just a note from the nurse indicating my lack of risk. This was performed at a job orientation, btw, by public health nurses, so all of the employees had the same criteria.


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## 4evermom (Feb 3, 2005)

Quote:


Originally Posted by *suabel* 
Just to chime in here: are you sure you need any sort of injection for a TB test in your state? When I became employed by our public school system last year, I needed a TB test. Because I had no risk factors, for instance, being out of the country in the past XX years, etc. I did not require any needle stick at all, just a note from the nurse indicating my lack of risk. This was performed at a job orientation, btw, by public health nurses, so all of the employees had the same criteria.









It could be that what they actually want is a TB risk assessment and are wording things poorly...


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