All About TB Testing

 If you volunteer in a hospital, long term care facility or private retirement residence around seniors then this may be old hat for you.  However, my first exposure was in a conversation with a Life Enrichment Manager at Chartwell Robert Speck.

URGENT ADDENDUM** (as of May 5, ,2023...Scroll to the bottom)

While explaining to her our program and the benefits of the excursions on the mental health of their residents, she nonchalantly mentioned that their volunteers needed to get tested for TB.  Having experienced the rigmarole of having got my Level 3 Vulnerable Sector Police clearance certificate after having to submit my fingerprints since my gender and birthdate matched an offender, I was prepared... which is an understatement.

As I had not heard of this requirement from any other home I was negotiating with (until more recently when discussing with the Activities Manager at Evergreen Verve), I went online and found the volunteer requirements for Chartwell Volunteers plainly stated on the website (depending on residence... of which there are 6 in Mississauga!).  Investigating further, I found that if there was not a medical reason for the testing, the cost would need to be borne by the volunteer.  Later I found out that Verve has a similar policy but Parkland on the Glen said that we would be considered an outside contractor and the pilots, who are volunteers of our program, are not directly volunteering for their Residence and thus would not fall under the requirements of mandatory TB testing.  The testing is specific to Peel Region as cases of tuberculosis in the community have been rising through COVID.

Delving deeper into the cost of this testing created more questions than answers.  The Gold Standard of testing is a process called 2 Step Tuberculin Skin Testing which involves 4 visits to a doctor.  The first two are to get injected with Tuberculin serum and reading the test 48-72h later.  If this is negative, the second test is conducted similarly a week to 4 weeks later and preferably within 3 months.  This is done to detect latent infections that are stimulated by the first test.  The second test is unnecessary for anyone who has previously had the 2 Step TST.  The 1 Step test should be repeated annually or as required by the volunteer organization.  Please note that this test does not confer immunity against tuberculosis and can sometimes be complicated by BCG vaccines.

This test is done through any doctor's office at a cost of $40 to $70.  Some mention that the serum needs to be purchased at a pharmacy and they will use it to conduct the test.  I called my own doctor's office to enquire on their costs and have not yet received a reply 3 days later.  

AppleTree Medical clinics have their prices online for $40 per Step including result reporting but not signing of any specific forms and only offer it on a walk-in basis.  Unfortunately reading some of their reviews, wait times appear to be significant for these non-essential services.  We may be able to skip the line and get a discount for the second Step by using Dr. Pinto at 545 Steeles Ave. W. Brampton.  You will need to register at the kiosk in their office with your Health Card and inform the nurse that you are there to see Dr. Pinto ONLY for a TB Test as part of Dr. Saldanha's volunteer cycling group. He is available 12:00n - 9:00p on Monday, Wednesday and Friday; 1:00p - 9:00p on Thursday and 9:00a -5:00p on Saturday. Payment ($40+HST) is due via Credit or Debit card only, NO CASH.

Some pharmacies also provide the testing service.  IDA pricing online indicates that they charge $40 for the 1st Step and $10 for the 2nd in Sault St. Marie but I couldn't verify Mississauga availability.  Shopper's Drug Mart also advertises TB Testing through their Wellness Clinics but no pricing is available.  Summit Health Travel and Vaccination clinic in Etobicoke offer the test for $115 per Step ($75 for initial visit with injection and $40 for followup reading).

DynaCare and LifeLabs offer a QuantiFERON-TB blood test for tuberculosis which they say is not affected by the possible reaction to BCG vaccines many of us have received as children. LifeLab charges $95 for the test, payable online via their site.  Dynacare doesn't mention the cost of their test online.  Neither offer the new TSPOT.TB blood test.

At this point I know that Chartwell Robert Speck requires the 2 Step TST for all their volunteers.  I also found out that Verve Senior Living (Evergreen Retirement Residence, Credit River Retirement Residence, Shores of Port Credit Residences and Port Credit Residence - where we are storing our trishaw ) all need TB testing for their volunteers.  So it appears that it would be prudent to get your TB test updated or get the 2 Step TST to increase the chances of you being successful with our program.

So as you can see, there is much more to TB testing than meets the eye!

ADDENDUM:  I received an email from the Lifestyle & Programs Manager at Chartwell Robert Speck informing me of a recent change to the TB testing requirements.  Unless a volunteer is working over 250 hours per year in contact with the seniors (ie. inside the retirement home) TB testing is unnecessary.  This will come as welcome news to all of you who have been concerned about this new requirement.  Thank you for your patience and understanding as I worked to resolve this.