Background We used workers' compensation data to identify health care workers at risk of tuberculosis exposure in the hospital and nonhospital environment. Methods We identified State Fund workers' compensation claims having a documented tuberculin skin test (TST) conversion (size =10 mm) with a previous negative skin test between 1996 and 2000 in the State of Washington. Results Health care workers experienced an overall accepted workers' compensation claim rate of 2.3 claims/10,000 full-time equivalent employees (FTEs) per year for tuberculin reactivity. Receptionists accounted for the largest number, with 18.4% tuberculin reactivity claims. The number of tuberculin reactivity claims was the highest for offices and clinics of doctors of medicine (3.7 per 10,000 FTEs), followed by medical laboratories (2.6 per 10,000 FTEs).