Most Hawaii residents will no longer be required to get a tuberculosis skin test when starting a new job or school.

Beginning Monday, the state Health Department said it will follow new screening procedures recommended by the U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics to streamline testing.

Tuberculosis, or TB, is a contagious disease that mainly affects the lungs and can be spread through coughing and sneezing.

TB skin tests typically involve the injection of antigens on the inner forearm and require a follow-up exam to check for swelling or a raised bump in the area in 48 to 72 hours. If there is a reaction, doctors typically order a chest x-ray and take samples of phlegm coughed up from the respiratory tract to diagnose the disease. Infectious disease specialists will often put patients on medicine for months to prevent the infection.

Under the new rules, patients will be asked a set of questions — including whether they traveled abroad for four weeks or more to countries where TB is prevalent — to assess their risk of contracting TB. If patients have no symptoms and are deemed low risk, health providers will be able to clear them the same day. The new rule doesn’t apply to health care workers, who must obtain an annual TB test.

“The screening procedures we established 12 years ago have been updated with better, proven procedures to more accurately determine someone’s risk of exposure to TB,” Dr. Elizabeth MacNeill, TB Control Branch chief, said in a news release, adding that the new process will help providers do a better job of screening for TB. “This allows us to make better use of health resources and reduce unnecessary x-rays for those who have no risk. It also allows us to focus on providing treatment for those who would really benefit from treatment.”

Not everyone agrees the new process will help prevent the spread of TB in the community.

“They should still do it because it’s important. I’ve known people who’ve had TB before,” said Makiki resident Ramesse Ming, who previously worked in the restaurant industry. “This is a tourist destination. As far as Hawaii is concerned, people are always traveling here, possibly bringing potential diseases.”

The new guidelines also allow patients to choose to take a blood test instead of the TB skin test. Patients should check if blood tests are covered by health insurance plans and should note that the blood test is not approved for children under age 5.

The Department of Health said it will continue offering free TB skin tests at designated locations statewide. For more information, go to health.hawaii.gov/tb/ or call 832-5731.