The full content of Annals is available to subscribers

Subscribe/Learn More  >
Academia and the Profession |

Tuberculosis Control Strategies: The Cost of Particulate Respirators

Mary D. Nettleman, MD, MS; Mary Fredrickson, RN; Natalie L. Good, MHA; and S. Ann Hunter, MA, BSN
[+] Article, Author, and Disclosure Information

From the Iowa City Veterans Affairs Medical Center and the University of Iowa College of Medicine, Iowa City, Iowa. Requests for Reprints: Mary D. Nettleman, MD, MS, University of Iowa College of Medicine, 200 Hawkins Drive C 42 GH, Iowa City, IA 52242. Acknowledgments: The authors thank Kristi Martin and Kasey Ferguson for their assistance in distribution of the questionnaire and telephone follow-up. The authors also acknowledge the assistance of the facilities that participated in the survey.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1994;121(1):37-40. doi:10.7326/0003-4819-121-1-199407010-00007
Text Size: A A A

Objective: To assess the cost of the mandatory use of high-efficiency particulate respirators to treat patients with known or suspected tuberculosis.

Design: A questionnaire was used to determine the number of high-efficiency particulate respirators required and the number of cases of tuberculosis in employees that could potentially be prevented. Indirect costs included the training and fitness testing of employees. The clinical efficacy of respirators is not known. To provide a best-case scenario, it was assumed that the respirators could prevent as many as 25% of tuberculosis cases in health care workers.

Setting: 159 acute care facilities administered by the Department of Veterans Affairs.

Participants: Quality improvement, infection control, and employee health specialists.

Measurements: Cost of the respirators compared with their maximum predicted efficacy.

Results: The use of the respirators would cost $7 million per case of tuberculosis prevented and $100 million per life saved.

Conclusions: High-efficiency particulate respirators are a costly means of trying to prevent tuberculosis. Costs could be reduced by reusing masks or by restricting the number of health care workers allowed to have contact with potentially infectious patients. As the health care budget undergoes further restrictions, specific means of accommodating the cost of new regulations must be found.


Grahic Jump Location
Figure 1.
Percentage of employees receiving annual purified protein derivative skin tests at each facility (149 facilities providing data).
Grahic Jump Location




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.