LETTER
Respirators and Tuberculosis
Harold L. Israel, MD, MPH
1 January 1995 | Volume 122 Issue 1 | Pages 70-71
TO THE EDITOR:
The illuminating article by Nettleman and colleagues [1] places the cost of particulate respirator use in preventing tuberculosis in Veterans Administration hospital workers at $7 million per case prevented and $100 million per life saved. They assumed a case mortality rate of 7% on the basis of the national 1992 incidence and mortality rate figures. That mortality rate, however, is heavily concentrated in patients with the acquired immunodeficiency syndrome, homeless persons, alcoholic persons, and those born outside the United States. The case mortality rate among cooperative and well-nourished Veterans Administration health care workers should be less than 1%. If the case mortality rate among employees treated for tuberculosis is 1%, the cost per life saved by particulate respirators becomes $660 million. A more productive use of this vast sum can surely be devised by public health authorities.
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Author and Article Information
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Thomas Jefferson University; Philadelphia, PA 19107
1. Nettleman MD, Fredrickson M, Good NL, Hunter SA. Tuberculosis control strategies: the cost of particulate respirators. Ann Intern Med. 1994; 121:37-40.
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