HEPA respirators and tuberculosis in hospital workers

Adal et al. (July 21 issue)1 demonstrate that at the University of Virginia Hospital, where the incidence of tuberculosis is low, the infection controls already instituted may be sufficient and the cost of adding respirators with high-efficiency particulate air filters (HEPA respirators) for their 3852 workers is impressively high. The situation is different at our hospital, Lincoln Medical and Mental Health Center in South Bronx, New York. In contrast to their figure of 11 patients with documented tuberculosis per year, we have over 160 such patients per year, of whom approximately 30 percent have multidrug-resistant tuberculosis