TUBERCULOSIS-CONTROL STRATEGIES - THE COST OF PARTICULATE RESPIRATORS

Objective: To assess the cost of the mandatory use of high-efficiency particulate respirators to treat patients with known or suspected tube rculosis. Design: A questionnaire was used to determine the number of high-efficiency particulate respirators required and the number of cas es of tuberculosis in employees that could potentially be prevented. I ndirect costs included the training and fitness testing of employees. The clinical efficacy of respirators is not known, To provide a best-c ase scenario, it was assumed that the respirators could prevent as man y as 25% of tuberculosis cases in health care workers. Setting: 159 ac ute care facilities administered by the Department of Veterans Affairs . Participants: Quality improvement, infection control, and employee h ealth 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 mil lion per life saved. Conclusions: High-efficiency particulate respirat ors are a costly means of trying to prevent tuberculosis. Costs could be reduced by reusing masks or by restricting the number of health car e workers allowed to have contact with potentially infectious patients . As the health care budget undergoes further restrictions, specific m eans of accommodating the cost of new regulations must be found.