To the Editor.—The article by Gottridge et al1 on over utilization of chest roentgenograms in tuberculin reactors may or may not be doing a service for overworked and underfunded hospital employee health services.
We2 and others3 have long held concern about proper use of the chest roentgenogram, but must caution that staff tuberculin testing and roentgenograms are currently the only way to control tuberculosis in a medical institution. The one tuberculin-positive employee who fails to receive a roentgenogram may well be the one who is a nurse in the newborn nursery or a resident in the immunosuppressed ward.
Presumably, the individuals tested and followed by Gottridge et al were healthy and employed (ie, not a very sick population), but the occasional case of active tuberculosis picked up in a skin testing survey still cannot be avoided.
A more important concern, however, is that the authors studied 221
REICHMAN LB. Excessive Roentgenograms and Employee Health. Arch Intern Med. 1990;150(7):1542-1546. doi:10.1001/archinte.1990.00390190174033