Annual routine chest x-ray examinations have been recommended for many years for tuberculin skin test-positive hospital employees who have not received chemoprophylaxis. To examine the case-finding effectiveness of this policy in a university teaching hospital, employee health records covering an 18-year period were reviewed. Pulmonary tuberculosis was diagnosed in four employees during that time period. None of the patients were identified through the routine annual chest x-ray examination. In the study institution the policy requiring routine annual chest x-ray examinations for tuberculin-positive hospital employees who had not received preventive therapy was rescinded. Currently, the first chest x-ray examination is required at the time of skin test conversion, the second 1 year after conversion, and the third 2 years after conversion. Health teaching and counseling regarding the symptoms of tuberculosis have been initiated for tuberculin-positive hospital employees.
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