Current tuberculosis screening practices.

Health department officials in all 50 states and 14 major cities responded to a survey questionnaire designed to obtain information about current tuberculosis screening practices. Persons being screened fell into the groups designated as high risk by the American Thoracic Society (ATS) and the Centers for Disease Control (CDC). The methods used for screening were generally those advocated by ATS, CDC, and the Food and Drug Administration (FDA), although chest radiographs continue to be overused. Screening in about one-half of the groups is mandated by law or regulation. There appears to be some confusion about the circumstances in which "two-step" tuberculin testing should be used. Data on the productivity and costs of screening activities were very limited. We encourage those responsible for tuberculosis screening programs to evaluate them, discontinue those which are unproductive, and intensify those which are productive.