The futility of universal pre-employment chest radiographs.
In a developmental center, a preemployment chest x-ray was required for all job applicants. We scrutinized the pros and cons of this practice through a review of the medical literature and our experience, and discussion with our colleagues. We concluded that such chest x-ray caused unwarranted radiation exposure, did not produce compliance with the tuberculosis laws, gave a false sense of security regarding workers' compensation risk management, was contrary to established occupational medicine practice guidelines, and was unnecessary and wasteful. We discontinued such chest x-rays. The purpose of the pre-employment examination should remain narrowly job related. Even long-established procedures require periodic utilization review.
Lohiya
Ghan-Shyam
GS
Tan-Figueroa
Lilia
L
Lohiya
Piyush
P
Bui
De
D
D003362:Cost-Benefit Analysis; D019317:Evidence-Based Medicine; D006801:Humans; D008400:Mass Chest X-Ray / Q000009:adverse effects / Q000191:economics; D014376:Tuberculosis / Q000517:prevention & control*; D014481:United States; D014938:Work Capacity Evaluation