Tuberculosis risk factors in adults in King County, Washington, 1988 through 1990

Objectives. Tuberculosis has become a resurgent public health problem in the United States. Because resources are limited, control programs frequently must target populations at greatest risk. The purpose of the study was to examine risk factors for tuberculosis in adults. Methods. In King County, Washington State, from 1988 through 1990, the characteristics of patients with tuberculosis were compared with census data, and a case-control study was conducted. Self-administered questionnaires were completed by 151 patients with active tuberculosis and 545 control subjects. Results. Infection with the human immunodeficiency virus, non-White race/ethnicity, and foreign birthplace were each associated with a sixfold or greater increase in risk. Each of the following was associated with at least a doubled risk: history of selected underlying medical conditions; low weight for height; low socioeconomic status; and age 70 years or older. Men had 1.9 times the risk of women, smokers of 20 years' or more duration had 2.6 times the risk of nonsmokers, and heavy alcohol consumers had 2.0 times the risk of nondrinkers. Conclusions. Intervention targeting easily identified groups may be an effective way to reduce the incidence of tuberculosis.