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A study was made to document and evaluate effective technologies for the control of potential health hazards at the Community East Hospital (SIC-8062), Indianapolis, Indiana. Specific attention was devoted to the negative pressure rooms and the risk of nosocomial transmission of tuberculosis to health care workers and patients. Several factors affected the integrity of the system in addition to ventilation flow rates. One of these was the airtightness of the isolation room as affected by opening of room doors and windows, construction joints, cracks, and the degradation of airtight seals over the passage of time. Three negative pressure rooms were examined. In one room, 100% outside air (OA) was supplied to the isolation room via two induction units. Exhaust was provided from the anteroom directly to the outdoors. A second isolation room could be used either as a positive or negative pressure room. The difference in pressure was neutral. Another room was supplied with 100% OA through a HEPA filter and reheat box. Air was exhausted directly to the outdoors through two grills. At least 6 air changes per hour were provided by two of the rooms.