IMPACT OF THE BLOODBORNE PATHOGENS STANDARD ON VACCINATION OF HEALTH-CARE WORKERS WITH HEPATITIS-B VACCINE

OBJECTIVES: To evaluate the impact of Occupational Safety and Health A dministration (OSHA) regulations on the vaccination of healthcare work ers (HCWs), to assess interpretation of these regulations, and to eval uate changes in hospital vaccination policies. DESIGN: Between June 1, 1992, and August 15, 1992, a telephone survey was conducted among 150 hospitals selected randomly from participants in the American Hospita l Association 1991 annual survey. RESULTS: Of the 150 hospitals, 96 (6 4%) provided information on hepatitis B vaccination coverage of their employees. Of the 103,419 employees in these hospitals, 77,302 (75%) w ere eligible to receive the hepatitis B vaccine, and 38,850 (51%) of t hese were vaccinated completely (had received 3 doses of vaccine). Pol l owing issuance of the final regulations, 73% of hospitals reported g reater employee acceptance of hepatitis B vaccine, and hospitals were more likely to offer hepatitis B vaccine to maintenance workers, secur ity personnel, dietary staff and clerical personnel. Seventy-five hosp itals (50%) reported conducting postvaccination serologic testing on a ll hospital employees, 12 (8%) as a result of OSHA regulations. Twenty -three hospitals (16%) reported administering routine booster doses of hepatitis B vaccine at 3, 5, or 7 years. CONCLUSIONS: The new OSHA st andard resulted in a greater awareness of risk for HBV infection among HCWs and an increase in the number of HCWs receiving hepatitis B vacc ine; however, vaccination coverage remained suboptimal. Postvaccinatio n serologic testing of employees with negligible risk and the routine administration of vaccine booster doses may be diverting resources and preventing comprehensive coverage of high-risk employees.