Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-30T21:35:39.862Z Has data issue: false hasContentIssue false

Hepatitis B Vaccination of Personnel Employed in Victorian Hospitals: Are Those at Risk Adequately Protected?

Published online by Cambridge University Press:  02 January 2015

Sandra C. Thompson*
Affiliation:
Macfarlane Burnet Center for Medical Research, Melbourne, Victoria, Australia
Maureen Norris
Affiliation:
Macfarlane Burnet Center for Medical Research, Melbourne, Victoria, Australia
*
Population Health Unit, Territory Health Services, PO Box 721, Alice Springs, NT 0871, Australia

Abstract

Objective:

To examine the policies and practices in hospitals within the state of Victoria, Australia, with respect to vaccination of staff against hepatitis B infection.

Design:

A written self-administered questionnaire to be completed by the infection control officer (or designated officer for hepatitis B vaccination) within each hospital.

Setting:

Public (teaching and nonteaching) and private hospitals, including metropolitan and rural institutions in Victoria.

Participants:

A random sample of 30% of Victorian hospitals were asked to participate in the survey. Of 78 eligible institutions, 69 (88%) completed and returned questionnaires.

Results:

There was no consistent hepatitis B prevention policy in place across Victoria. Of the 69 responding hospitals, 63 (91%) offered hepatitis B vaccination to staff, and 58 (84%) of these also paid all costs of vaccination. Of the 63 hospitals offering vaccination to staff, 39 offered vaccination to all staff, 23 offered vaccination based on job title, and one offered vaccination based on anticipated exposure. In many institutions, postexposure protocols were recalled more readily than preexposure vaccination guidelines. Numerous respondents indicated a need for clear guidelines on policy and clarification on practical matters of management, such as acceptable immune levels, management of nonresponders to the primary series, and the need for, and timing of, booster doses of vaccine. Eleven (18%) of the 63 hospitals offering hepatitis B vaccination to staff undertook routine prevaccination screening, a practice not generally regarded as cost-effective in Australia. Fifty-five of these hospitals (91%) also undertook postvaccination screening.

Conclusions:

It is evident from this study that a considerable number of potentially susceptible healthcare personnel in Victorian hospitals remain unprotected against hepatitis B infection. A more reliable and consistent approach to preexposure hepatitis B vaccination is recommended

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. West, DJ. The risk of hepatitis B infection among health professionals in the United States: a review. Am J Med Sci 1984;287:2633.Google Scholar
2. Polakoff, S. Acute hepatitis B in patients in Britain related to previous operations and dental treatment. BMJ 1986;293:3336.Google Scholar
3. Hadler, SC. Hepatitis B infection and health care workers. Vaccine 1990;8(suppl):S2428.Google Scholar
4. Pattison, CP, Maynard, JE, Berquist, KR, Webster, HM. Epidemiology of hepatitis B in hospital personnel. Am J Epidemiol 1975;101:5964.CrossRefGoogle ScholarPubMed
5. Dienstag, JL, Ryan, DM. Occupational exposure to hepatitis B in hospital personnel: infection or immunisation? Am J Epidemiol 1982;115:2639.Google Scholar
6. Hadler, SC, Doto, IL, Maynard, JE, Smith, J, Clark, B, Mosley, J, et al. Occupational risk of hepatitis B infection in hospital workers. Infect Control 1985;6:2431.CrossRefGoogle ScholarPubMed
7. Whelan, G, Breen, KJ, Fry, C. Prevalence of hepatitis B in a general hospital: screening of patients and staff. Med JAust 1979;2:220221.Google Scholar
8. Radvan, GH, Allworth, AM, Hardy, GL, Keller, AJ. Hepatitis B markers in health care workers. The Newcastle study. Med JAust 1984;140:583585.Google ScholarPubMed
9. Welch, J, Webster, M, Tilzey, AJ, Noah, N, Banatvala, JE. Hepatitis B infections after gynaecological surgery. Lancet 1989;1:205207.Google Scholar
10. Heptonstall, J. Outbreaks of hepatitis B virus infection associated with infected surgical staff. Commun Dis Rep 1991;1:R81R85.Google ScholarPubMed
11. Lettau, LA, Smith, JD, Williams, D, Lundquist, WD, Cruz, F, Sikes, RK, et al. Transmission of hepatitis B with resultant restriction of surgical practice. JAMA 1986;255:934937.Google Scholar
12. Shaw, FE, Barrett, CL, Hamm, R, Peare, RB, Coleman, PJ, Hadler, SC, et al. Lethal outbreak of hepatitis Bina dental practice. JAMA 1986;2:32603264.CrossRefGoogle Scholar
13. Harpaz, R, Von Seidlein, L, Averhoff, FM, Tormey, MP, Sinha, SD, Kotsopoulou, K, et al. Transmission of hepatitis B to multiple patients from a surgeon without evidence of inadequate infection control. N Engl JMed 1996;334:549554.Google Scholar
14. Centers for Disease Control. Guidelines for prevention of transmission of human immunodeficiency virus and hepatitis B to health care workers and public-safety officers. MMWR 1989;38(no. S6):137.Google Scholar
15. McDonald, MA, Elford, J, Kaldor, JM. Reporting of occupational exposures to blood-borne pathogens in Australian teaching hospitals. Med J Aust 1995;163:121123.CrossRefGoogle Scholar
16. deVries, B, Cossart, YE. Needlestick injury in medical students. Med J Aust 1994;160:398400.Google ScholarPubMed
17. Lanphear, BP, Linnemann, CC Jr, Cannon, CG, De Ronde, MM. Decline of clinical hepatitis B in workers at a general hospital: relation to increasing vaccine-induced immunity. Clin Infect Dis 1993;16:1014.Google Scholar
18. Hansen, JP, Falconer, JA, Hamilton, JD, Herpok, FJ. Hepatitis B in a medical center. J Occup Med 1981;23:338342.CrossRefGoogle Scholar
19. Schneider, WJ. Hepatitis, B: an occupational hazard of health care facilities. J Occup Med 1979;21:807810.Google Scholar