5021.0: Wednesday, November 15, 2000 - Board 4

Abstract #8469

Assessing the immune status of health care workers at a California HMO: Implications for disease prevention and control

Rishi T. Dholakia, MPH1, Evra S. Smith, RN, BSN2, Robert L. Veninga, PhD3, and A. Marshall McBean, MD, MSc3. (1) University of Minnesota, Minneapolis, 18756 South Jeffrey Avenue, Cerritos, CA 90703, 562-402-1535, jus2smiley@aol.com, (2) Department of Epidemiology and Employee Health, Kaiser Permanente Medical Center, (3) School of Public Health, Division of Health Services Research and Policy, University of Minnesota, Minneapolis

Objective: This study assessed pre-placement healthcare workers’ (HCW) immunity to vaccine-preventable diseases (VPDs) (measles, mumps, rubella and varicella) and hepatitis B (HB), and tuberculin skin-test (TST) results at a California HMO. A risk profile illustrates age and ethnicity differences. Implications for disease prevention, health administration and education are discussed. Methods: Chi-square tests were applied to relationships between ethnicity or age and (a) TST results, (b) requirement for VPD-immunizations and (c) HB variables. Results: Of the 715 HCWs completing health screening, 26% were non-immune to one or more VPD. 28.7% were reactive to the TST and 25.3% of those non-immune to HB accepted vaccination. Chi-square tests were statistically significant for: reactive TST and age (p<.05) and ethnicity (p<.01); non-immunity to VPDs and age (p<.01) and ethnicity (p<.01); and acceptance of HB vaccine and ethnicity (p<.01) A chi-square applied to the relationship between ethnicity and (a) HB immunity, (b) declining HB vaccination and (c) accepting HB booster was statistically nonsignificant. Discussion: HCWs with reactive TSTs were predominantly Asian and most likely to be in the 40-49 year age group. Black and Hispanic HCWs and those aged 20-29 years primarily needed VPD-immunizations. Hispanic HCWs were most likely to accept HB vaccination. Conclusions: Risk profiling facilitates planning for resource/budget allocation and education of HCWs and the community. Screening for VPDs and tuberculosis via the TST should be included in pre-employment health screening programs for prevention and control of communicable diseases. Community based prevention programs should target statistically significant groups identified.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. Recognize the importance of developing age- and ethnicity-specific prevention and intervention programs for health care workers for vaccine preventable diseases, tuberculosis, and hepatitis B. 2. Articulate the importance of allocating sufficient resources for accurate and complete surveillance of immunity to vaccine preventable diseases among Black and Hispanic health care workers and those aged 20-29 years. 3. Identify the importance of continued pre-employment health screening of health care workers for disease prevention

Keywords: Immunizations, Health Care Workers

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA