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The hepatitis B risk for hospital employees is a function of their own prior experience with this disease and their frequency of exposure to patient blood, plus characteristics of the hospital's patient population, services, and prevention policies. Assessment of the hospital's risk includes consideration of costs associated with employee cases of hepatitis B, employee turnover rates, frequency of exposure incidents, and costs for preexposure and postexposure hepatitis B prevention policies. Benefits occur for both employee and hospital when the risk of hepatitis B transmission is minimized. Each institution must remember that it does not operate in isolation; its policies will be compared to those of other health care organizations. Participation in community efforts to develop local standards is advisable, but administrators should also recognize the possibility of having unique groups of high-risk employees in their own hospital. Analysis of each of the twelve issues will provide hospital decision-makers with information needed to select appropriate hepatitis B prevention strategies for their institution. This information should help in the development of a plan that will balance the costs and benefits of hepatitis B vaccine and, at the same time, protect employees from this occupational health problem.
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