Hepatitis B prevention in small rural hospitals.

A retrospective study of 246 potential hepatitis B exposure incidents in 12 rural hospitals in Arizona over a two-year period revealed a rate of 6.3 incidents per 100 employees per year. Needle punctures accounted for 68% of the incidents; 17% were cuts from instruments or broken glassware. Although 51% occurred in nursing personnel, housekeepers accounted for a surprising 19.5% of the reports. Only 50% of the employees received any medical attention following incidents. None received hepatitis B immune globulin (HBIG); seven received immune globulin (IG). The mean cost to the hospitals for the 122 incidents where treatment was given was $64.50 per incident. In all, 10 hospitals had no written policy for hepatitis B prevention, 3 did not stock IG and 11 did not stock HBIG. There was little awareness of hepatitis B as a nosocomial problem within these institutions, perhaps because no reported cases of clinical hepatitis B occurred in employees of the 12 hospitals in the two years.