[MCOH-EH] Laboratory screening and vaccinations appropriate for hospital contractors (not HCP)

[Grubbs, Scott]

We are trying to come up with a rational approach to screening contractors who come into the hospital – plumbers, electricians, other trades.  Most of them will only be working the hospital for relatively short periods of time.

We are considering the following:

1: Hepatitis B surface antibody titer and offer the first vaccination if not immune

2: Respirator fit test

3: Measles, mumps and rubella:  Titers indicating immunity or proof of two  MMR vaccinations

4: Tuberculosis:  Negative T-spot, or negative Two-step PPD (TST)

5: Varicella: Titer indicating immunity or proof of two varicella vaccinations

6: 10-panel drug screen

Overall, the panel seems defensible.  I am curious if your institution has a similar approach?

(The one question I have at the moment is the need for the Hepatitis B surface antibody testing/vaccination.  Contractors should not be having direct patient contact, so the chance of transmitting/contracting Hepatitis B seems remote.  However, I wonder if Hepatitis B surface antigen would make more sense, because if they get injured, they might bleed and be a source of transmission of Hepatitis B. )

Any thoughts would be welcome.

Scott Grubbs, MD
WorkWell Occupational Health
Greenville, SC





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