Thank you, this is very helpful! Tim

From: MCOH-EH <mcoh-eh-bounces@mylist.net> On Behalf Of Reneau, Jennifer
Sent: Thursday, March 5, 2020 12:33 PM
To: MCOH-EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] Occupational Exposures to HPV

One of our employees brought this to our attention………

February 19, 2020

Dear Members,

Supporting our mission of prevention and treatment of HPV-related diseases, ASCCP announces a call to members recommending HPV vaccination for clinicians routinely exposed to the virus. This recommendation encompasses the complete provider team, including but not limited to, physicians, nurse practitioners, nurses, residents, and fellows, as well as office and operating room staff in the fields of obstetrics and gynecology, family practice, gynecologic oncology, and dermatology. In 2018, the U.S. Food and Drug Administration approved a supplemental application for Gardasil 9, expanding the approved use of the HPV vaccine to include persons aged 27 to 45 years old. While there is limited data on occupational HPV exposure, ASCCP, as well as other medical societies, recommend that members actively protect themselves against the risks. As the leader in anogenital and HPV-related diseases, ASCCP will continue to research and educate you on the potential health risk from HPV exposure.

Colleen K. Stockdale, MD, MS Mark H. Einstein, MD, MS Warner K. Huh, MD 2019-2020 ASCCP President 2019-2020 ASCCP President-Elect 2019-2020 ASCCP Immediate Past President

Jennifer Reneau RN BSN

Manager, WUSM Occupational Health Services

(314) 362-3528/314-747-0450

(314) 362-0058 fax

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From: MCOH-EH <mcoh-eh-bounces@mylist.net> On Behalf Of Tim Crump
Sent: Tuesday, February 11, 2020 11:02 AM
To: MCOH-EH <mcoh-eh@mylist.net>
Subject: [MCOH-EH] Occupational Exposures to HPV

I suspect this is a question that has come up before, so apologies if I have missed previous communications.

Do people have thoughts on whether certain workers should be offered HPV vaccine. The only info I can find on this is from Immunize.org, where they say:

Are healthcare personnel at risk of occupational infection with HPV?

Occupational infection with HPV is possible. Some HPV-associated conditions (including anogenital and oral warts, anogenital intraepithelial neoplasias, and recurrent respiratory papillomatosis) are treated with laser or electrosurgical procedures that could produce airborne particles. These procedures should be performed in an appropriately ventilated room using standard precautions and local exhaust ventilation. Workers in HPV research laboratories who handle wild-type virus or "quasi virions" might be at risk of acquiring HPV from occupational exposures. In the laboratory setting, proper infection control should be instituted including, at minimum, biosafety level 2. Whether HPV vaccination would be of benefit in these settings is unclear because no data exist on transmission risk or vaccine efficacy in this situation.

So it would seem that they are not advocating for vaccination for this reason. Offering the vaccine seems to open the door to a lot of difficult questions: how would we get a list of all people who might be involved in these electrosurgical procedures? Would we offer it to workers who fall outside the recommended age range? With no data supporting its use, I could see some raised eyebrows in terms of cost. Yet we do always say that we try to err on the side of caution in worker safety. Have others reached reasoned conclusions on this topic that they are willing to share? Thanks, Tim

Tim Crump, MSN, FNP

Tim Crump, MSN, FNP

Family Nurse Practitioner

Multnomah Pavilion 1 SE, Suite 1110

Occupational Health

Healthcare Human Resources

Oregon Health & Science University

3181 SW Sam Jackson Park Rd

Mail code: UHN 89

Portland, OR 97239-3098

Department Phone: 503-494-5271

Office Phone: 503-346-1152

Fax: 503-494-4457

Email: crumpt@ohsu.edu

Mon-Fri, 7:30-4:00

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