September 11, 1991

Surgery, AIDS, and Hepatitis B-Reply

Author Affiliations

University of California, San Francisco

University of California, San Francisco

JAMA. 1991;266(10):1362. doi:10.1001/jama.1991.03470100052030

In Reply.  — I wholeheartedly agree with Dr Boscia's position that hepatitis B immunization must receive the highest priority in programs for preventing occupational blood-borne infections. Policies that offer vaccination to all health care workers at the time of entry into professional and training schools or at the time of employment are justifiable by the high transmissibility of hepatitis B virus in the health care setting, and vaccination should be mandated to protect both patients and their providers.The concept of procedure-specific infection control includes all aspects of a procedure that could influence exposure risk, including the circumstances under which the procedure is performed, in assessing indications for specific infection control interventions. Dr Peterson argues for evaluation of the benefits and risks associated with new interventions to reduce blood exposures before widespread implementation. I concur with this view and strongly encourage surgical personnel to take an active role in identifying