Posted By David Waterton Hi, i work for a local authoruty Social Work Department. The issue of whom should be afforded protection against the hep B and C is very contentious. Some staff feel it should be on demand..that is not a view shared by management. I have put together a draft guidance note and attempted to include a pro-forma for deciding on the level of risk..high, medium orlow.(not very sophisticated i know--but i like simple) For the various routes of contact e.g blood, bites, needle stick contact etc. One problem i have is conflicting advice and views expressed to me by medical "experts" In relation to historical data we have never had a member of staff infected by a service user (3000 + staff) I know it is not a copmlete guide to future events and that in theory a person could contact the virus at any time. However, in the context of considering the probability of exposure leading to infection it is my view that using historical factors is valid. I would be happy to exchange the work i have completed and would welcome any comments advice etc from those having walked this rocky path..

Posted By Laurie I had a similar query some months ago with reference to staff working with Special Programmes students in Further Education. Advice from the local Public Health and HSE was the same - not required unless there was really a specific threat e.g mental care nurses Laurie

Posted By Alison Dando In our NHS Trust it is based on a risk assessment, a copy of which is given to the Occupational Health Dept. before they start the course of immunisation because vaccination is a control measure. A generic one can be done based on occupation e.g. nursing staff who may come into contact with a carrier, medics who perform invasive procedures, estates staff and portering staff who will either come into contact with discarded or inappropriately contained unsheathed needles (sharps boxes do fall apart if not put together correctly)etc. Some can be done on forseeability, if in a given circumstance a person has come into contact with an unsheathed needle or it is known that needle sharing people are frequenting a given area etc. (risk assessments have to cater for forseeability, if the situation has happened once then in similar circumstances it is considered forseeable that it can happen again). What it shouldn't be done on, is a basis of cost, the HSE don't like that one in the law courts and a solicitor will rub his hands in glee if pursuing a case for compensation. Remember what is reasonably practical ? -_Reg.7(1) COSHH Regs. Prevention or control, you will need to be able answer that question in court, if needed. Hope this helps

Posted By Ken Taylor Whilst historical data can be considered as part of the risk assessment process, I would contend that, in view of the nature of the incidence of communicable disease, the data to be considered should relate to the nature, location, clients, etc of the work activity itself rather than be limited to the experience of the particular employer. In a previous local authority existence, our occupational health service came up with a 'vaccination policy' which considered the various risk groups across the Council's departments and decided which staff groups should be offered vaccination against particular diseases. I am attempting to do something along those lines for my present employers in consultation with our medical advisor and nursing staff and taking into account the local health authorities published guidance on communicable disease control for schools and nurseries. This is likely to go along the generic risk assessment route but with reminders to consider individual circumstances that may vary. I suspect that there is likely to be a number of occupations where vaccination will be 'strongly advised' in initial employment literature.