Hepatitis B exposure incidents in community hospitals.

To determine the frequency and distribution of potential hepatitis B exposure incidents among employees of community hospitals, a two-year retrospective study and a one-year prospective study were undertaken in Arizona hospitals. The annual rate of exposure incidents was, respectively, 7.9 and 7.7 per 100 employees; 78 per cent of the incidents were needle punctures. The rate of incidents increased significantly with the size of the hospital and decreased in older employees. While the highest risks of incidents were in phlebotomists, surgical technicians, and laboratory technicians, 14 per cent of all exposures occurred in housekeepers and central supply workers. Only 45 per cent of incidents were reported from employees who would normally expect to be targeted to receive hepatitis B vaccine. The post-exposure use of immune globulins (IG and HBIG) increased from 9 per cent of exposures in the retrospective study to 16 per cent during the prospective study. Exposure incidents occurred at the same rates and in the same occupational groups in community hospitals as previously reported from teaching hospitals and medical centers.

The Comprehensive Nutrition Action Program in Arizona.

Through the Comprehensive Nutrition Action Program for Arizona (funded by the Nutrition Program, Center for Disease Control, Atlanta), a nutrition care delivery system was developed. Four sub-systems-screening, referral, monitoring, and the development of community nutrition workers--allowed for the identification of problems, intervention, utilization of other agencies, and expansion of manpower with community nutrition/health workers. Improvement in nutritional status was demonstrated by this program. As a result, it has been expanded.