title: A survey of policies at children's hospitals regarding immunity of healthcare workers: are physicians protected?
abstract: OBJECTIVE
  To determine policies at children's hospitals regarding immunizations, annual tuberculosis (TB) screening, and blood or body fluid exposure follow-up, particularly as they apply to physicians.
  
  
  METHODS
  A three-page survey was sent to infection control practitioners (ICPs) in April 1994 at hospitals affiliated with the National Association of Children's Hospitals and Related Institutions. One follow-up mailing was sent to nonresponding ICPs.
  
  
  RESULTS
  Responses were received from 62 (67%) of 93 ICPs. Thirty-five (66%) of 53 children's hospitals had an immunity policy that applied to medical students, 42 (79%) of 53 to resident physicians, 32 (52%) of 62 to hospital-based physicians, and 18 (29%) of 62 to private or community physicians (who admit patients to one hospital). Physicians were required to show evidence of an annual TB screen at 36 hospitals (58%). Immunity policies or TB screening were provided for the following physician groups: medical students, 13 (21%); resident physicians, 43 (69%); hospital-based physicians, 50 (81%); and private or community physicians, 23 (37%). Infection control practitioners reported that the following diseases had been identified within the past 5 years at their hospitals: measles, 82%; mumps, 40%; rubella, 31%; TB, 94%; hepatitis B, 94%; pertussis, 90%; varicella, 98%; and influenza, 94%. Physicians in these institutions were reported to have contracted the following diseases from patient exposure: measles, hepatitis B, TB, pertussis, varicella, and influenza.
  
  
  CONCLUSIONS
  Children's hospitals vary widely in their policies regarding healthcare-worker immunity, and, in many cases, physicians may not be protected from nosocomial transmission of community infections.
authors.affiliation: Department of Pediatrics, University of Louisville, KY, USA.
authors.forename: N E
authors.initials: NE
authors.lastname: Lane
authors.forename: R I
authors.initials: RI
authors.lastname: Paul
authors.forename: D F
authors.initials: DF
authors.lastname: Bratcher
authors.forename: B H
authors.initials: BH
authors.lastname: Stover
mesh_terms: D006776:Hospitals, Pediatric; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D017053:Infection Control / Q000458:organization & administration*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008505:Medical Staff, Hospital; D016134:Organizational Policy; D014374:Tuberculin Test / Q000706:statistics & numerical data; D014376:Tuberculosis / Q000517:prevention & control / Q000635:transmission; D014481:United States; D014777:Virus Diseases / Q000517:prevention & control / Q000635:transmission