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Executive Summary

HEPATITIS B VACCINE SHOULD BE PROVIDED FREE OF CHARGE TO EMPLOYEES in the health care field who are at high risk of contracting the disease, the Service Employees International Union, the National Union of Hospital and Healthcare Employees, and Local 1199-Drug, Hospital and Healthcare Employees Union maintained in a joint petition to the Occupational Safety & Health Administration (OSHA). The petition, submitted Sept. 22, requests that "OSHA immediately issue a clear policy directive stating that employers must offer hepatitis B vaccine free of charge to high-risk employees." Noting that the rate of hepatitis B infections has increased 68% in the last six years, the unions said they believe that the major factor for the low rate of vaccination among health care workers is "the practice by the employers of charging employees for the vaccine." They asserted that because the series of three hepatitis vaccine injections costs approximately $100 per employee, "it can readily be predicted that there will be a low participation rate, especially since many of the occupational categories of health care employees that are most at risk of infection earn just slightly above the minimum wage." The three health care unions are also requesting that OSHA "promulgate standards and/or regulations to adequately protect health care employees from the hazard posed by occupational exposure to hepatitis B." In 1983, OSHA issued a voluntary guideline that suggested several methods, including vaccination, for reducing the risk of hepatitis B in the workplace. Petitioners assert that the guidelines need to be incorporated into a formal regulation or standard to insure compliance. The unions are suggesting that the regulation "include as a minimum all the recommendations outlined in OSHA's October 1983 hepatitis B directive with a clear emphasis on the need to provide education to employees about the benefits of vaccinations." The petitioners point out that at least two states, Oregon and North Carolina, "have interpreted OSHA's 1983 directive to require that health care employees make the vaccine available free-of-charge." The unions maintain that OSHA already has the necessary legal authority to cite employers that do not make the vaccine available free-of-charge to high risk employees. They cite a 1981 decision by the Occupational Safety and Health Review Commission that "upheld an OSHA citation for failure of employer to provide free vaccination to employees at risk of contracting occupationally related infections when a safe and effective vaccine was readily available."

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