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Progress in establishing safety protocols based on CDC and OSHA recommendations.

In 1987, following the first documented reports of occupationally acquired human immunodeficiency virus (HIV) in healthcare employees, the American Nurses Association and some labor unions petitioned the Occupational Safety and Health Administration (OSHA) to issue an emergency infection control standard. OSHA responded by enforcing a series of voluntary guidelines developed by the Centers for Disease Control (CDC) four years earlier. A draft of regulations proposed by OSHA was published in the Federal Register, and the final set of these regulations is expected in early 1991. In the proposed guidelines, hepatitis B is cited as a major health risk to healthcare personnel--a more significant risk than HIV. The degree of risk varies between units in the hospital and between hospitals and other facilities. Standards are set for types of protective clothing and equipment, and for housekeeping and laundry areas. The report sets rules governing infectious waste disposal. It establishes guidelines for tracking employees, pre- and post-exposure. In enforcing these rules and guidelines, hospitals should stress continued education and training in order to increase compliance. A recent study revealed that, after a two-year training/evaluation period, physician compliance with infection control procedures increased from 20% to 80%, and nurse compliance rose from 50% to 86%.