Occupational Hepatitis B

Protecting workers against Hepatitis B

The Department of Health recommends Hepatitis B vaccination to individuals who are at increased risk of hepatitis B because of their lifestyle, occupation or other factors such as close contact with a case or carrier (see below).

An individual assessment of risk should be made to those who may be at risk because of their occupation. The Control of Substances Hazardous to Health (COSSH) Regulations 1994 require employers to undertake their own risk assessment and to bring into effect measures necessary to protect workers and others who may be exposed, as far as is reasonably practicable, against these risks.

NB. It is important that immunisation against hepatitis B does not encourage relaxation of good infection-control procedures. Universal precautions should be adhered to in the hospital setting.

Health care workers, including students and trainees, who have direct contact with patients' blood or blood-stained body fluids or with patients' tissues should be vaccinated against hepatitis B. This group will include:

Doctors, surgeons, dentists, nurses, midwives, laboratory workers and mortuary technicians but immunisation should also be considered for any other staff at risk of injury from blood stained sharp instruments, contamination of surface lesions by patients' blood or blood-stained body fluids, or of being deliberately injured or bitten by patients.

Severe Learning Disability

Staff and residents of residential accommodation for those with certain learning disabilities should also consider Hepatitis B vaccination. Close daily living contact, and the possibility of behavioural problems, may lead to staff and other clients being at increased risk of infection. Similar considerations may apply to children and staff in day care settings and specialist schools for those with severe learning disability. Decisions on immunisation should be made on the basis of local risk assessments.

Other occupational risk groups

In some occupational groups, such as morticians and embalmers, there is an established risk of hepatitis B and immunisation is recommended. The incidence of infection is not apparently greater than in the population as a whole for members of the police, ambulance, fire and rescue services.  Nevertheless, there may be individuals within these occupations who are at higher risk and who should be considered for immunisation. Such a selection should be decided locally by the occupational health service or as a result of appropriate medical advice following an occupational risk assessment.

Immunisation is available on request to all Prison Service staff in regular contact with prisoners.

Inmates of custodial institutions.

Guidance on immunisation of prisoners recommends that immunisation against hepatitis B should be offered to all prisoners.

For detailed information on Hepatitis B go to:

Chapter 18-Immunisation against Infectious Disease "The Green Book" 2006 edition

Post-immunisation antibody testing is recommended for some occupational groups and in particular, all healthcare workers to ensure they have made a serological response to the vaccine.