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Healthcare professionals are a high-risk occupational group for exposure and infection rates. In some areas of the world, if a health care worker is positive for an infectious disease, (s)he may be denied employment in a specific or for the total area of healthcare. Laws have been enacted that will deny employment of a health care worker if this worker is positive. (This action gives the general public a false sense of security.) Some hospitals are currently requiring health care professionals to pass a pre-employment medical to determine the health care status of this potential new hire.

Needle stick injuries are not uncommon. Thousands of health care workers each year are injected with patients' blood when needles that have been used to perform often life-saving procedures suddenly become virulent projectiles penetrating a palm, a wrist, a finger, a thigh. Approximately 800,000 U.S. health care workers will be injured by patient needles this year, according to estimates used by the federal Centers for Disease Control and Prevention (CDC).

Combined estimates from the CDC and EPINet-a computer-based standardized injury tracking system used by about 1,500 U.S. hospitals-suggest that more than 2,000 of those workers will test positive for new infections of hepatitis C, another 400 will get hepatitis B and 35 will contract the AIDS virus.

While AIDS is the most feared infection, hepatitis B and C are also serious and life threatening. Both diseases can lead to liver damage, cirrhosis and cancer. A vaccine is available for hepatitis B, which has helped reduce the number of health care workers infected each year from a high of 17,000 in 1983.

"Every year up to a million health-care workers receive a needle stick, and for many it is a death sentence," says Andrew Stern, international president of Service Employees International Union, the largest health care workers' union in the country, which is campaigning to have all workers use specially designed safety needles. "It's an outrage. This is a preventable crisis. More die of needle sticks than died in the ValuJet crash, but ValuJet sparked all kinds of investigation."

The Hepatitis C Virus epidemic brings large risks to workers' compensation programs and requires new risk management techniques. The workers' compensation industry has generally not recognized these risks, although it is becoming aware of the new challenges that the Hepatitis C Virus epidemic brings. There is much uncertainty about employers' and insurers' liabilities for Hepatitis C Virus-infected workers. The authors intend that, by presenting the results of our actuarial analysis, this report will help define the issues and that our recommendations will reduce the industry's long-term financial exposure.