Occupational Exposure to Aerosolized Human Papillomavirus: Assessing and Addressing Perceptions of and Barriers to Vaccination of at-Risk Health Care Workers

Abstract

Objectives: This study aimed to assess current vaccination rates among health care workers at risk for occupational human papillomavirus (HPV) exposure and explore factors that influence decisions about HPV vaccination. Design: Using a mixed-methods design, this study included a questionnaire and qualitative focus groups. Setting: The study took place at an academic medical center. Participants: Participants were 37 health care professionals in occupations at risk for workplace HPV exposure. Main Outcome Measures: The primary qualitative outcome measured was HPV vaccination status. The primary qualitative outcomes assessed were perceptions of occupational HPV exposure risk, protective measures, and HPV vaccination. Results: Most participants were female (86.5%, n = 32) and younger than 35 years (51.4%; n = 19) and therefore would have been eligible to receive the HPV vaccine series as a teenager or young adult. Nearly two-thirds (67.6%; n = 25) of participants had received the HPV vaccine; of those, half were vaccinated as teenagers (52%; n = 13). One-third (n = 4) of those vaccinated as adults reported vaccination due to workplace HPV exposure. Focus groups revealed themes consistent with the Health Belief Model. Most participants recognized their risk of aerosolized HPV exposure in the workplace but felt uneducated about occupational exposure risk and protective measures. Many participants recognized risk of exposure through surgical smoke but perceived that risk was stratified by medical specialty, proximity to surgical field, and personal protective equipment use. Many participants had some level of concern for head and neck lesions with exposure to aerosolized HPV. Most participants recognized the need to protect themselves against workplace HPV exposure. Those who were vaccinated felt that they were better protected against HPV exposure. Almost all participants said that they had not received formal education on workplace HPV exposure risk. Many participants voiced perceived barriers to HPV vaccination. Conclusion: Health care workers encounter the HPV virus in a myriad of fields and procedures. Our mixed-methods study demonstrated that at-risk health care workers feel uninformed about their risk of HPV exposure in the workplace, availability of HPV vaccination, and appropriate protective equipment recommendations.