To evaluate the addition of hepatitis vaccine to health schemes for hospital workers in Zimbabwe we undertook a cross sectional study of viral markers in 226 hospital workers and compared the results with 97 volunteer blood donor controls. One hundred and thirty one (58%) hospital workers had hepatitis markers compared with 45 (46%) of the donor group. Racial group was the strongest risk factor. Blacks were 70% more likely to have markers than whites. This racial difference was not explained by job status or patient contact. Our data suggest that work in a district general hospital does not constitute a clinically important hazard for hepatitis B infection. Because of the high cost of the vaccine, additional studies to assess the risk of hospital work in other settings in Zimbabwe are required before health policy regarding routine hepatitis B vaccination is determined.