occupational risk of hepatitis b

8/3/2019 Occupational Risk of Hepatitis B

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HBVHepatitis B Fact SheetHepatitis B Fact Sheet

a series of fact sheets written by experts in the field of liver disease

A Publication of the Hepatitis C Support Project

www.hbvadvocate.org

What Are the Occupational Risksof Hepatitis B?

Many people inected with the hepatitis B virus (HBV) won-

der i their bloodborne inection poses a health risk to

thers in workplace settings, such as oices, actories, health

are acilities, schools or daycare centers. They wonder i it

s necessary to disclose their inection to protect coworkers,

tudents or patients.

Federal and state laws in the United States have examined this

opic in-depth and have overwhelmingly concluded that any

workers who might conceivably come into contact with blood

r body luids in the course o their jobs be immunized against

epatitis B and trained in universal precautions.

Universal precautions, mandated by the Occupational Sae-

y and Health Administration (OSHA), require every worker

o keep a barrier between them and anyones blood or body

uids. This practice must be applied to everyone, not just

o those who have a diagnosed bloodborne inection such as

epatitis B or C or HIV.

Why must they be used w

everyone?

Because there are m

people who are unaware

their bloodborne inectio

According to national he

experts:

25 percent o people with

dont know theyre inecte

75 percent o those w

hepatitis C dont know the

inected, And 65 percent those w

hepatitis B dont know the

infected.

With so many undiagnosed

ections around, health oic

require universal precauti

to be used with everyone a

times. Employers must also sign blood and body luid

posure policies as i every

was inected with HIV or v

hepatitis.

Hepatitis B is 50- to 100-times more infectious than HIV

because of the high volume of hepatitis B viruses in the

blood of infected people, compared to the lower viral load in

people infected with HIV.

Written by: Chistine M. Kukka HBV Project Manager


2/3www.hbvadvocate.org

Hepatitis B Fact SheetHepatitis B Fact Sheet Fact SeriesHBV

Occupational Risks of Hepatitis B

Because all employers, super-

visors, police, teachers and day-

care providers must practice uni-

versal precautions, the U.S. Cen-

ers or Disease Control and Pre-

vention (CDC) and other agencies

have stated that neither adults nor

students have to disclose their

nections in most workplaces,

schools or daycare centers.

Universal precautions have been

very successul in saeguarding

everyones health. For example,

one CDC study o police, frefght-ers and prison guards ound their

HBV inection rates were no high-

er than the general population,

despite their increased chances

o exposure to blood through ac-

cidents, fghts and bites.

But what about medical settings,

where accidental needle sticks,surgery, and other procedures

nvolving sharp instruments in-

crease the odds that a patient

might be exposed to the blood o

an inected doctor or nurse? Does

his mean HBV-inected people

cant become doctors or nurses?

Can hepatitis B sideline

a health care career?

Hepatitis B is 50 to 100-times more

ransmissible than HIV because

o the high volume o hepatitis B

viruses in the blood o inected

people, compared to the lower

viral load in people inected with

HIV. A sae and eective vaccine

does prevent HBV inection, but

unortunately, not all patients have

been immunized and a small per-

centage o people who have been

immunized dont develop enough

antibody protection to fght o theinection.

Even when health care workers

practice universal precautions

and are as careul as possible,

there is still a chance that a doctor

or nurse could cut him or hersel

during an exposure-prone med-

ical procedure, such as surgery,

and inect a patient who has not

been vaccinated.

Medical organizations and hos-

pitals require health care workers

who perorm exposure-prone pro-

cedures to be tested or blood-

borne inections and vaccina

against hepatitis B. The Natio

Institutes or Health and the S

ety or Healthcare Epidemiol

o America (SHEA) have iss

the ollowing guidelines or dtors, nurses, and other practit

ers inected with HBV:

Providers with HBV DNA le

lessthan10,000genomeequ

lents per millimeter of b

(GE/mL): SHEA recomme

that no restrictions be pla

on a providers practice

includes surgeryas long

the provider has not inec

a patient in the past, rece

advice/guidance rom

her hospitals Expert Rev

Panel, and is tested twic

year to monitor his/her v

load. The provider must a

be treated by a physician

expertise in hepatitis B wis authorized to communic

the providers results to the

pert Review Panel.

The inected practitioner m

also strictly ollow recommen

saeguards, including wea

double-gloves or more h

risk procedures and reque

changing gloves during high-procedures.

Providers with HBV DNA

els greater than 10,000 GE/

SHEA recommends that

viders who have circula

HBV DNA levels greater t

How long do the hepatitis

viruses live outside of the

body? Hepatitis A (HAV) can

live or months

Hepatitis B (HBV) can

live or greater than or

equal to 7 days

Hepatitis C (HCV) can

live or at least 16

hours, but no longer

than 4 days

Source: Centers for Dis-

ease Control


3/3

2010 Hepatitis C Support Pro

www.hbvadvocate.org

The inormation in this act sheet is designed to help you understand and man-

age HBV and is not intended as medical advice. All persons with HBV should

consult a medical practitioner or diagnosis and treatment o HBV.

Executive Director,Editor-in-Chief, HCSP Publications

Alan Franciscus

Managing Editor / WebmasterC.D. Mazoff, PhD

This inormation is provided by the Hepatitis C Support Project a nonproft organization or HCV education, support and advocacy.

Reprint permission is granted and encouraged with credit to the Hepatitis C Support Project.

Hepatitis B Fact SheetHepatitis B Fact Sheet Fact SeriesHBV

For more inormation about hepatitis B, visit the ollowing websites.

HepatitisBFoundation:www.hepb.orgHIVandHepatitis.com

HCSP VERSION 3.0 September 20

Occupational Risks of Hepatitis B

or equal to 10,000 GE/mL rou-

tinely use double-gloving or

all procedures where gloves

are required. Additionally,

these providers are prohibited

rom perorming Category III

procedures that carry a risk

or provider-to-patient HBV

transmission despite use o

double-gloves. These proced-

ures include surgery, open

resuscitation eorts, obstet-

rical or gynecological surgery,

orthopedic procedures, plas-

tic surgery, transplantationsurgery, trauma surgery, and

lengthy open surgical proced-

ures. SHEA also cautioned

inected practitioners against

interacting with violent or seiz-

ure-prone patients who might

bite providers.

To avoid discrimination and in-vasion o providers privacy, a

number o medical ethicists have

made additional recommenda-

ons that are now under consider-

ation. They propose that:

Hospitals should provide

hepatitis B vaccination to pa-

tients undergoing elective pro-

cedures to reduce HBV trans-mission risk.

HBV-inected health care work-

ers should practice without re-

strictions on patients who have

already been inected with, or

have been vaccinated against

hepatitis B.

Ironically, similar problems con-

ront providers who ail to respond

to a hepatitis B immunization. A

small percentage o people ail

to create sufcient antibodies to

protect them against hepatitis

B, even ater two rounds o vac-

cination. These people remain

vulnerable to inection rom HBV-

inected patients. In some cases,

these people are discouraged

rom practicing medicine because

o their risk.

More articles about this topic are

available at:

Society for Healthcare Epidemiol-ogy of America: SHEA Guidelineor Management o HealthcareWorkers Who Are Inected withHepatitis B Virus, Hepatitis C

Virus, and/or Human Immuno-deiciency Virus. Published inthe March 2010 issue o thejournal Infection Control and

Hospital Epidemiology, www.shea-online.org/Assets/iles/

guidelines/BBPathogen_GL.pd

Hepatitis B Virus-InecPhysicians and Discloso Transmission Risks

Patients: A Critical Ansis, published in the BMedical Ethics Jou

www.biomedcentral.com/146939/2/4 CDC Report: Recommen

tions for Preventing Tra

mission of ImmunodeficieVirus and Hepatitis B Vto Patients During Expos

Prone Invasive Proceduwww.cdc.gov/mmwr/prev

mmwrhtml/00014845.htm

For more information about he

titis B, contact the following

ganizations:

Hepatitis B Foundation1-215-489-4900

www.hepb.org

Hepatitis B Support Listwww.hblist.org

HepatitisFoundationInter-national

1-800-891-0707www.hepi.org
http://www.shea-online.org/Assets/files/guidelines/BBPathogen_GL.pdfhttp://www.shea-online.org/Assets/files/guidelines/BBPathogen_GL.pdfhttp://www.shea-online.org/Assets/files/guidelines/BBPathogen_GL.pdfhttp://www.shea-online.org/Assets/files/guidelines/BBPathogen_GL.pdfhttp://www.shea-online.org/Assets/files/guidelines/BBPathogen_GL.pdfhttp://www.cdc.gov/mmwr/preview/mmwrhtml/00014845.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/00014845.htmhttp://www.shea-online.org/Assets/files/guidelines/BBPathogen_GL.pdfhttp://www.cdc.gov/mmwr/preview/mmwrhtml/00014845.htm

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