Updated guidelines on managing healthcare workers with bloodborne diseases

By: February 10th, 2010 Email This Post Print This Post

Managing healthcare workers with a bloodborne disease can be a perilous situation for any manager or employer, and with no specific regulatory guidance, each case needs to be evaluated carefully.

In some instances work restrictions may be necessary to ensure patient safety. In other instances healthcare workers may have duties that do not put them at risk to transmit diseases.

The featured article in the February issue of Medical Environtment Update focuses on this nuanced issue, and offers some guidance from experts in the field.

In a very timely release, the Society for Healthcare Epedimiology of America (SHEA) has published an updated “Guideline for Management of Healthcare Workers Who Are Infected with Hepatitis B Virus, Hepatitis C Virus, and/or Human Immunodeficiency Virus,” in the March issue of Infection Control and Hospital Epidemiology.

These guidelines, which update the last position paper published in 1997, recommend “separate management strategies for healthcare workers who are infected” with bloodborne diseases such as hepatitis B, hepatitis C, and HIV.

SHEA has developed graduated recommendations “according to the relative viral load level of the infected provider (Tables 1 and 2). However, SHEA emphasizes that, because of the complexity of these cases, each such case will be slightly different from the next, and each should be independently considered in context.”

“I think you have to make some very difficult decisions and you have to make those decisions based on what you know about our clinical experience and then what we know about the science that’s underneath it, and that’s what we’ve tried to do in the paper that we wrote,” lead author David K. Henderson said in the MEU article.

Below are a list of SHEA’s general recommendations:

  • Comprehensive education on bloodborne pathogens for all healthcare providers
  • Comprehensive management of infected providers similar to the management of all impaired providers
  • Realize the importance of patient safety and medical confidentiality while assessing each situation
  • Offer employees with disabilities reasonable accommodations
  • Practitioners that develop a bloodborne disease are ethically bound to report infections to their institution
  • Practitioners that are not institutionally bound should report bloodborne diseases to their state health department
  • Routine voluntary testing of providers should be conducted specifically for providers who conduct Category III procedures

Below is a list of links to more resources on managing healthcare workers with bloodborne diseases:


Good article, but addressing what employees have a BBP is another issue. With OSHA not allowing an employer to require Hepatitis B vaccination, and HIPAA privacy rules, it is very difficult to know which of your employees needs to be looked at.

In 16 years of following blood exposures, we have not identified a single employee with a BBP. We also screen for Hep C upon hire (to protect us from workers compensation claims from employee already infected, and to get employees who do not know they have the disease, followed up.)

We have found employees with Hep C, but none in positions where they could bleed into a patient.

can a college student( myself 44) be taken or let go from surgical tech school/program that i have been in for about 11 months i have hep C thank you for your help i need some advice and facts

I have hep C and am a student in florida for almost 12 months can the school kick me out due to this? It was never ask during enrollment or in my contract what do i do mike age 44


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