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Published online by Cambridge University Press: 07 December 2009
Introduction
There are several health-related aspects of being employed as a healthcare professional that affect the health and wellbeing of staff, carers and patients. All health provider organizations have an occupational health department, or have arrangements with another provider to provide this function. Listed below are some aspects of the service that should be provided in relation to virus infections.
Pre-employment health check
All employees should have a pre-employment health check before their employment contract is confirmed. There are several issues that need to be addressed; the best example of a virological issue is ensuring that those health professionals in direct physical contact with patients do not pose a risk of transmitting bloodborne virus infections (hepatitis B, hepatitis C and HIV) to patients. These details are included in the latest UK Department of Health advice: Health Clearance for Tuberculosis, Hepatitis B, Hepatitis C and HIV: New Healthcare Workers published in March 2007.
Hepatitis B – Health professionals who have a high HBV DNA viral load are at risk of transmitting the infection to patients if they are performing exposure-prone procedures (See note below).
Current regulations in the UK state that healthcare workers should not perform exposure-prone procedures if they have HBs Ag and either HBe antigen or an HBV DNA viral load of >103 genome equivalents per ml of blood.
Hepatitis C – Newly employed healthcare workers performing exposure-prone procedures should be tested for HCV antibody before starting to perform this work in the UK. Those who are HCV antibody positive should be tested for HCV RNA, and healthcare workers who are HCV RNA positive should not perform exposure-prone procedures.
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