When we hear the words hepatitis or HIV we may cringe or even get a little scared. Images of injection drug abusers may come to mind or we may have thoughts of contracting it sexually from an infected person. We would probably even freak out knowing we had to handle infectious blood or came in contact with an infected person.
Individuals living with a blood borne infectious disease face a lot of stigma and discrimination in society based on their perceived health status. Not only do individuals have a challenging time living and managing their disease in their personal lives, but also face obstacles in the workplace.
What are Blood Borne Diseases?
Blood borne diseases are infectious microorganisms in human blood and can cause disease in humans. Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) are the most common pathogens. Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. Hepatitis C is a liver disease which can cause acute and chronic hepatitis, which can lead to cirrhosis (liver scarring), liver failure, and liver cancer. HIV targets the immune system and weakens the body’s ability to fight off other infections and illnesses.
How are Blood Borne Diseases Transmitted?
HBV, HCV, and HIV can be transmitted through:
- Saliva (dental procedures)
- Fetal and joint fluid
- Sexual encounters
- Mucous membranes: eyes, nose, mouth
Hepatitis B virus can survive in a dried state on surfaces at room temperature for over a week, whereas hepatitis C has no reliable data about the survival time in an exposed environment, and HIV becomes inactive when exposed to air
In the workplace, such as laboratory or clinic, transmission is most likely to occur due to accidental puncture from contaminated needles, broken glass, or other sharp objects; contact between broken or damaged skin and infected bodily fluids; or contact between mucous membranes and infected bodily fluids.
For example, if someone infected with HBV cut their finger on a piece of glass, and then you accidentally cut yourself on the same infected piece of glass, there is a possibility that you could contract Hepatitis B.
Unbroken skin is an effective physical barrier against blood borne pathogens. However, infected blood can enter your system through open sores and blisters, cuts, abrasions, acne, and sunburns, but it is extremely rare for HIV to be transmitted by broken skin and wounds. From 1981 and 2006, 57 cases and 140 possible cases of HIV transmission to U.S. healthcare workers were documents. Of the 57 cases, 48 were associated with a puncture or cut injury.
Blood borne diseases are NOT transmitted by:
- Coughing, sneezing
- Touching or shaking hands
- Hugging or kissing
- Insects or pets
- Sharing food, drinks, utensil
- Toilet seats
Who is at Occupational Risk?
Blood borne diseases are not an occupational concern unless workers come into contact with blood in the workplace. The most common occupations that are at high risk of exposure are:
- Healthcare workers
- Laboratory workers
- Emergency responders
- Correctional facility officers
- Dental workers
- Tattoo artists
Employers must train employees who are at risk and ensure training covers: symptoms, transmission, and control measures to minimize exposure.
Disclosure in the Workplace
Individuals who have a blood borne disease have the right to privacy with a few exceptions. HBV, HCV, and HIV are not transmitted through typical day-to-day contact, so employees do not have to disclose their status to their employer or union unless your job could put others at risk of coming in contact with your blood. Individuals with blood borne diseases have the right to decide when, how, to what extent and to whom they will disclose their personal information.
However, blood borne diseases are considered a disability, so individuals with a positive status may need to discuss with their human resources department or manager about managing symptoms while at work (modified work schedule, time off for appointments, workspace accommodations), or to claim medical benefits. Employers must maintain the maximum degree of privacy and confidentiality when handling and keeping medical information, in addition to employment records and files. Medical information should be kept separate from employee files. Employees with a positive status still do not need to completely disclose their condition, but generally, state they have a health condition that requires modifications to their daily lifestyle. This information should only be given to the person(s) who needs to know the information.
Employers may request a doctor’s note. The note only needs to state that accommodations are needed to maintain health and to fulfill essential job tasks. Employers cannot probe for further details on the underlying medical condition. Further medical documentation may be required depending on the job. Individuals may request to send documents directly to the insurer or provide a sealed envelope to HR. An employer who fails to properly safeguard personal information about an employee may infringe the Code.
Remember, if you have a positive blood borne disease status you have legal rights and obligations. Employers must follow and abide by Canadian law (AODA) when accommodating employees with a disability. Stay tuned for Part 2 of What You Need to Know About Blood Borne Diseases in the Workplace!
Written by Jenna Kressler | Curriculum Developer