Health Care Workers – Avoiding Infections at Work

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How can I keep myself from getting an infection at work?

As a health care worker, you may be exposed to many different sources of infection. Infections may be transmitted by blood, body fluids, air, respiratory secretions or by direct contact with other infectious materials. You can protect yourself from infection by following the infection control guidelines in your workplace, by using personal protective equipment (such as gloves and masks) and by treating all blood and body fluids as though they are infectious. This handout discusses some of the infections that may be transmitted in your workplace and ways you can avoid getting them.

What are blood-borne pathogens, and how can I protect myself from getting infected?

Many infections can be spread by blood or body fluids. Human immunodeficiency virus (HIV) and the hepatitis B virus are common examples. However, infections caused by other viruses and bacteria (such as syphilis and hepatitis C) can also be spread by blood or body fluids. The following guidelines can help you protect yourself:

• Consider every patient to be infected and avoid contact with their blood or body fluids.
• Avoid risky behavior when using needles and other sharp instruments (including scissors, scalpels, blades and knives). For example, do not attempt to recap needles. Carefully dispose of sharp instruments in appropriate containers.
• Wear protective equipment (including gloves and face shields) to avoid getting blood on your skin or in your eyes when you are performing procedures that may cause splashes or spills.
• Be certain you are immunized against hepatitis B. This vaccine may be offered to you in your workplace.

Do all body fluids carry blood-borne pathogens?

Body fluids such as tears, sweat, saliva, urine and vomit are not thought to carry blood‑borne pathogens unless they are visibly contaminated with blood. (However, urine or fecal material may contain bacteria or infectious agents that are not considered blood‑borne pathogens.) Most other body fluids can transmit blood-borne pathogens. This includes semen, vaginal secretions, pericardial fluid (fluid around the heart), peritoneal fluid (fluid in the lining of the abdomen and pelvis), joint fluid, amniotic fluid (fluid around an unborn baby during pregnancy), pleural fluid (fluid in the lungs) and cerebrospinal fluid (fluid in the brain and spinal cord).

What should I do if I’m exposed to blood by a cut, a needle-stick or a splash?

If an incident occurs, tell your employer or the employee health service right away. If your skin is broken (by a needlestick), or if fluid has splashed into your eyes, your mouth or onto broken skin, both you and the source patient will be tested. The source patient’s current and past infections will also be checked.

If the source patient is infected with hepatitis B and, despite immunization, you never developed immunity to hepatitis B, you will be offered hepatitis B immune globulin. If the source patient has syphilis, you will be treated with antibiotics. If the source patient has HIV infection, you may need to take preventive medicines for 4 weeks. These medicines should be started within hours of the accident. Depending on the risks posed by the source patient, you should have repeat blood tests for 6 to 9 months so that if any infection develops, it will be found as soon as possible.

What about a splash of blood on my skin?

If your skin has no breaks, cracks or rashes, you have virtually no risk of getting a blood‑borne infection from a splash of blood. If your skin is splashed, immediately wash the affected area thoroughly.

How can I protect myself from tuberculosis infection?

It’s important to know which patients might have tuberculosis. You could catch this disease by breathing in droplets that get into the air when infected people cough. Infected patients may have symptoms such as a chronic cough (lasting for weeks and bringing up mucus or blood), weight loss, fever or night sweats. If you work around any infected patients, wear a protective mask. Have patients wear a mask and isolate them from other patients. For example, remove them from the waiting room in an office setting, or put them in isolation in the hospital setting.

If I haven’t had chickenpox, should I get the varicella vaccine?

Even if you don’t have a history of chickenpox (varicella) infection, you should have a blood test to check for immunity.

Most adults are immune to varicella, even if they have no history of the disease. If the test shows that you aren’t immune to varicella, you should have the 2-shot varicella vaccine series. If you aren’t vaccinated, you’re at risk of getting chickenpox and spreading it to patients.

I have had chickenpox. Can I get infected again?

A history of chickenpox infection usually means that you are immune. However, in rare cases people do get chickenpox a second time. This can happen even if a blood test shows that you’re immune to varicella. There is no 100% certain way to avoid this. Chickenpox infection is usually milder the second time. If you have a second round of chickenpox infection, tell your supervisor as soon as you find out so you can avoid patient contact.

Is pertussis prevented by immunization?

After children are immunized against pertussis (whooping cough), the immunity only lasts until they are teenagers. This means teenagers and adults can get pertussis. A pertussis booster vaccine is available for both teenagers and adults. Adults who work in health care should receive the booster once every 10 years to reduce the chance of pertussis.

Pertussis is responsible for some coughs or bronchitis that seem to “hang on” longer than the usual cold. If your cold lasts more than 2 weeks, you should contact your healthcare provider. Pertussis can be life-threatening to unimmunized infants.