B. Preventing workplace exposure

Because it is impossible to know who is infected with the HIV or HBV, it is recommended that all blood be treated as if it were infected - this means that all blood should be treated as if it were a toxic substance. Workers exposed to blood should follow the guidelines recommended by the World Health Organization. Appendix II, World Health Organization Guidelines on AIDS and first aid in the workplace at the back of this Module contains more detailed information on preventing the transmission of HIV in work that may involve exposure to infected blood or infected persons.

What if a worker is exposed at work?

A written policy stating what to do and whom to contact in case of exposure should be developed in all workplaces where workers may be exposed to blood or other body fluids. Workers should be familiar with the policy, and it should be posted where everyone can see it. If a worker is exposed to blood or other potentially infectious fluids:

· Wash the wound with clean water and soap.

· If splashed in the eyes, wash the eyes with a sterile eye wash solution (or clean water).

· If splashed in the mouth, rinse the mouth immediately with a large volume of clean water.

· Fill out an accident report. The report should include the date, time, place of the incident and a detailed description of circumstances.

· Get referrals for proper medical assessment and/or treatment and/or counselling.

Note: All procedures must protect the confidentiality of the exposed worker. If workers suspect that the process is not completely confidential, they may be reluctant to report the injury, or to seek needed treatment and counselling.

Engineering controls

Engineering controls should be the first choice to control hazards in the workplace. Engineering controls remove the hazard, rather than require the worker to use special protective equipment or follow special work procedures. Engineering controls are available to protect workers against needlesticks. For example, some unions are asking health care employers to get new devices like "self-sheathing needles" that allow the needle to remain covered before, during and after it is used. They are also pressing for other types of safer procedures and equipment which have become available. Proper worker training in good housekeeping practices is also vital for the prevention of needlesticks.

Infection control plans

Experts and some regulatory agencies recommend that every employer prepare an infection control plan designed to reduce or eliminate exposure if the workers face possible occupational exposure to HIV and HBV. The infection control plan should have specific procedures for specific categories of workers and job tasks and, most important, it should be supported and followed by all supervisors.

Is there ever a reason to know if someone is infected with HI V?

In situations where there is a real risk of exposure, such as in a hospital, the best solution is to assume that anyone could be infected and take the same precautions for everyone. Since it is impossible to know everyone who is infected, workers must be especially careful when handling all blood and certain body fluids.