Hepatitis B and working in healthcare in Australia
We are often asked, can people work in healthcare as healthcare workers (HCWs) if they are living with hepatitis B in Australia? Healthcare workers include registered health practitioners (doctors, nurse etc), allied health professionals (physiotherapists, dietitians etc) and support staff – including personal care assistants, Aged Care workers, NDIS workers etc. The answer is yes but there are some special requirements that need to be in place and are the responsibility of the health care worker and the employer. The Australian Centre for Disease Control has the Communicable Diseases Network (CDNA) National Guidelines including the ‘Australian National Guideline for the Management of healthcare workers living with blood borne viruses and healthcare workers who perform exposure prone procedures at risk of exposure to blood borne viruses’ which provides clear information on this topic.
The main recommendations include:
• Testing for blood borne viruses (including hepatitis B, hepatitis C and HIV) is encouraged for all HCWs to protect theirs and the health of and safety of their patients
• For those performing exposure prone procedures (EPPs) the recommendation is testing (at a minimum) once every 3 years.
• Access to confidential testing, support, treatment and counselling is the right of all HCWs.
• Vaccination against hepatitis B should be undertaken by all HCWs including student HCWs before they start their studies, clinical placements or employment and be tested for immunity following vaccination. Alternatively, have a demonstrated immunity on recent blood tests from a past infection.
What are your responsibilities if you are living with hepatitis B?
• You must have ongoing appropriate medical care, adhering to the recommended frequency of monitoring (usually 6 monthly).
• You must have your viral load checked at requested timeframes and it should not be above 200 IU/mL
• Always maintain appropriate infection control measures per the ‘Australian Guidelines for the Prevention and Control of Infection in Healthcare’ www.safetyandquality.gov.au
• All HCWs if required, should know their responsibility to report their BBV status under local legislation and/or policies.
What if you are performing exposure prone procedures (EPPs)?
• An EPP is defined as a procedure where the HCW may have an increased risk of injury – where their blood may infect a patient’s blood. These include where the person’s hands/fingertips are not always visible (even when wearing gloves), and can encounter sharp bone, teeth, instruments, needle tips etc.
• Your viral load must remain below 200 IU/mL, and you undertake 6 monthly testing to monitor your viral load if on treatment. If not on treatment testing is required every 3 months as a minimum.
• If you have a potential exposure to a patient/another worker, you may be required to provide your records of health monitoring to a designated person in the workplace for further assessment and public health action if required.
What is not considered an EPP?
• Insertion of intravenous access, giving injections, inserting catheters, stitching wounds etc, internal exams that do not involve sharp instruments or tissue, or general care of patients/clients.
What should you expect from your employer if you are living with hepatitis B?
• Your health condition (just like any other) remains private and confidential.
• You are protected under the Anti-Discrimination Act 1991 (Qld) (Queensland Human Rights Commission) including the ‘Anti-Discrimination Law in Queensland’ if you feel you have been discriminated against you can report to them for support and advice.
• Your employer has a duty of care to all employees regardless of hepatitis B status to protect the rights of HCWs to provide equal opportunity to both clients and staff.
Further information is available at:
Anti-discrimination law in Queensland | QHRC | Queensland Human Rights Commission www.qhrc.qld.gov.au
B Positive: Hepatitis B Guide for Primary Care | ASHM Health www.ashm.org.au
National Guidelines the Management of Healthcare Workers Living with Blood Borne Viruses and Healthcare Workers who Perform Exposure Prone Procedures at Risk of Exposure to
Blood Borne Viruses www.cdc.gov.au
Guideline Australian Guidelines for the Prevention and Control of Infection in Healthcare (2019) www.safetyandquality.gov.au
