Occupational Health and Infection Prevention

By Kiran Gupta

Occupational health is closely linked to prevention. HCWs are at risk for being exposed to various types of infections during patient care. Prompt action may be necessary for assessment of a HCW exposed to infectious pathogens.

The most important strategy to protect HCWs from potentially infectious pathogens is prevention of the exposure. This is achieved through adherence to all advised standard and transmission-based precautions as outlined above.
In addition, vaccination against certain pathogens is a crucial component of an occupational health program. Vaccinations recommended for HCWs include measles/mumps/rubella, varicella, hepatitis B, pertussis, and influenza.
Influenza vaccination of HCWs is an important method to prevent transmission of influenza to patients, by creating herd immunity in the health care environment and reducing the risk of HCW infection. HCWs should receive annual influenza vaccination unless they have a medical contraindication.

Among pathogens commonly seen in the setting of occupational exposure, blood-borne pathogens including hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV are particularly important.
The risks for a HCW acquiring infection after a contaminated percutaneous exposure to HBV, HCV or HIV are approximately 30% (for an unvaccinated HCW), 3%, and 0.3%, respectively. High-risk exposures include those from infected source with high viremia or exposures involving a large-bore hollow needle, deep puncture, or large amount of visible blood.
When exposures occur despite all efforts at preservation, for some infections postexposure prophylaxis is available. Postexposure prophylaxis can include vaccination (e.g., HBV), use of infused immunoglobin (IVIG) (e.g. HBV, pertussis and influenza).