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Hepatitis B infected health care workers: Guidance on implementation of Health Service Circular 2000/020

  • Document type:
    Guidance
  • Author:
    Department of Health
  • Published date:
    23 June 2000
  • Primary audience:
    Professionals
  • Gateway reference:
    not required
  • Series number:
    HSC 2000/020
  • Pages:
    11
  • Copyright holder:
    Crown

This guidance is intended to assist in implementation of Health Service Circular (HSC) 2000/020 Hepatitis B Infected Health Care Workers.

Summary of HSC 2000/020

This circular supplements previous guidance restricting the working practices of certain hepatitis B infected health care workers, and aims to reduce further the risk of transmission of infection to patients. The circular recommends carrying out additional testing of hepatitis B infected care workers who are e-antigen (HBeAg) negative and perform exposure prone procedures, and restricting the working practices of those with higher viral loads. Previous guidance on hepatitis B infected health care workers who are e-antigen positive still applies (Health Service Guidelines HSG (93)40: Protecting health care workers and patients from hepatitis B - 18 August 1993, and its Addendum issued under cover of EL(96)77 - 26 September 1996). Throughout the circular, hepatitis B infected health care workers refers to those who are hepatitis B surface antigen (HBsAg) positive.

Action

3. NHS Trusts, Primary Care Trusts, independent contractors in the General Medical and Dental Services and Health Authorities (who employ relevant staff) should ensure that there are arrangements in place:

  • to have all hepatitis B infected health care workers who are e-antigen negative and who perform exposure prone procedures or clinical duties in renal units tested for viral load (hepatitis B virus DNA). The testing of staff currently employed should be completed by 1 June 2001 at the latest;
  • to restrict hepatitis B infected health care workers who are e-antigen negative and who have a viral load which exceeds 1000 genome equivalents per ml from performing exposure prone procedures in future. Health care workers whose viral load does not exceed 1000 genome equivalents per ml need not have their working practices restricted but they should receive appropriate occupational health advice;
  • to re-test hepatitis B infected health care workers continuing to perform exposure prone procedures who are e-antigen negative and whose viral load does not exceed 1000 genome equivalents per ml at 12 monthly intervals. These health care workers should cease to perform exposure prone procedures if their viral load is shown by testing to have risen above the specified level, or if investigation of a case of hepatitis B in a patient indicates the possibility of a transmission from a health care worker;
  • to manage blood exposure incidents for both health care workers and patients. Health Authorities, NHS Trusts or Primary Care Trusts should designate medical staff to assess incidents and to consider the need for hepatitis B immunoprophylaxis, where indicated. Independent contractors should ensure that they have similar arrangements in place for staff and patients.

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