Blood Borne Viruses (BBVs)

Last reviewed on 16/02/2015 09:53

This page gives guidance for workers in roles where they may be exposed to blood borne viruses, such as Hepatitis B and C, and HIV/AIDS.

This page also gives information on issues surrounding the employment of people who may have contracted a blood borne virus.

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What are Blood Borne Viruses (BBVs)?

BBVs are mainly found in blood or bodily fluids.

The main BBVs of concern are Human Immunodeficiency Virus (HIV), Hepatitis B and Hepatitis C.

Human Immunodeficiency Virus (HIV) HIV, the virus which can cause Acquired Immune Deficiency Syndrome (AIDS), is nearly always transmitted through unprotected vaginal or anal sex, through sharing injecting drug equipment, or from mother to baby.

There is also a risk from needle stick injuries and from blood transfusions received in resource-poor countries.

HIV is transmitted through bodily fluids, in particular blood, semen, vaginal secretions and breast milk. It is not transmitted through casual contact, coughing, sneezing, by sharing a toilet, by eating utensils, or by consuming food or beverages handled or prepared by someone with HIV.

Therefore, somebody living with HIV in your workplace is not a risk to others.

Hepatitis Hepatitis means inflammation of the liver. Viruses can cause this by infecting the liver. There are a number of different hepatitis viruses. Two of the most common are Hepatitis B and C.

Hepatitis B and C are easily transmitted through contaminated blood. Most people do not know if they are infected. They may live for many years without symptoms. A proportion take 20 to 30 years to develop severe liver disease, some recover completely with treatment, others recover without any treatment at all. A small proportion develop liver cancer.

Hepatitis B is mainly transmitted through blood, semen, vaginal fluid and breast milk. Importantly, there is an effective vaccination against Hepatitis B.

Hepatitis C is mainly transmitted through blood, with a low risk of transmission through semen and vaginal fluid, or unprotected anal sex. There is no vaccine against Hepatitis C and current treatments for it are not effective in all cases.

 

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Who is most at risk from BBVs?

Workers who come into contact with bodily fluids from other humans are at risk from BBVs, particularly if their work also involves sharp or abrasive implements or substances that may break the skin.

Healthcare workers are at an obvious risk. Less obvious, perhaps, are those who work for cleansing or recreation/parks departments and staff who conduct bodily searches or searches of personal effects. Staff who work in these circumstances may come into contact with used needles.

The level of risk will depend on:

  • frequency and scale of contact with bodily fluids
  • the type of fluid or material they come into contact with
  • the activity the person must conduct in relation to the infections material
  • the nature of the infection contained in the material.

 

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Legal duties and obligations relating to BBVs

As well as the moral duty of employers to protect employees and members of the public, General Health and Safety Legislation covers all employers and workplaces.

In addition, two other sets of regulations also apply to Blood Borne Viruses:

The Control of Substances Hazardous to Health Regulations 2002 (COSHH), as amended BBVs are biological hazards and the risks of infection to employees or others affected by your work must be assessed.

→ Read our guidance on Hazardous Substances.

The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 These regulations require the reporting of specified incidents involving exposure to BBV to the relevant enforcing authority.

Therefore employers must:

  • ensure that a risk assessment is carried out with all BBV hazards identified, deciding who might be harmed and how likely it is that BBVs could cause ill health at work
  • determine if existing precautions are adequate or whether more should be done
  • give employees adequate information, instruction and training on any risks to their health from BBVs at work
  • record the findings of the risk assessment
  • review the adequacy of control of BBVs on a regular basis
  • record incidents involving exposure to blood and other body fluids, and report where required

→ Read more on Recording and Reporting Accidents, Ill Health and Near Misses.

 

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Reducing risks from BBVs

Where a risk of exposure to BBVs has been identified, simple, inexpensive measures to prevent or control risks can be taken:

  1. ensure good personal hygiene practices are observed, in particular hygienic hand-washing
  2. use procedures such as avoiding the use of sharps such as needles, blades, glass, etc.
  3. also consider using equipment with built-in safety devices
  4. use personal protective equipment such as gloves, eye protection, face masks, etc.
  5. ensure contaminated waste is disposed of in a safe manner, e.g. sharps disposal bin
  6. use disposable equipment where there is a risk of BBV contamination, otherwise decontamination procedures must be strictly complied with
  7. ensure employees are aware of immediate steps to be followed upon contamination with blood or other body fluids

Implementing an Infection Control Policy An Infection Control Policy should be implemented to outline your organisation’s rules and procedures in this regard.

To help you develop appropriate policies, Health Protection Scotland has produced Model Infection Control Policies.

→ Visit Health Protection Scotland's pages on Model Infection Control Policies (external site).

Immunisation This is another important control measure that can be taken. Immunisation is available against Hepatitis B.

The need for a worker to be immunised should be determined by the risk assessment, and it should only be seen as a supplement to reinforce other control measures.

Where assessed as necessary, an employer must provide HBV immunisation free of charge to employees.

The cost of the vaccine itself is minimal compared to the potential costs to the organisation if a worker was to become infected at work through inadequate control.

First Aid If you are a first aider, the risk of being infected with a BBV while carrying out your duties is small. There have been no recorded cases of HIV or HBV being passed on during mouth-to-mouth resuscitation.

Where BBVs are a known risk in the workplace, however, training should include information on preventing BBV transmission.

Simple precautions should be taken such as using gloves, eye protection and face shields and practising hygienic hand washing.

 

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Employment issues around BBVs

HIV and other BBVs are an issue for workplaces because:

  • HIV and other BBVs can affect anyone
  • most people infected with HIV and other BBVs are of working age and therefore may require support at work
  • advances in treatment mean more people with HIV and other BBVs will continue to work, or will want to return to work
  • employers have legal responsibilities towards people with HIV and other BBVs (see Discrimination and BBVs below)
  • employers have a role in contributing to the prevention of HIV and other BBVs through small practical steps.

Advances in treatment mean more and more people with HIV and other BBVs will continue to work, or want to return to work.

Your employees are your most valuable asset, therefore it makes good business sense to make sure that your organisation is equipped to respond to issues surrounding HIV and other BBVs.

 

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Discrimination and BBVs

Under the Equality Act 2010, it is unlawful for people with disabilities to be treated less favourably because of their disability. This applies to all employers as well as areas beyond the employment field.

Under the terms of the Act, 'disability' includes 'progressive' conditions such as HIV, as long as there is 'some’ impact on normal day-to-day activities.

According to the Act, the employer has a duty to make 'reasonable adjustments' if a disabled person would be at a substantial disadvantage compared to non-disabled people if the adjustment was not made.

The duty applies to both physical features of the employer's premises, e.g. fittings and equipment, and to all other aspects of employment including recruitment, training and retention.

If a person with HIV has grounds to believe they have been discriminated against by their employer, they can take the organisation to an employment tribunal.

It would be unfair to dismiss someone for being HIV positive unless there was some job-related consequence, which is likely to be rare. However, unfair dismissal requires two years of service.

Additionally, there may be issues concerning other employees’ attitudes and behaviour and the employer should handle situations carefully to avoid harassment or bullying as this could trigger legal liabilities.

The employer is vicariously liable for the actions of his/her employees acting in the course of employment. Vicarious liability is when one person is liable for the negligent actions of another person, even though the first person was not directly responsible for the injury. For instance, a parent sometimes can be vicariously liable for the harmful acts of a child and an employer sometimes can be vicariously liable for the acts of a worker. This definition has been generously interpreted in recent years and damages in such cases can be extensive.

Employers also have a duty of care to look after their employee's health. Failure to do so can lead to claims of breach of contract, which can include psychiatric damages.

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Combating discrimination and raising awareness

Employers have a duty to combat discrimination in the workplace around BBVs and have a valuable role to play in raising awareness (thus helping to prevent the spread of infection). Doing so is not difficult and is inexpensive.

Here are some practical steps you can take, all of which could be formulated within a formal written policy on BBVs:

Provide training Train all staff, including senior management (guarding against vicarious liability) on HIV and other BBVs and their respective roles within the policy context. You may be able to access free training from your local health board or other agencies listed at the end of this leaflet. World AIDS Day is a good opportunity to introduce the subject into the workplace.

Comply with your legal duties and obligations Make sure your organisation complies with all relevant legislation.

Provide information Provide information on sources of advice, support and information, both within and outwith your workplace. These can be displayed on staff notice boards and/or in toilets. At the bottom of this page, you can find some sources of support and suggestions for further reading.

Develop a BBV policy and integrate it with existing policies Integrate HIV and other BBVs with existing policies, e.g. equal opportunities, health and safety. Respect the confidentiality of employees’ personal and medical information, avoiding any unnecessary and damaging disclosures. People with HIV or BBVs may need to be reassured about the confidentiality they are entitled to by your organisation.

Be explicit about anti-discrimination measures If your workplace has anti-discriminatory policies, you should consider adding in specific references to HIV and other BBVs.

Provide healthcare information for travelling workers If part of your employees' job may involve travel outside the UK, particularly to an area of high incidence of HIV and AIDS, you should provide employees with advice about healthcare. A good source is Health Scotland’s leaflet Information for Travellers on HIV and Sexual Health (2002), (see further reading).

Remember: you do not need to know the HIV status of individual employees to protect the health and safety of all your employees.

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Developing an HIV and BBV policy for your workplace

Ideally, you should develop a policy that sets clear guidelines for all and that incorporates all the steps outlined above (see reducing risks and combating discrimination).

A good policy will also set out how these can be applied consistently, leading to the fair management of HIV and other BBVs in the workplace.

The policy should be based on consultation with all relevant stakeholders – e.g. Trade Union representatives, staff, senior management, occupational health – and be communicated to all employees.

Health Scotland’s How to Write and Implement a Health Policy: A simple guide (2001) gives more advice on developing health policies in the workplace (see further reading).

"The best thing that employers can do is to make sure that there's a flexible and supportive policy for anyone who is ill. If HIV is specified in their policies, it gives the right message to people whether or not they are HIV positive." (An employee with HIV)

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Helpful organisations when employing workers with BBVs

Call our Adviceline on 0800 019 2211 – your call will be handled in confidence by an experienced member of staff.

ACAS The Advisory, Conciliation and Arbitration Service provide confidential help on all employment matters. → Telephone the ACAS Helpline on 08457 47 47 47 or visit www.acas.org.uk.

British Liver Trust Provides support and information on adult liver disease, including Hepatitis. → Telephone 01473 276 328 or visit www.britishlivertrust.org.uk.

Health Protection Scotland Undertakes surveillance of HIV and other BBVs and provides expert operational support on them to NHS boards and local authorities in Scotland. → Visit www.hps.scot.nhs.uk.

HIV Scotland National HIV agency for the voluntary sector in Scotland. → Visit www.hivscotland.com.

Waverley Care Waverley Care provides up-to-date information on HIV to agencies and individuals, as well as providing a support service for people living with HIV. → Telephone 0131 661 0982 or visit www.waverleycare.org.

National AIDS Trust (NAT) The UK’s leading HIV and AIDS policy development and advocacy organisation. → Visit www.nat.org.uk.

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Further information on BBVs and the workplace

Free resources from Healthy Working Lives Links below are to publications pages giving options to download these resources:

Free guidance from the Health and Safety Executive Note – all links are to external pages on the HSE website giving options to download or order these resources:

→ Download Infection at work: controlling the risks: Advisory Committee on Dangerous Pathogens (PDF – 140 KB, external site)

Other resources:

This page was partly adapted from Blood Borne Viruses in the Workplace INDG342 HSE.

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