Here is important information about the hepatitis risks that some health care workers face - and what you can do to protect yourself from occupational infection.
- blood splashed on hands that have chapped or broken skin
- cut from a scalpel used in surgery
- injury from a sharp that is found in bed linen or hospital laundry
- needlestick injury after drawing blood on a patient
- needlestick injury from a needle improperly disposed of in the trash
- splash of blood or bloody fluid in the eye or mouth while changing suction tubing or working in a laboratory.
First, all health care workers who may be exposed to blood or other infectious body fluids as part of their job duties should receive the hepatitis B vaccination series. The vaccine is given as a series of three injections over six months and is offered free of charge by the U-M Occupational Health Services for all Health System employees with potential exposure.
First, wash or irrigate the area exposed. Then, immediately call U-M Occupational Health Services at (734) 764-8021. U-M OHS staff will evaluate the type of exposure, your vaccination status and the status of the source patient, and will recommend proper treatment. Often, no treatment is necessary, but it is always essential to have an evaluation done as soon as possible.
- What is hepatitis?
- Hepatitis means "inflammation of the liver." When the liver becomes inflamed, the major symptoms are jaundice (yellow skin), fatigue and nausea. Viruses, chemicals or toxins can cause hepatitis. Occasionally, the disease can be very severe and cause liver failure, which may be fatal. A type of viral hepatitis - hepatitis B - is a serious threat to health care workers and can be prevented.
- What is hepatitis B?
- Hepatitis B is caused by a virus (HBV) that is present in many body fluids, including blood and semen. The Centers for Disease Control and Prevention estimates that there are approximately 300,000 hepatitis B infections yearly in the U.S. - and that 8,700 of those occur in health care workers. Many of these infections will be subclinical, meaning the person will not experience any symptoms and may be unaware of the infection. However, a significant proportion will develop acute hepatitis with jaundice and fatigue, and about 10,000 people will require hospitalization. Most people who are infected with hepatitis B get over the disease and can no longer give it to others or suffer chronic complications. However, in 10% of people, the infection will not resolve and will become chronic (persisting for a long time).
- What are the consequences of having chronic hepatitis B?
- People with chronic hepatitis B either develop chronic hepatitis (which can lead to cirrhosis) or may become carriers. Carriers are people who do not have liver damage and may feel perfectly well but are able to transmit the disease to others through blood or sexual contact; mothers may transmit the disease to their newborn child.
- How is Hepatitis B transmitted?
- Hepatitis B is found in the blood and many other body fluids of infected people. It is transmitted through sexual contact or by blood or other infective fluids of an infected person (someone actively sick or a chronic carrier) coming into contact with blood or mucous membranes (eyes and mouth) of a susceptible (not immune) person. That is why it is called a bloodborne infection. Hepatitis B also can be transmitted from an infected mother to her baby in utero (in the uterus) or at birth.
- Why are health care workers at risk?
- Many health care workers are exposed to blood or other body fluids. If the fluid is infected with the virus and comes in contact with the healthcare worker's blood or mucous membranes, there is a 10 to 30 percent chance of becoming infected with the hepatitis B virus. Some examples of significant contact are available here.
- As you can see, many different kinds of health care workers are potentially exposed every day.
- What can a health care worker do for protection against hepatitis B?
- Second, every health care worker at the University of Michigan Health System should comply with the UMHHC Policy of Body Substance Precautions (Michigan Medicine Internal Audience only). Standard Precautions (SP) is a method of using personal protective equipment such as gloves, gowns, masks, eye and face shields, etc., to prevent contact with body fluids. This equipment is available in every patient care area.
SP includes using and disposing of sharp objects safely. This means disposing of all sharps carefully in the designated sharps disposal containers. Soiled linen and other objects also should be disposed of properly.
Spills should be cleaned using proper protective equipment and a disinfectant. Using SP also will protect the health care worker from other bloodborne infections such as HIV and hepatitis C - potential hazards to health care workers for which there is no protective vaccine.
- Who else should be vaccinated?
- The CDC has identified persons at substantial risk for coming into contact with the hepatitis B and has recommended vaccination for susceptible individuals. People are identified as being at risk if they are likely to experience sexual or blood contact with infected people. Your health care professional or the nurses in the U-M Occupational Health Services can advise you of the CDC's recommendations for people other than health care workers.
- Is the vaccine effective?
- Yes. The vaccination provides immunity against infection in more than 90 percent of individuals who receive the complete three-dose series. Protection is long lasting. Currently, the CDC does not recommend booster doses after completing the series.
- Is the vaccine safe?
- Yes. In most cases, vaccination does not produce any symptoms. Sometimes, a mild amount of soreness in the injection site (upper arm) occurs several hours after injection and lasts one or two days. Rarely, mild joint aches and low-grade fever will follow vaccination and last for several days. The vaccine is derived from yeast proteins and does not contain any human serum. It cannot transmit any infectious disease. If you have a very serious allergy to yeast, the vaccine may cause an allergic reaction, but this occurs very rarely.
- How do I know whether I should have the vaccine?
- The nursing staff in U-M Occupational Health Services will discuss your job duties with you and will help you determine whether you should have the vaccine. They also will ask you a few questions about your health to make sure the vaccine is right for you.
- What if I don't want to be vaccinated?
- The federal government requires that workers who may be exposed to blood or other potentially infectious fluids must receive information about the vaccine, be offered the vaccine free of charge and, if they don't want the vaccine, sign a declination statement. This enables the employer to have a record of the vaccination status of each employee so that proper treatment can be given in the event of an exposure. Signing the declination statement will not affect your continued employment. If you change your mind later and decide you want to take advantage of the protection offered, the vaccine will be provided free of charge through the U-M Occupational Health Services.
- What if I experience an exposure to body substances?
- If the ENTL nurse evaluates you after hours, you will need to call the U-M Occupational Health Services the next business day; this will ensure necessary follow-up.
- Where can I receive more information regarding hepatitis B and other risks of health care workers?
- U-M Occupational Health Services staff are available for questions regarding any aspect of the health and safety of University Hospital employees. All of us can help make our workplace a safe and healthy environment. We want to work with you to achieve that goal.