Guidance

Bloodborne viruses in healthcare workers: report exposures and reduce risks

Monitoring significant occupational exposures to HIV, hepatitis B and hepatitis C in healthcare workers, and advising on avoiding injuries.

Exposure risks to healthcare workers

Healthcare workers are potentially exposed to BBVs while they work via:

  • percutaneous routes, where a sharp object cuts or penetrates the skin
  • mucocutaneous routes, which include contamination of the nose, eyes, broken skin or mouth

Healthcare workers include:

  • clinical staff who have regular clinical contact with patients
  • laboratory staff who have direct contact with potentially infectious clinical specimens
  • non-clinical support staff who may have contact with patients, but not usually of a prolonged or close nature

The risk of a BBV being transmitted depends on:

  • the viral load in the infected source patient
  • the depth of the injury
  • whether the procedure involved placing a needle in a patient’s vein or artery

Significant exposures

A significant exposure is a percutaneous or mucocutaneous exposure to blood or other body fluids from a source patient who is infected with:

  • HIV
  • hepatitis B surface antigen positive (HBsAg positive)
  • hepatitis C

Data collection

Data collection is temporarily suspended whilst the Significant Occupational Exposures surveillance system is under review.

Submit an exposure report: voluntary and confidential

Data collection is temporarily suspended whilst the Significant Occupational Exposures surveillance system is under review.

Epidemiology

Eye of the needle is the UK Health Security Agency (UKHSA) report on significant occupational exposures to bloodborne viruses in healthcare workers: it includes a slide set on significant occupational exposures.

HIV

HIV: surveillance, data and management

UK guideline for the use of HIV post-exposure prophylaxis 2021, British Association for Sexual Health and HIV (BASHH).

HIV-infected health care workers: guidance on management and patient notification, DH 2005.

HIV-infected healthcare workers and exposure prone procedures

Hepatitis B

Hepatitis B: guidance data and analysis

See Immunisation against infectious diseases: the green book on vaccination against hepatitis B and immunisation of healthcare and laboratory staff.

Hepatitis B infected healthcare workers and antiviral therapy DH, 2007.

Hepatitis C

HSC 2002/010 - Health service circular and guidance on hepatitis C infected health care workers DH, 2002.

Guidance on the investigation and management of occupational exposure to hepatitis C, CDPH, 1999

Management of bloodborne viruses in healthcare workers

UK Advisory Panel for healthcare workers infected with bloodborne viruses gives advice about transmission and management of BBVs in healthcare workers and keeps a confidential register of infected workers.

Good practice guidelines for renal dialysis/transplantation units: prevention and control of blood-borne virus infection DH, September 2002.

Guidance for clinical healthcare workers: protection against infection with bloodborne viruses DH, March 1998

Health clearance for tuberculosis, hepatitis B, hepatitis C and HIV: new healthcare workers DH, March 2007

RIDDOR: Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 from HSE.

Medical and dental students: health clearance for hepatitis B, hepatitis C, HIV and tuberculosis from Medical Schools Council, 2008.

Raising awareness of needlestick injuries in healthcare settings

Published 5 December 2012
Last updated 20 December 2021 + show all updates
  1. Updated guidance for data collection and submitting an exposure report to reflect the current ongoing review of the Significant Occupational Exposures surveillance system.

  2. First published.