Definition of Healthcare Workers

The Association of National Health Occupational Physicians (ANHOPS) guidance on Immunisation of healthcare workers defines three categories of healthcare workers:

1	Clinical and other staff, including those in primary care, who have regular, clinical contact with patients. This includes staff such as doctors, dentists and nurses, paramedical professionals such as occupational therapists, physiotherapists, radiographers, ambulance workers and porters, and students in these disciplines;
2	Laboratory and other staff (including mortuary staff) who have direct contact with potentially infectious clinical specimens and may additionally be exposed to pathogens in the laboratory. This includes those in academic (or commercial research) laboratories who handle clinical specimens. They do not normally have direct contact with patients;
3	Non-clinical ancillary staff who may have social contact with patients, but not usually of a prolonged or close nature. This group includes receptionists, ward clerks and other administrative staff working in hospitals and primary care settings and maintenance staff such as engineers, gardeners, cleaners, etc. These staff may be exposed to other specific occupational risks which require their own surveillance programmes.

Individual risk may vary according to the nature of work the HCWs is involved with. HCWs may move within categories, therefore, risk assessment needs to be ongoing.

ANHOPS .  Immunisation of healthcare workers. Where: ANHOPS, September 2001

Definition of Exposure Prone Procedures (EPPs)

(An extract from HIV Infected Health Care Workers: Guidance on Management and Patient Notification. London: Department of Health, July 2005)

Exposure prone procedure criteria

Judgements are made by occupational physicians, or in conjunction with the United Kingdom Advisory Panel on Health Care Workers Infected with Blood-borne Viruses (UKAP) where doubt or difficulty exists, about whether any procedure is or is not exposure prone against the following criteria:

Exposure prone procedures (EPPs) are those where there is a risk that injury to the worker may result in exposure of the patient's open tissues to the blood of the worker. These procedures include those where the worker's gloved hands may be in contact with sharp instruments, needle tips or sharp tissues (spicules of bone or teeth) inside a patient's open body cavity, wound or confined anatomical space where the hands or fingertips may not be completely visible at all times.

Please see Annex A (page 52) of this document for examples of UKAP advice on exposure prone procedures:
HIV Infected Health Care Workers: Guidance on Management and Patient Notification. London: Department of Health, July 2005

Last reviewed: 17 April 2008