Abstract
Background: Healthcare workers are exposed to a variety of biological hazards. The World Health Organization (WHO) reports that of the 35 million health-care workers, 2 million experience percutaneous exposure to infectious diseases each year. 37.6% of Hepatitis B, 39% of Hepatitis C and 4.4% of HIV/AIDS in Health-Care Workers around the world are due to needle stick injuries. Health care organizations in the west have well-equipped occupational health centre which not only provide pre-employment checks and screening, but also give specific advice following occupational exposure to blood borne pathogens in line with the recommendations for post-exposure prophylaxis. While industries are required to have occupational centres in their setting, it is ironic that medical institutions and hospitals in India and many south asian countries do not have occupational health screening and effective pre-employment checks for their own employees.
Material and Methods: A pubmed search of “occupational health screening for health care workers-was conducted. A search of websites health ministry of ten south asian countries (except Democratic People’s Republic of Korea) was conducted to find existing guidelines for occupational health screening of health care worker. An email communication was sent to ministry of health departments of eight south asian countries enquiring for presence of recommendations or guidelines for occupational health screening of health care worker and pre admission screening tests for graduate and post graduate medical courses. A similar e mail was to at least one medical education institution of nine south east asian countries and medical councils of eight south east asian countries.
Results: Website search of health ministry and medical councils of south east asian countries did not reveal any existing guidelines for occupational health screening of health care worker. Response to our email questionnaire was obtained from health ministries of only two countries, one medical council and one medical institute. There is a urgent need for the establishment of occupational health services for healthcare workers in India and south asian countries where it is non existant.
References
- Needle stick injuries. Occupational Health World Health Report 2002.World Health Organization; Geneva: accessed 20 April 2019 https://www.who.int/occupational_health/topics/needinjuries/en/
- World Health Organization; Geneva, Workers’ health: May 2007 global plan of action, WHA 60.26, 23 May 2007, https://www.who.int/occupational_health/WHO_health_assembly_en_web.pdf accessed02Feb 2019
- World Health Organization; Geneva. The joint WHO-ILO-UNAIDS policy guidelines on improving health workers’ access to HIV and TB prevention, treatment, care and support servicehttps://apps.who.int/iris/bitstream/handle/10665/44467/9789241500692_eng.pdf?sequence=1accessed 03May 2019
- Guidance For Occupational Health Services In Medical Centers .American College of Occupational and environmental medicine, Illinois, Sept 2010 https://acoem.org/acoem/media/PDF-Library/Public_Affairs/Policies_And_Position_Statements/Guidelines/Guidelines/Medical-Center-OHS-Guidance.pdfaccessed 05 July 2019
- Centre for disease control. Atlanta ,Recommended Vaccines for Health care Workers.Available fromhttp://www.cdc.gov/vaccines/adults/rec-vac/hcw.html Accessed 08July 2019
- Department of Health, London , Health Clearance for tuberculosis, hepatitis B, hepatitis C and HIV: New healthcare workers., March 2007 http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_074981.pdfaccessed 28 April 2019
- Graduate Medical Education Resident Policy Manual University of Utah Health Care Salt Lake City USA .https://medicine.utah.edu/gme/files/policies-docs/1.5.pdf accessed 28 April 2019
- Student Health services, The University of Alabama, Medical clearance Schools of Dentistry, Medicine, & Optometry. https://medschool.ucla.edu/workfiles/Site-Current/Policies/MD%20Program%20Policies-0619-V1.pdfaccessed 28 April 2019
- Health clearance policy, David Geffen School of Medicine, Los Angeles https://www.immunizationrequirement.ucla.edu/My-Requirements/Second-Requirement accessed 14 April 2019
- Health Policy for Medical Students ,Stony Brook School of Medicine New York http://medicine.stonybrookmedicine.edu/som/studhealthpol#exposureaccessed 28 April 2019
- Libby TE, Lindley MC, Ahmed F, Stevenson J, Grabowsky M, Strikas RA. Student vaccination requirements of U.S Health professional schools: a national survey. J Allied Health. 2014;43:12-21.
- Occupational assessment, screening and vaccination against specified infectious diseases NSW Heath Procedures http://www.health.nsw.gov.au/immunisation/Documents/Occupational/student_kit.pdfaccessed 24 April 2019
- Graduate Medical Education. Cleveland Clinic, Ohio https://my.clevelandclinic.org/departments/graduate-medical-education/incoming-residents-fellows/occupational-health-screening. accessed22 April 2019
- The Medical Schools Council ,London ,2007 Medical and dental students: Health clearance for Hepatitis B, Hepatitis C, HIV and Tuberculosis , https://www.medschools.ac.uk/media/1886/medical-and-dental-students-health-clearance-for-hepatitis-b-hepatitis-c-hiv-and-tuberculosis.pdf ,accessed3July 2019
- Medical Council of India ,New Delhi , Post Graduate medical education regulations 2000(Amended upto 2017 ) https://www.mciindia.org/documents/rulesAndRegulations/Postgraduate-Medical-Education-Regulations-2000.pdf accessed02 April 2019
- Ministry of Labour and Employment, New Delhi, Feb 2009, National policy on safety health and environment at work place. http://www.dgfasli.nic.in/npolicy/OSH-Policy.pdf accessed 02 April 2019
- National Institute of occupational health, Ahmedabad. http://www.nioh.org/accessed 02 April 2019.
- All India Institute of Medical Sciences New Delhii-Post Graduate Prospectus https://www.aiimsexams.org/pdf/Final%20PG%20Prospectus%20January%202019.pdf accessed 20 July 2019
- All India Institute of Medical Sciences New Delhi-MBBS Prospectus July 2014 session Available from https://www.aiims.edu/aiims/academic/aiims-syllabus/MBBS-schedule.pdfaccessed 01 July 2019
- Shyam Pingle, Occupational safety and health in India, Now and the future. Ind Health 2012;50: 167-71.
- Sukriti, Pati NT, Sethi A, Agrawal K, Agrawal K, Kumar GT, Kumar M, Kaanan AT, Sarin SK. Low levels of awareness, vaccine coverage, and the need for boosters among health care workers in tertiary care hospitals in India .J GastroenterolHepatol.2008 ;23:1710-5.
- Rambha Pathak, Chintu Chaudhury, Deepak Pathania ,Surendra Kumar Ahluwalia, Prabhakar K Misra, Arunpreet S Kahlon. Hepatitis B vaccine: Coverage and factors relating to its acceptance among health care workers of a tertiary care center in North India. International Journal of Medicine and Public Health 2013;3:55-59
- Jindal M, Rana SS, Gupta RK, Das K, Kar P. Serological study of hepatitis A virus infection amongst the students of a medical college in Delhi & evaluation of the need of vaccination. Indian J Med 2002 ;115:1-4
- Aziz S, Memon A, Tily HI, Rasheed K, Jehangir K, Quraishy MS. Prevalence of HIV, hepatitis B and C amongst health workers of Civil Hospital Karachi.J Pak Med Assoc2002 ;52:92-4.
- Danchaivijitr S, Rongrungruang Y, Boonchsalermvipas S, Gusalanan A, Tuntiwattanapibul Y. Prevention and treatment of infectious diseases in healthcare workers.J Med Assoc Thai 2005 ;88 Suppl 10:S65-9.
- Yanai H, Limpakarnjanarat K, Uthaivoravit W, Mastro TD, Mori T, Tappero JW Risk of Mycobacterium tuberculosis infection and disease among health care workers, Int JTuberc Lung Dis. 2003:7:36-45
- Jo KW, Woo JH, Hong Y, Choi CM, Oh YM, Lee SD, Kim WS, Kim DS, Kim WD, Shim TS. Incidence of tuberculosis among health care workers at a private university hospital in South Korea.IntJ Tuberc Lung Dis 2008 ;12:436-40.
- National Vaccine policy, Ministry of Health and Family welfare , Government of India ,New Delhi http://mohfw.nic.in/showfile.php?lid=900 accessed 24 May 2019.
Corresponding Author
Narendra P L, MD, PDFC, MRCA, MRCS-I
Associate Professor, Department of Anesthesiology and Intensive Care, Subbaiah Institute of Medical Sciences and Research, Purale Shivamogga 577222, Karnataka, India