The 1993 Department of Health guidelines permit a surgeon who is hepatitis B surface antigen (HBsAg) positive but e-antigen (HBeAg) negative to perform exposure prone procedures, unless demonstrated to have infected patients.
However, there is increasing evidence of transmission of hepatitis B to patients from health care workers in this supposedly low infectivity category.
The Occupational Physician must decide whether existing guidelines represent an adequate risk assessment and indeed whether this is an acceptable risk for patients.
If an NHS Trust continues to follow these guidelines it may be in breach of its duty of care to patients.
Yet refusing to allow such carriers to operate without testing for additional serological markers may be unlawful discrimination.
Further research is clearly needed as well as an urgent review of the guidelines.
Mots-clés Pascal : Equipe soignante, Chirurgien, Médecine travail, Hépatite virale B, Virose, Infection, Transmission homme homme, Malade, Facteur risque, Prévention, Recommandation, Surveillance biologique, Sérologie, Homme, Appareil digestif pathologie, Foie pathologie
Mots-clés Pascal anglais : Health care staff, Surgeon, Occupational medicine, Viral hepatitis B, Viral disease, Infection, Transmission from man to man, Patient, Risk factor, Prevention, Recommendation, Biological monitoring, Serology, Human, Digestive diseases, Hepatic disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0102267
Code Inist : 002B05C02G. Création : 16/11/1999.