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Healthcare-Associated Infections: Infection Prevention for Occupational Health

Gloved hand dropping catheter into sharps disposal box

Health care personnel (HCP) are at an increase risk for occupational exposure to many different type of infectious diseases. All health care facilities should have a robust employee health program, also referred to as an occupational health program in order to protect HCP. The infection preventionist should have a good understanding of the occupational infection prevention concerns for HCP and the measures being taken to manage and protect them.

The content below details the various components of the occupational health program related to infection prevention. For additional information, refer to the Occupational Health and Safety Surveillance Program webpage.

HCP can be exposed to a variety of infectious diseases while performing their job duties. Facilities have a responsibility to implement an occupational health program to protect HCP.

  • The person(s) dedicated to overseeing the program should receive specific training for occupational infection prevention.
  • Sufficient resources should be allocated for the program to ensure all elements are implemented.
  • Policies and procedures should reflect the latest evidence-based practices and adhere to all federal, state, and local requirements.
  • Performance measures, such as HCP documented evidence of immunity or vaccine uptake, should be monitored and goals set for any identified opportunities for improvement.
  • The program should be evaluated on a periodic basis to assess its effectiveness.

HCP should receive initial, periodic, and as-needed education and training on key occupational infection prevention policies and procedures. Topics may include:

  • Modes of disease transmission.
  • Use of standard, enhanced barrier, and transmission-based precautions.
  • Hand hygiene.
  • Sharps injury prevention.
  • Immunization recommendations.
  • Infectious disease screening.
  • Occupational health services.
  • Expectations for reporting exposures.
  • Expectations for reporting illnesses or conditions (work-related or acquired outside of work).
  • Sick leave policies and procedures.

Resources

It is recommended that all health care facilities have policies that outline communicable diseases exposure and illness management. These policies should include:

  • Workflows that encourage HCP who demonstrate signs and symptoms of illness to remain home until the infectious period has passed, without penalty.
  • A system for HCP to report signs and symptoms of suspected or confirmed infectious diseases, as well as exposures to infectious diseases.
  • Disease specific recommendations to help determine when HCP may return to work following an illness or exposure to an infectious disease or illness.
  • Processes to report communicable diseases and outbreaks to the local health department per Wisconsin communicable disease reporting requirements.
  • Processes for the management of potentially infectious exposures and response, including outbreak management of communicable diseases amongst HCP.

Resources

The Occupational Safety and Health Administration (OSHA) issued the Bloodborne Pathogens Standard 29 CFR Part 1910.1030 to protect HCP and others who come in contact with blood and other potentially infectious material (OPIM) during their job duties. The standard requires employers to write and implement an exposure control plan. The plan should detail administrative, engineering, and work practice controls to prevent or minimize employee exposure to blood and OPIM.

Key infection prevention elements that facilities should focus on include:

  • Implementing engineering and work practice controls that minimize occupational exposures, such as:
    • Cleaning and disinfecting contaminated equipment and surfaces.
    • Safe laundry handling.
    • Proper hand hygiene practices.
    • Standard precautions.
    • Food and drink restrictions in potentially contaminated areas.
    • Leak-proof containers for specimen storage.
    • Sharps and safety devices
  • Ensuring the availability and proper use of personal protective equipment (PPE).
  • Ensuring that the work environment is clean and in sanitary condition.
  • Providing appropriate management of infectious waste including the safe management and disposal of sharps.
  • Using signs and labels to communicate hazards to employees.

For more information on bloodborne pathogen exposures, OPIM, and exposure control plans visit the HAI: Reportable Exposures webpage.

Visit the Reportable Exposures webpage

Post-exposure prophylaxis (PEP)

Health care facilities should have an agreement with a medical provider that can provide care and perform all medical evaluations and procedures in accordance with current recommendations of the U.S. Public Health Service (PHS), including administer PEP if indicated. When indicated, PEP must be started within 72 hours after exposure (preferably within hours). A list of Wisconsin providers, P-01180C offering PEP is available.

Medical providers caring for HCP with a possible exposure can reach out to experts for support and advice on managing occupational exposures by visiting the National Clinician Consultation Center webpage or calling the PEP line at 1-888-448-4911. Exposed HCP may also call the PEP line, but they should seek local medical attention first.

Find more information by visiting the HIV: PEP webpage.

Visit the PEP webpage

Resources

HCP are at risk for exposure to infectious diseases including hepatitis B, influenza, measles, mumps, rubella, and varicella. The Immunization Action Coalition provides vaccination recommendations to protect HCP from these illness and others.

Facilities should implement an effective immunization program that focuses on preventing vaccine-preventable diseases among HCP by:

  • Developing processes for offering immunizations and documenting evidence of immunity against vaccine-preventable disease.
  • Developing strategies to increase vaccine uptake for HCP and create goals to improve vaccination rates. Refer to the CDC Immunization Programs for HCP for strategies that could be used to increase uptake.

The Occupational Health and Safety Administration (OSHA) requires that a hepatitis B vaccine is offered to all HCP who may have contact with blood or other potentially infectious material (OPIM) within 10 days of employment, at no cost to the HCP. Post-vaccination screening for protective levels of hepatitis B surface antibody should be conducted 1-2 months after completion of the vaccination series. Refer to the OSHA Hepatitis B fact sheet (PDF) for more information.

HCP who decline a hepatitis B vaccination are required to sign a declination statement or provide proof of immunity. Note: Some individuals may have received this vaccine either as a part of their general health care or from a former employer or school affiliation.

The Wisconsin Immunization Program is available as a resource, if needed.

Contact the Immunization Program

Resources

Respiratory hazards in health care facilities can include chemicals, vapors, gases, and infectious agents. Exposures to infectious agents, such as TB, measles, and whooping cough can also lead to disease transmission among HCP, patients, residents, or visitors. Facilities should perform a risk assessment to determine the types of respiratory hazards that may be encountered in their facility and the type of PPE that should be used.

Facilities that identify respiratory hazards should establish and maintain a respiratory protection program per the Occupational Safety and Health Administration’s (OSHA) Respiratory Protection Standard (29CFR 1910.134). Components of a respiratory protection plan include:

  • Worksite-specific procedures.
  • Elements for required respirator use.
  • Medical clearance.
  • Training.
  • Fit testing.

More information on respiratory protection programs can be found on the HAI: Respiratory Protection Program webpage.

Visit the Respiratory Protection webpage

Resources

Every health care facility should have a written TB infection control plan that ensures prompt detection, airborne precautions placement, and treatment of persons who are suspected or have confirmed TB disease. The CDC TB risk assessment can be used to assess the facilities risk for TB. Facilities that do not expect to encounter TB should still have a plan in place to minimize potential exposures.

The TB plan, along with policy and procedures, should be reviewed annually and evaluated for effectiveness to ensure the actions taken by the facility are minimizing the risk for the transmission of TB.

Facilities should review the DHS Tuberculosis Precautions webpage and the CDC Tuberculosis Infection Control webpage for further information.

Screening

Screening for latent TB infection (LTBI) and TB infection should be performed before HCP begin any job duties in which they will have direct contact with patients. It is recommended that:

  • Baseline TB screening is preformed upon hire.
  • A risk assessment is conducted annually to reevaluate exposure risk.
  • Screening is repeated based on exposure to risk.

The Wisconsin TB Program has developed a decision tree, P-02530 (PDF) to assist with screening HCP and caregivers upon hire, as well as a worksheet, F-02314E (PDF) to determine the need for repeat TB testing after baseline testing. Wisconsin screening and testing guidance, P-02382 (PDF) is also available.

Resources

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Last revised May 5, 2026