CDC suggests check-ups, counseling for HCWs
CDC suggests check-ups, counseling for HCWs
Medical evaluations linked to job assignments and ongoing access to health counseling are two approaches recommended for assisting immunocompromised health care workers in draft guidelines under consideration by the Centers for Disease Control and Prevention in Atlanta.
The recommendations are part of an updated employee health guideline under discussion by the CDC Hospital Infection Control Practices Advisory Committee. Though still in draft form, a copy of the recommendations obtained by Hospital Infection Control recommends a placement evaluation be conducted when workers are initially appointed or are reassigned later to jobs to reduce risk of infection. A health inventory is an important part of this evaluation, and should include the following, according to the CDC:
* Document a history of any conditions that may predispose the health worker to acquiring or transmitting infectious diseases -- for example, a history of such childhood diseases as chickenpox and measles; history of high-risk characteristics or conditions for, exposure to, or treatment for tuberculosis; history of hepatitis; dermatologic condition; chronic draining infections or open wounds; and immunodeficient conditions.
* Physical examinations may be useful to detect conditions that may increase the likelihood of transmitting disease to patients, or unusual susceptibility to infection, and to serve as a baseline for determining whether any future problems are work-related. However, the cost-effectiveness of routine complete physical examinations or of routine laboratory testing (such as complete blood counts, serologic tests for syphilis, urinalysis, chest roentgenogram) or preemployment screening for enteric or other pathogens for infection control purposes has not been shown.
* Screening for tuberculosis by using the skin tests or for some vaccine-preventable diseases, such as hepatitis B, measles, mumps, rubella, or varicella, may prove to be cost effective to the hospital and beneficial to the health care workers. In general, the health inventory can be used to determine whether physical examinations or laboratory tests are needed.
* Access to health counseling about illnesses they may acquire from or transmit to patients is especially important for all hospital personnel, but particularly for women of childbearing age and persons with special clinical conditions, such as immunosuppression from any cause. *
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