Introduction

There are three major factors to consider when developing infection control-related administrative policies and work restrictions. OHCP and patients may (1) be susceptible to latex-related adverse reactions, (2) develop acute or chronic medical conditions, which may predispose them to opportunistic infections, or (3) may acquire potentially transmissible pathogens.^1-3 Policies dealing with these issues should (1) be written, (2) include a statement of authority that defines who can exclude OHCP from duty (e.g., personal physicians), and (3) be clearly communicated through education and training.^1-3

Latex-related adverse reactions may be minimized by (1) reducing exposure to latex-containing materials by using appropriate work-practice controls, (2) substituting non-latex products where appropriate, (3) training and educating OHCP to recognize signs and symptoms of latex-related adverse effects and to monitor for signs and symptoms of latex sensitivity among OHCP and patients, and (4) establishing an institutional infrastructure for the seamless referral of OHCP and patients with signs and symptoms suggestive of latex allergy to a physician to confirm the diagnosis.^1,2

OHCP and patients may also develop acute or chronic medical conditions such as immune deficiency syndromes, chronic diseases (e.g., diabetes mellitus, cancer, emphysema, heart failure, malnutrition), or undergo immunosuppressive therapy (e.g., radiotherapy, chemotherapy, anti-graft rejection medications, steroids, monoclonal antibodies) that render them susceptible to opportunistic infections. Such individuals should discuss the problem with their personal physician to determine if the condition might affect their ability to safely perform their duties.^1-3

Finally, OHCP may become exposed to or infected with transmissible pathogens. Policies should encourage OHCP to report exposures or illnesses without jeopardizing wages, benefits, or job status.³ Decisions concerning work restrictions intended to prevent healthcare-associated transmission of pathogenic organisms should be based on the mode of transmission and the period of infectivity of the pathogen; and, in some instances, the level of circulating viral burden and level of risk for transmitting a pathogen (i.e., HBV, HCV, and HIV) in association with a procedure.^1-3