Employee/Occupational Health
What to know
Occupational health programs protect healthcare workers through immunization, exposure management, and surveillance. Candidates must know post-exposure protocols for bloodborne pathogens (HBV, HCV, HIV), needlestick management, and the difference between post-exposure prophylaxis and pre-exposure vaccination. Know that hepatitis B vaccine series with post-vaccination titer is standard, and that non-responders need revaccination or evaluation. Understand TB screening (baseline and periodic), fit testing for respirators (annual), and exclusion-from-work criteria for communicable diseases (e.g., healthcare workers with active TB, measles, or varicella must be excluded until non-infectious).
Traps
- Confusing HIV PEP timing (start as soon as possible, within hours) with vaccine schedules.
- Assuming a needlestick from an HCV-positive source requires immunoglobulin (it does not).
- Forgetting that HCWs with herpes zoster can work if lesions are covered, but disseminated zoster requires exclusion.
- Missing that annual TB testing is no longer universal for all HCWs in low-risk settings; risk assessment drives frequency.
- Confusing employee health records confidentiality with general infection control reporting.
Worked example / rule of thumb
A nurse sustains a needlestick from an HIV-positive patient. Wash the site, report immediately, and start HIV PEP as soon as possible (ideally within hours, not days), with baseline testing and follow-up. Rule of thumb: for exposures, the clock matters-act first, document second. For vaccine-preventable illness, immunity status determines work restriction.