In a number of projects at the UT, staff members and/or students work with human blood and/or blood products (blood cells). These projects involve a certain risk of accidental blood contact. This protocol is intended for the above staff members and students.
There may be blood contact if someone is injured by a contaminated needle or glassware. Splashes and aerosol formation may also cause contaminated material to enter the body via wounds, splits, eczema and via the mucous membrane of the eyes and mouth.
Based on Article 4.91 of the Working Conditions Decree, the working conditions policy rules provide that staff members in diagnostic and research laboratories who frequently come into contact with human blood or human blood products should be allowed by their employer to be vaccinated against hepatitis B (see Annex I).
Blood of (‘healthy’ or hospital) donors may contain viruses. The 'highest-risk' viruses are the hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). A vaccination is only available against hepatitis B.
Hepatitis B is a serious form of liver infection. After an infection, 90% of infected people are able to overcome the disease with their own immune system; 10% of infected people are not able to do so. These persons will continue to be contagious (sometimes without them knowing) and later have an increased risk of liver cirrhosis (atrophy due to scarring) or liver cancer.
People are vaccinated against hepatitis B with a non-infectious vaccine containing HBV surface proteins obtained through genetic modification. The vaccine is administered through three injections at 0, 1 and 6-month intervals. A titre test (4 to 8 weeks after the final dose) should demonstrate if the vaccination has produced sufficient results. A vaccination offers protection for at least fifteen years.
The vaccination can be administered by GGD Twente (Nijverheidstraat 30, 7511 JM Enschede, 053-4876888). Depending on the age of the person concerned and any previous vaccinations, the GGD Twente will decide if a titre test should be performed first or if the 1st vaccination can be administered immediately. A vaccination card containing vaccination data will be issued afterwards. The faculty ensures that the registration card is registered. This card or a copy hereof must be stored for at least fifteen years.
People who are not vaccinated against hepatitis B and suffer a needlestick injury must be given immunoglobulins, depending on the risk of infection. Immunoglobulins should be given within 48 hours and provide full protection. A vaccination must be administered afterwards.
People who are vaccinated against hepatitis B still run a risk of infection with hepatitis C or HIV.
Any needlestick injuries should immediately be reported to the company doctor of the University of Twente (088-2726312). Depending on the nature of the contact and risk of infection, the company doctor may decide to take further action, for example a baseline serum, serological testing etc. Moreover, needlestick injuries must always be reported using the accident form.
Cleaning staff suffer needlestick injuries mostly because other people act negligently when it comes to sharp and dirty materials. Any unsafe situations should always be reported to the head of the lab, who can confront the negligent staff about their behaviour. The procedure used for cleaning staff who suffer needlestick injuries is the same as the procedure used for laboratory staff.
Basis: Working Conditions Decree, Article 4.91(6), (8) and (9).
- Staff members who work in medical and paramedical professions and who run a risk of having intensive contact with human blood shall be allowed by their employer to be vaccinated against hepatitis B.
- The staff members referred to in the first paragraph shall, in any case, include:
- doctors, nurses and paramedics who often come into contact with human blood or with other patient materials contaminated with human blood;
- forensic pathologists and their staff who work with non-fixed, potentially contaminated materials;
- staff members who work on haemodialysis departments and who are directly involved in patient care or in the technique of the haemodialysis procedure, including technical maintenance staff;
- staff members in diagnostic and research laboratories who often come into contact with human blood or human blood products;
- obstetricians and maternity carers;
- dentists, oral hygienists, dentist's assistants and those who are indirectly involved in dental care of patients and run a risk of infection.
- Staff members who look after test animals in laboratories working with the hepatitis B virus shall be allowed by their employer to be vaccinated against hepatitis B.
- Staff members in hospitals who perform cleaning work or remove waste shall be allowed by their employer to be vaccinated against hepatitis B if there is a fair chance of infection.
- Staff members transporting non-fixed, potentially contaminated pathological materials shall be allowed by their employer to be vaccinated against hepatitis B if there is a fair chance of infection.
- A vaccination card shall be drawn up for staff members who are vaccinated against hepatitis B. This card shall at least specify the vaccination date and the antibody titres (after vaccination or after an interim check-up), along with the test date. Vaccinated staff members shall receive a copy of the vaccination data. On request, the vaccination card shall be provided to a designated supervisor and shall be stored by the institution for at least fifteen years.