Step 7 of 8

Employment Forms 07 - HEPB Form

  • Hepatitis B Acceptance/Declination

  • This is a general education document for all employees about the principles of universal precautions used to prevent exposure to bloodborne diseases in the workplace. The two major infection agents we are concerned about are Hepatitis B virus (HBV) and Human Immunodeficiency Virus (HIV) which is the virus that causes AIDS. The Occupational Safety and Health Administration (OSHA) has regulations concerning universal precautions, employee compliance, and institutional regulations for education and documentation of training. Reading this document and attending an in-service will meet the requirement for this year's education regarding universal precautions. The purpose of the training is to promote discussion about this and related topics. It should promote not only good care for our patients, but also caring for ourselves. Any additional questions should be directed to the Clinical Director. This is to be used in combination with the other instructional material and video during your orientation process.


    1. OSHA established explicit regulations regarding employer/employee rights and responsibilities for universal precautions, Hepatitis B exposure, etc. We have a copy of the regulations on file. If you so desire, this copy is accessible to all employees for review. If you have any questions, do not hesitate to ask.
    2. The information sheet on Hepatitis B vaccine reviews the basic epidemiology of Hepatitis B (and who is at risk of getting the virus). The HIV virus can be transmitted in a similar fashion to HBV. However, it is actually harder to acquire the HIV virus (it is less readily transmissible through the same routes as HBV) and presently the HIV virus has only been documented to be transmitted by actual blood or sexual contact. Unlike HBV, there is no documented HIV transmission to close, non-sexual household contact. The symptoms of Hepatitis B can include severe fatigue, nausea, and lack of appetite for at least three days. Later in the course of the illness some people become jaundiced (i.e. their skin and white part of the eyes turns yellow). The symptoms of HIV disease can include a flu-like illness, often within one to two weeks of exposure; fatigue, weight loss, night sweats, swelling of the lymph nodes. If you have any of these symptoms and suspect they may be related to an exposure at work report to your on site supervisor for instructions.
    3. This paragraph describes the modes of transmission of bloodborne pathogens in the workplace. Potentially infective materials include human blood and any human bodily fluid, which might be contaminated with blood. This could include vaginal secretions, pleural fluid, and saliva in patients with open sores in their mouths. Occupational exposure means that this type of potentially infective material has contacted an employee's broken skin or mucous membrane (mouth or eyes most commonly). Exposure can also be parenteral. Parenteral means piercing mucous membranes or the skin barrier through such events as needle sticks, human bites, cuts, and abrasions.
    4. Because it is often impossible to know whether a patient has an infectious disease, the best way to protect yourself is to treat ALL patients alike, taking the SAME precautions with EACH one. The following general guidelines should be part of your work routine, and practiced diligently. These guidelines apply to you if: you have contact with patients' blood and bodily fluids through direct patient care; for example doctors, medical assistants drawing blood. They also apply if: you have contact with patients' blood and bodily fluids indirectly through the handling of blood specimens, soiled linen, dirty equipment, and waste; for example laboratory technicians and housekeeping.