HIV Research Laboratory Occupational Medicine Policy

OBJECTIVE

This policy is designed to protect employees who conduct research with HIV. Researchers who handle, manipulate, or assay live HIV cultures are covered under this policy.

POLICY

This policy sets forth the requirements for conducting research with HIV by University of Florida personnel.

AUTHORITY

By authority delegated from the University President, the Vice-President for Business Affairs is responsible for the safety of all University facilities. Under this authority, policies are developed to provide a safe teaching, research, service, housing and recreational environmental.

Reference

UF Bloodborne Pathogen Program Compliance Materials

OSHA. 29 CFR Part 1910.1030. Occupational Exposure to Bloodborne Pathogens, Final Rule, Dec. 6, 1991

CDC. Public Health Service Guidelines for the Management of Health-Care Worker Exposures to HIV and Recommendations for Postexposure Prophylaxis; MMWR 1998; 47(no. RR-7)

PROCEDURES

Pre-employment

Prior to beginning work in an HIV research lab, an employee shall be given, at no cost to the employee, the following:

  • A baseline serum sample shall be stored with the UF Student Health Care Center. This is a requirement to work in the HIV lab.
  • A confidential HIV test shall be offered to the employee. The HIV test is available at the UF Student Health Care Center. The test must be offered by the employer, but may be declined by the employee. This test shall include HIV counseling. Results of the test shall be given to the employee in person in a face-to-face meeting with a health care professional. No exceptions.

All results of HIV testing shall remain completely confidential and shall be stored in a separate section in the employee’s medical record. At no time will the employer or any administrator or official of UF have access to the employee’s confidential record concerning HIV testing.

  • If the HIV researcher also works with human blood or other potentially infected material, all other aspects of the UF Bloodborne Pathogen Program (1) under the OSHA Bloodborne Pathogen standard (2) shall be implemented for that employee. The employer shall offer free HBV immunization, annual training, and have a written exposure control plan in the workplace.

Continuing employment

HIV researchers shall be given the following at no cost to the employee:

  • Annual serum banking shall be offered to the employee, but may be declined.
  • Annual HIV tests shall be offered to the employee, but may be declined.
  • Annual training regarding HIV and post-exposure prophylaxis, including the risks of chemoprophylaxis, shall be given to the employee. This is a required, not optional, component.

Post-exposure prophylaxis

  • An exposure to an HIV culture in a research laboratory is considered a high-risk exposure (HIV Status Code 2) according to Public Health Service CDC guidelines (3). The following shall be implemented:
  • If the exposure is to intact or broken skin, or in the event of a puncture wound, immediately wash the affected area with water for five minutes. Soap may be used, if immediately available. If the exposure is to the eyes, they shall be rinsed for five minutes in an eyewash station. Other exposed mucous membranes (nose and mouth) shall be rinsed for five minutes with water.
  • The employee shall proceed immediately to the nearest health care facility. University of Florida faculty and staff have two options for care in the event of a potential bloodborne pathogen exposure. They may either seek care at the Family Practice Clinic at the UF Medical Plaza, next to the Cancer Center, 395-8231 (open Monday through Friday 8:00 a.m. to 5:00 p.m.), or they may come to the main UF Infirmary Building on Fletcher Drive (open Monday through Friday 8:00 a.m. to 8:00 p.m. and weekends, 12 noon to 4:00 p.m. during regular semesters, Monday through Friday 8:00 a.m. to 4:30 p.m. during Summer semesters). After hours, UF faculty and staff should seek care for bloodborne pathogen exposures at the Shands at UF Emergency Department. It is important for the employee to seek treatment within the first two hours of exposure.
  • An employee with an exposure to HIV will be seen immediately, free of charge.
  • The current Public Health Service (CDC) chemoprophylactic treatment/ post-exposure prophylaxis (PEP) shall be recommended and offered to an employee with a high-risk exposure, within the first two hours of exposure. The medical use of chemoprophylaxis is a decision that shall be made by a health care professional in conjunction with the employee, based upon the most current CDC recommendations, the nature of the exposure event, and other medical factors. Shands pharmacy is well stocked with the appropriate medication.
  • Baseline tests and informed consent statements shall be required for PEP.
  • Counseling concerning the risks and benefits of the chemoprophylactic treatment shall be given to the employee at the time of the exposure event.
  • The employee may contact an infectious disease specialist, if desired.
  • All HIV exposures that occur in the workplace are covered under Worker’s Compensation. SHCC and UF Medical Plaza personnel are familiar with the paperwork to process this type of Worker’s Compensation claim for UF employees.
  • Post-exposure follow-up, including the offer of HIV testing and counseling, shall be given in accordance with the CDC recommendations and the OSHA Bloodborne Pathogen rule. The SHCC and UF Medical Plaza protocols on HIV exposures will be followed.

Revised/Reviewed October, 2011