As yet, there is no cure for AIDS. Individuals infected with HIV have been receiving improved care and newer and more effective treatment including prophylaxis. These recent advances in treatment delay the onset of AIDS by slowing the progression from HIV infection to AIDS. Several centres are administering drugs such as zidovudine (ZDV), lamivudine (3TC), and indinavir (IDV), which have been shown to prolong life in AIDS patients. But so far, no AIDS victims have recovered. Doctors can only try to control the severe diseases which so easily attack people with AIDS. For example, pneumocystis carinii pneumonia may be prevented with early medication.
Should AIDS be an occupational concern?
In Canada, only a few cases of probable occupational HIV infection have been reported. Nevertheless, where ever there is the possibility of contact with blood in the workplace, workers should take precautions to prevent contact with the skin, eyes or mucous membranes (e.g. mouth).
The Laboratory Centre for Disease Control recommends using "universal precautions" to prevent the spread of AIDS in the workplace. This approach stresses that workers assume that all people are potentially infectious for the AIDS virus. "Universal precautions" involves using protective clothing such as gloves, gowns or aprons, masks and protective eye wear when dealing with people's blood and other blood-contaminated body fluids such as semen and vaginal secretions. "Universal precautions" do not apply to feces, nasal secretions, sputum, sweat, tears, urine and vomit, unless they contain visible blood. They also do not apply to saliva except in dentistry where saliva is likely to be contaminated with blood.
Hand washing after contact with blood, blood-contaminated body fluids and soiled items is also recommended to reduce the risk of infection.
The best approach to most diseases is to prevent their occurrence. Occupationally-related diseases are no exception. In the case of AIDS, prevention is the only cure.
Occupational Groups Risking Exposure to the AIDS Virus
The occupational groups listed below risk exposure to the AIDS virus in the workplace. The table that follow suggest preventive measures for these groups. For many situations, using all protective barriers listed in the table is not necessary. But workplaces should always make them available for emergency responses.
Surgeons, Nurses and Nurses Aides
Only a few cases of virus transmission to health care workers have been reported. Surgeons, nurses and nurses aides, however, should take precautions to avoid needlestick injuries, cuts with sharp instruments and exposure through skin lesions to potentially infectious blood and body fluids.
Physicians and Laboratory Workers
These people continuously handle infectious samples. Doctors, in diagnosing AIDS patients, carry out physical examinations and collect blood samples. Laboratory technicians analyze potentially infected samples. Although in Canada none of these professionals has been reported to have developed AIDS, they should always implement safe laboratory practices.
Ambulance Workers
Ambulance workers are potentially at risk because they attend accidents and fatalities. Ambulance workers perform first aid on individuals for whom no medical information is available. Blood contact is a possibility for workers when removing injured people from the scene of an accident.
Dental Workers
Dental workers are exposed daily to the blood and saliva of patients. Precautionary measures should be adopted because of possible exposure to the AIDS virus, and because the mouth can be the vehicle for the transmission of many infectious diseases.
Embalmers
Embalming the bodies of persons with AIDS presents a risk because the AIDS virus can live for hours in a deceased body.
Police and Firefighters
These workers attend accident scenes where they might be exposed to the AIDS virus through blood contact with skin cuts or scratches.
Mental Health Institution Workers and Correctional Service Workers
These workers risk exposure to the AIDS virus when cleaning blood spills or when giving first aid where there is a possibility of blood contact.
A particular concern that correctional service workers share with police is dealing with violent people. Workers bitten by prisoners or suspects require prompt medical attention. Bites frequently result in infection with organisms other than the AIDS virus.
Cleaners
Cleaning staff risk exposure when cleaning up spills of blood or other body fluids. Cleaning staff need to know how to use protective clothing and proper cleaning techniques. All cleaning equipment used to clean spills of body fluids should be kept in a restricted area and should not be used in any other area of the hospital.
Laundry Workers
Launderers in health care facilities are exposed to potentially contaminated linen. All laundry should be bagged and labelled as possibly infectious if there was contact with any person with an infectious disease.
Incinerator Attendants
Incinerator attendants in health care facilities risk exposure to the AIDS virus while disposing of infectious waste.
Post-mortem Attendants
These workers are at risk especially if an autopsy is necessary when an AIDS patient dies.
| Table Preventive measures for reducing occupational exposure to the AIDS virus |
| Occupation | Preventive Measures |
- Surgeons, nurses and nurses aids
| - Wash hands.
- Use gloves.
- Wear goggles, gowns and masks if splashing of body fluids is expected.
- Use disposable needles, syringes and devices for mouth-to-mouth resuscitation.
- Bag and label contaminated linen.
|
- Physicians and laboratory workers
| - Wash hands.
- Use coats and gloves.
- Wear goggles, gowns and masks if splashing of body fluids is expected.
- Use disposable needles and syringes, mechanical pipetting devices and biological safety cabinets.
- Disinfect work surfaces and equipment with sodium hypochlorite solution.
|
- Ambulance workers
| - Wash hands.
- Use gloves.
- Use disposable needles, syringes and devices for mouth-to-mouth resuscitation.
|
- Dentists and other dental workers
| - Wash hands.
- Use gloves.
- Use disposable needles and syringes
- Use goggles, gowns and masks if splashing of blood is expected.
|
- Embalmers
| - Wash hands.
- Use gloves, gowns, boot-covers, goggles and masks.
- Use disposable surgical instruments.
- Sterilize reusable equipment. Disinfect work surfaces with sodium hypochlorite solution.
|
- Police and firefighters
| - Wash hands
- Use gloves.
- Use disposable devices for mouth-to-mouth resuscitation.
|
- Mental health institution workers and correctional service workers
| - Wash hands.
- Use gloves.
- Keep cleaning equipment in restricted areas.
- Use disposable devices for mouth-to-mouth resuscitation.
|
- Cleaners
| - Wash hands.
- Use gloves.
- Keep cleaning equipment in restricted areas.
|
- Laundry workers
| - Wash hands.
- Use gloves.
|
- Incinerator attendants
| - Wash hands.
- Use gloves.
|
- Post-mortem attendants
| - Wash hands.
- Use gloves.
- Wear goggles, masks and boot-covers if splashing of blood and body fluids is expected.
- Bag, label and incinerate wastes.
|
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