Exposure Incident Management Guidelines

Definition of an Exposure Incident

An exposure incident refers to any contact with blood or other potentially infectious material through mucous membranes, broken skin, or punctures that occurs during the performance of an employee's duties. If you suspect exposure, you should:

• Decontaminate: Clean the affected area promptly.
• Seek Medical Treatment: Obtain immediate medical attention.
• Report to Supervisor: Inform your supervisor of the incident.

A confidential medical evaluation and follow-up should be conducted by a physician as soon as possible.

Reporting Requirements

Adhere to the TWO HOUR RULE for incident reporting. Complete the necessary forms promptly after the incident, but do not delay medical treatment to fill out paperwork. Continue with treatment and reporting in line with your employer’s policies and procedures.

Post-Exposure Protocols

Healthcare workers exposed to HBV or HIV infected material should be offered appropriate and expedited post-exposure treatment. Those at high risk of exposure to HIV should consider preventative treatments in advance to ensure minimal time lapse from exposure to first-line antiretroviral treatment, maximising prevention of HIV or HBV infection.

Exposure Control Plan

Employers should develop an exposure control plan that outlines prevention, treatment, and follow-up procedures for accidental exposure to bloodborne pathogens. NHS Trusts should designate one or more doctors for immediate consultation if an exposure incident occurs. Local policies should define who is responsible for providing post-exposure treatment and follow-up.

Expert Advice and Occupational Health Services

Recommended sources for expert advice include:

• Consultants in virology, microbiology, infectious diseases, HIV disease, and public health medicine.
• Doctors in Occupational Health services.

Ensure that Occupational Health services can expedite infection-preventing medications within the required time frame. They should also provide guidance on managing work-related injuries, such as needle-stick injuries, and on NHS or industrial injuries benefits.

Support and Testing

Provide information, counselling, and psychological support to employees reporting exposure. This may include:

• Collecting a baseline sample for storage and follow-up testing for HIV, HBV, or HCV infections.
• Advising on appropriate treatment.

Early testing is useful, but a 6-month test post-exposure usually excludes the possibility of infection transmission.

Up-to-Date Treatment Guidelines

Designated physicians must stay informed about the latest post-exposure treatment guidelines, including the use of hepatitis B vaccine and anti-retroviral drugs for HIV exposure. Actions taken should consider both the worker's and the source patient's interests.

Out-of-Hours Support

An appropriate person should be available outside normal working hours to advise and treat employees who experience significant occupational exposures. This person must be familiar with the written policy on exposure management from the Health Authority, Health Board, or NHS Trust.