In 1991, scientific uncertainty about the risk of transmission of human
immunodeficiency virus or hepatitis B virus (hepatitis B e antigen [HBeAg]–positive)
led the Centers for Disease Control and Prevention to recommend that infected
health care workers (HCWs) be reviewed by an expert panel and inform patients
of their serologic status before engaging in exposure-prone procedures. The
data demonstrate that risks of transmission in the health care setting are
exceedingly low, suggesting that the national policy should be reformed. Implementation
of the current national policy at the local level poses significant human
rights burdens on HCWs, but does not improve patient safety. A new national
policy should focus on the management of the workplace environment and injury
prevention by creating a program to prevent blood-borne pathogen transmission;
by encouraging infected HCWs to promote their own health and well-being; by
discontinuing expert review panels and special restrictions for exposure-prone
procedures, which stigmatize HCWs; by discontinuing mandatory disclosure of
a HCW's infection status in low-level risk procedures; and by imposing practice
restrictions to avert significant risks to patients. Inclusion of these principles
would achieve high levels of patient safety without discrimination and invasion
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