Hepatitis is an inflammation of the liver that can be caused by viruses, chemicals or drugs. The two most common types of viral hepatitis are Hepatitis A (also called “infectious hepatitis”) and Hepatitis B (or “serum hepatitis”). In both types, the virus affects the liver in similar ways. However their transmission and prevention are quite different.

Other rarer forms of hepatitis (for eg. Hepatitis E and Hepatitis Delta ) are also found. This fact sheet will focus on the infection and control of Hepatitis B, which is the more serious type of the disease and can affect a number of occupational groups.

HOW DOES ONE GET HEPATITIS B ?

Hepatitis B passes from person to person through contaminated blood, body fluids or tissues from an infected person. Infection is most common via a break or cut in the skin. Accidental injuries occur from 'sharps' contaminated with infectious blood. ('Sharps' are needles, broken glass and other sharp objects which, if contaminated with Hepatitis B infected blood, can transmit the virus.)

Hepatitis B infection follows an extended incubation period of six weeks to six months. People are infectious before symptoms develop and during the time symptoms develop. A small proportion of infected people become chronic carriers and are permanently infected with the virus, but without the symptoms of the disease.

There is a vaccine available for Hepatitis B.

THE SYMPTOMS of HEPATITIS

The severity of the symptoms vary from person to person. The common symptoms are fatigue, lack of appetite, muscle aches, joint pain, nausea, vomiting, fever and jaundice (yellow pigmentation of the skin). Usually the symptoms last three to four weeks.

Not all persons infected with Hepatitis B will become ill. About one in four persons infected with Hepatitis B, though physically recovered, can remain chronically infected with the virus; they are capable of infecting other people. Chronic infection may lead to cirrhosis of the liver.

OCCUPATIONAL RISK OF HEPATITIS

People who work with contaminated materials such as sewage, human blood, body fluids and tissues, or waste matter containing these materials, are at risk of contracting both Hepatitis viruses.

At-Risk Occupations

Hepatitis A:

The workers at risk include:

• plumbers and sewage workers
• health care workers, including cleaners and attendants
• workers in institutions for mentally disabled people, where the standards of hygiene may be poor

Hepatitis B:

Workers at risk are those in direct contact with the blood, body fluids or body tissues of other people. Infectious material must enter the body via a cut, needlestick injury or less commonly through the lining of the mucous membranes of the eyes or mouth.

Those at risk are:

• health care workers (clinical or laboratory) through needlestick injury;
• health care workers exposed to blood or blood products;
• laboratory workers in contact with human blood, body fluid and tissues;
• accident and emergency workers;
• providers of first-aid in the workplace;
• workers at institutions of mentally disabled people when hygiene is poor;
• prison workers and workers in drug rehabilitation centres.

NOTE: This is not a complete list of at-risk occupations - other workers may be at risk and an assessment should be done of any potential risks in other occupations. Risks factors should be evaluated by a relevant professional (eg. occupational physician or nurse) to determine any control measures.

HOW TO PREVENT AND CONTROL HEPATITIS

• All blood, including your own, should be considered to be infectious. Spilt blood should be cleaned up immediately using a household bleach solution or disinfectant containing iodine.
• Precautions must be taken to prevent spread of blood. All cuts and abrasions, no matter how small, should be cleaned and covered with a waterproof dressing.
• Personal protective equipment such as gloves, aprons and eye protection may be necessary. Thick protective gloves should be worn when working in environments or with material where discarded needles are likely to be found. This especially applies to lavatory cleaners and public transport cleaners.
• Disposable, single-use needles should be used wherever possible. All used needles should not be recapped after use, but should be placed in a special container which is incinerated when full. When re-usable needles and other skin-puncturing implements have to be used, proper sterilisation must be undertaken. The sharing of an unclean needle is extremely dangerous.
• All incidents where any person is contaminated with blood, blood products or suffers a 'sharps' injury must be reported and medical advice sought.
• When your skin is splashed with blood, the affected area should be washed gently with soap and water as soon as possible.