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Occupational Medicine 1998;48:529-531
© 1998 Society of Occupational Medicine

research-article

Hepatitis B—are surgeons putting patients at risk?

L. N. Birrell and R. A. Cooke

Performance Through Health, Princess of Wales Community Hospital Stourbridge Road, Bromsgrove, Worcestershire, B61 0BB, UK

The 1993 Department of Health guidelines permit a surgeon who is hepatitis B surface antigen (HBsAg) positive but e-antigen (HBeAg) negative to perform exposure prone procedures, unless demonstrated to have infected patients. However, there is increasing evidence of transmission of hepatitis B to patients from health care workers in this supposedly low infectivity category. The Occupational Physician must decide whether existing guidelines represent an adequate risk assessment and indeed whether this is an acceptable risk for patients. If an NHS Trust continues to follow these guidelines it may be in breach of its duty of care to patients. Yet refusing to allow such carriers to operate without testing for additional serological markers may be unlawful discrimination. Further research is clearly needed as well as an urgent review of the guidelines.

Keywords      Exposure prone procedures; health care workers; hepatitis B; transmission

Received       27 February 1998
Accepted       28 May 1998

Correspondence and reprint requests to: Dr R. A. Cooke, Performance Through Health, Princess of Wales Community Hospital, Stourbridge Road, Bromsgrove, Worcestershire, B61 0BB, UK. Tel: (+44) 1527 577242; Fax: (+44) 1527 488149


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