[MCOH-EH] Occupational BBP exposure in MCOH setting

[Malgorzata Hasek]

Hello MCOH colleagues,

In your MCOH *occupational* BBP evaluation protocol, do you do the
following?

If the case is classified as BBP exposure, obtaining baseline testing of
the *exposed* is indicated, even when source testing is available, and
negative.

For the *exposed *employee:

Assess Hep B immunity status (obtain titer or verify documented immunity),
and complete the clinician written medical opinion. Obtain HCV and HIV
baseline testing on the exposed. If exposed declines baseline testing, ask
exposed to sign declination.  If exposed agrees to baseline testing blood
draw, but declines HIV test, employer must store blood for 90 days in case
exposed changes mind and would like HIV test done.

In addition to UTD clinical guidance (CDC/USPHS) which do not outline the
need for exposed baseline testing if source is negative, for occupational
exposures, in accordance with OSHA guidance, we must/should offer the
exposed baseline testing.

Agree/disagree?
This <https://www.osha.gov/laws-regs/standardinterpretations/2020-08-19-1>OSHA
Q/A helped me to refresh on this topic.

Thanks!

Margaret Hasek, MD, MPH, FACOEM, FACPM
Chicago, IL

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