POLICY STATEMENT ON HEALTH SERVICES WORKERS AND ACQUIRED IMMUNE DEFICIENCY SYNDROME

As the number of new confirmed cases of Acquired Immune Deficiency Syndrome (AIDS) continues to double each year, the consequent increased potential for occupational exposure to this infectious and fatal disease has become a major concern of health services workers. Workers for whom there exists a theoretical potential for occupational exposure to AIDS include:

• Nurses and other patient care personnel

• Medical diagnosticians and laboratory workers

• Visiting nurses and home health care providers

• Ambulance workers and emergency services technicians

In order for health services workers to provide the high quality professional care to which all patients are entitled, health care employers must be held accountable for establishing and maintaining safe, clean, therapeutic, and clinically responsible conditions and procedures for the treatment and care of patients with AIDS and other contagious and infectious diseases.

While the United States Centers for Disease Control recommendations for health services workers regarding AIDS provide a reasonable beginning basis from which to establish precautions, the American Federation of Teachers and its Health Care Division, the Federation of Nurses and Health Professionals, propose the following additional guidelines for use by health services providers in the development of responsible policies and procedures for controlling the spread of AIDS and reducing the risks associated with occupational exposure to this illness.

Policies and procedures for eliminating risks associated with occupational exposure to AIDS should reflect consultation with designated employee representatives and public health officials. Issues to be consi­dered should include, in addition to Public Health Service recommendations, the responsibility of employers to pro­vide adequate levels of qualified staff, appropriate instruction and training for all direct care and support personnel, a safe and hazard-free physical environment, effective infection control procedures for the disposal of contaminated materials, especially needles, syringes, scalpel blades, and other sharp items.

Information regarding a patient's HIV status should not be withheld from health services workers involved in his or her case.

Health care employers must provide all employees with a continuing program of instruction in the epidemiology of AIDS, specific occupational dangers, and safe work practices.

Health care employers must provide adequate, appropriate, and readily accessible protective outerwear, including gowns, gloves, masks, eye coverings, and resuscitation bags or other ventilation devices, as necessary or requested by individual health care workers in order to enable health care workers to comply with the universal blood precautions recommended by the Centers For Disease Control. In addition, health care workers in non-hospital settings should be provided with proper equipment and receptacles for the handling and disposal of contaminated needles and other materials, as well as sufficient and appropriate supplies of disin­fectants.

"The necessity for exercising special precautions, restrictions, changes in job assignments, or interruption of employment with regard to individual health services employees with AIDS should be determined entirely on the basis of medical and performance criteria, on a case-by-case basis. Health services workers with AIDS should be permitted to obtain medical evaluations by independent practitioners not associated with the employer. Individual health services workers with AIDS shall not be deprived of due process in connection with determinations resulting in the exercise of special precautions, res­trictions, or the interruption of employment.

Health services workers with AIDS who are unable to continue employment on account of their medical and physical condition should be eligible to receive disability retirement or comparable compensation, including continuation of health benefits.

As new information regarding the epidemiology of AIDS becomes available through the Public Health Service and other responsible agencies and researchers, health services employers should continue to consult with their employee representatives in order to effect changes in policies or procedures as indicated.

In order to assist health services employers and employees in the development of effective and responsible policies and procedures regarding the control of AIDS, the American Federation of Teachers and the Fed­eration of Nurses and Health Professionals call upon the Occupational Safety and Health Administration (OSHA) to develop and promulgate safety standards with respect to the presence of contagious and infectious diseases in the workplace. Affiliates are urged to report AIDS-related workplace hazards to OSHA for enforcement under OSHA's general duty clause, and to monitor OSHA's responsiveness to health care worker concerns regarding blood-borne and infectious diseases.

On the national, state, and local levels, the American Federation of Teachers and the Federation of Nurses and Health Professionals will continue to cooperate with our affiliates and with responsible government, profes­sional, industry, and consumer representatives in effort to control the spread of AIDS while assuring that safe, appropriate, and responsible care is provided to all who need it. (Executive Council)