Infectious Diseases Policies

A summary of University of Sydney and NSW Dept. of Health Infectious Diseases Policies that may apply to University staff and students. For more detailed information, follow the links on the right, under "Policy Documents Online".

The Faculty's current policy on infectious diseases is currently being reviewed by a group being led by Associate Professor Jon Iredell.

Faculty of Medicine: Infectious Diseases Policy [For Students]

Clinical experience is associated with a small risk of infection for all medical students. Unless medically contraindicated, students should be at all times up-to-date with immunisations against diphtheria, tetanus, polio, pertussis, measles, mumps, rubella, chicken pox, Hepatitis A and B, meningococcus and influenza. Students for whom immunisation is inadvisable on medical grounds should seek advice about alternative preventive measures in the event of exposure.

In addition, other infectious diseases such as HIV, Hepatitis C and Tuberculosis pose specific risks to health care workers; students should be aware of their own current status with respect to these infections and, if necessary, undergo appropriate immunisation. In addition to the personal risks to students there are small risks to susceptible patients from actively infected students.

Accordingly, the Faculty of Medicine expects that all medical students will be aware of their own infectious diseases status. Students who consider themselves at risk should seek advice individually and check their status as often as advised. Students should consult their own medical practitioner or other medical adviser; alternatively, within the University, its clinical schools and teaching hospitals there are medically qualified staff with appropriate expertise who have agreed to be available to offer confidential advice.

All students are expected to be aware of the NSW Health Department's definition of exposure prone procedures. Students with an infectious disease such as HIV, HBV or HCV must refrain from undertaking such procedures. No reason need be given for declining to participate in exposure prone procedures. Students should note that other infections may pose similar risks. The New South Wales Health Department requires that students comply with the provisions of its Occupational Screening And Vaccination Against Infectious Diseases circular (NSW Health Department Circular No. 2003/91*) and obtain, at their own cost, a documented screening and vaccination history consistent with the provisions of this Circular, which must be made available to the Health Service prior to the commencement of their clinical placement.

N.B: This policy applies to Medical students.

NSW Health Dept: Occupational Assessment, Screening & Vaccination Policy

Key Policy Requirements: [An extract]

Most staff and all "other clinical personnel", including all healthcare and work experience students, are classified as Category A.

Category A: Contact with clients or contact with blood, body substances or infectious material.
Category B: No contact with clients or blood or body substances.

Personnel assessed as Category "A" are required to be screened/protected (by Immunisation) for the following:

Diphtheria, Tetanus, Pertussis, Hepatitis B, Measles, Mumps, Rubella, Tuberculosis, Varicella

Personnel without all the required immunisation or unscreened will not be permitted to work with certain hospital client [patient] groups or in certain clinical areas.

N.B. - This policy is MANDATORY and will be enforced from January, 2008

NSW Health Dept Policy Directive: Occupational Assessment, Screening & Vaccination Against Specified Infectious Diseases

Document Number PD2007_006 Publication date 01-Feb-2007 [An Extract From The Document]

3. Risk Categorisation, Assessment, Screening and Vaccination

3.2 Staff Responsibilities

Staff must comply with the assessment, screening and vaccination requirements of this Policy; or Staff who do not consent to assessment, screening and vaccination in accordance with this Policy must acknowledge this in writing (using the Assessment, Screening and Vaccination Non-Participation Form.

Staff must report AEFls to their vaccination provider who should then report them to the Area Public Health Unit for follow-up.

Staff must maintain their own assessment, screening and vaccination records and have them available for inspection.


3.4 Universities, other Academic Institutions and Employment Agencies’ Responsibilities

Universities and other academic institutions must ensure that all other clinical personnel are advised in writing, prior to the commencement of their academic enrollment, of their responsibilities under this Policy.

Universities and other academic institutions must ensure that other clinical personnel have been advised that they must provide evidence of protection against all the specified infectious diseases and documentation of their TB status as outlined in Occupational TB screening strategy for assessment by the health facility, prior to or at the time of commencement of all clinical placements.

OHSIM Clinical Fieldwork: Health and Safety Guidelines

[An extract]

Patients or in-mates in many clinics may be a source of infectious diseases which are transmissible to health care workers/carers via blood, blood products or other body fluids (eg urine, saliva, tears, breast milk, cerebro-spinal fluid, amniotic fluid, semen, vaginal secretions etc). The potential health effects of acquiring such a disease will depend largely on the nature of the infective organism. These effects range from being asymptomatic through to life threatening eg HIV. Transmission of infectious diseases from health care workers to patients is also possible. Students and staff should be familiar with the particular infection control guidelines of the institution in which they are placed. Health care workers are required to maintain awareness of their infection status and keep-up-to date with appropriate vaccinations. Refer to the NSW Health Department Circulars

OHSIM: Hepatitis and the University

[An extract]

2. (d) THE RISK TO MEDICAL, DENTAL AND OTHER HEALTH CARE STAFF AND STUDENTS: The occupational risk of acquiring hepatitis B is high, and the National Health and Medical Research Council strongly advises immunisation of all medical and paramedical staff who are in direct contact with patients, or with human blood, body fluids or tissues. This is consistent with NSW Health Department guidelines which aim to protect health care workers (including students) and patients from hepatitis B transmission. The University supports this policy.

* Staff: Most clinical staff will be immunised through the teaching hospitals. Some research staff as well as academic and technical staff concerned with practical class work may also require immunisation, which is available through the University Health Service.

* Students: Hepatitis B immunisation is included in the immunisation schedule offered to all medical and paramedical (including Medicine, Dentistry, Pharmacy, Microbiology, Nursing, Physiotherapy and Occupational Therapy) students through the University Health Service. It is strongly recommended that students be vaccinated before they enter clinical training.

The standard course of hepatitis B immunisation involves three injections at 0, 1 and 6 months. Boosters are required 3-5 years after completion of the initial course. Both staff and students should have antibody tests to demonstrate adequate response to the primary course of the vaccine and to give guidance about the timing of future booster doses. A small percentage of healthy individuals fail to develop immunity after immunisation. The administration of hepatitis B specific immunoglobulin is advised should they be accidentally exposed to hepatitis B. This can be arranged through the University Health Service or the Casualty Departments of large hospitals (if exposure occurs out of hours) and should be done at once if a needlestick accident occurs.

Information on hospital policies and precautions to be observed when taking blood samples and handling infected material is available from hospital Infection Control Units and from the OHSIM Office at the University of Sydney. HEALTH CARE WORKERS, INCLUDING STUDENTS, SHOULD BE AWARE OF THEIR OBLIGATIONS UNDER NSW HEALTH DEPARTMENT POLICIES

2. (e) USE OF HUMAN BLOOD AND TISSUES IN PRACTICAL CLASSES AND RESEARCH LABORATORIES: as an alternative to the use of animal experimentation in undergraduate courses, exercises using human tissue, and particularly blood, have been devised. Other body fluids, eg urine or saliva, are also used. In addition, blood and tissues from volunteer staff, students and patients are frequently employed in research laboratories.

* Use of blood in practical classes: when patient blood samples are used they should be screened as for Blood Bank Blood. To meet the standards required for blood transfusion, the blood should be tested for syphilis, hepatitis B and C, HIV and HTLV1 prior to use in undergraduate classes.

* If student blood samples are used it is preferable for individual students to use their own blood. This should be obtained under aseptic conditions. If blood is spilled it should be dealt with as described in Precautions for Contact with Human Blood. Suitable freshly prepared disinfectant solutions and absorbent material should be readily available in the classroom. Instruments, glassware and blood samples should be decontaminated before entering the wash-up system for re-usable items or being discarded in the University waste. Clinical and related wastes should not be discarded in ordinary waste streams, but according to special guidelines which can be obtained from the OHSIM Office.

* Use of human blood in research laboratories: all human blood and tissues should be handled as if they are infectious. Advice about specific problems, eg decontamination of complex apparatus, may be obtained from the OHSIM Office. Disposal of wastes associated with human blood and tissues should be in accordance with the University's Clinical and Related Wastes-Guidelines for Management. Copies are obtainable from the OHSIM Office.

- OH&S Director, July 2007 -