Management and policy issues

The Occupational Health and Safety Act of 1993 requires that employers (as far as it is reasonably practicable) create a safe working environment. It is also the responsibility of employers to develop policies and programmes to educate and protect their employees. This is not only a legal obligation: it is also an ethical obligation.

Employers should integrate the following steps, plans and procedures into their management and policy plans:

• Universal precautions should be applied in every workplace.
• Employers should classify activities in terms of the potential risk of exposure to blood and body fluids.
• Employers should make protective equipment and clothes available to all workers who come into contact with blood or body fluids.
• Matters and issues relating to the occupational transmission of HIV/AIDS should be placed on the agenda of companies’ Health and Safety Committees so that appropriate control measures can be instituted.
• Employers should ensure that appropriate protective equipment and clothing are used and worn by workers when they perform activities involving blood and body fluids.
• Employers should ensure that appropriate first-aid equipment is always readily available for dealing with spilt blood and body fluids and that staff are trained to institute safety precautions following any accident.
• Employers should develop standard procedures that have to be applied in all activities in which people may be exposed to blood and body fluids.
• Procedures should be instituted for ensuring and monitoring compliance with safety measures.
• If personnel are not complying with safety measures, they should be subjected to appropriate counselling, re-education and training.
• Employers should make certain that workers who might be exposed to infection are well trained and educated in appropriate preventative measures.
• No health care professional should be allowed to perform a duty which may involve exposure to blood or body fluids without having undergone the necessary training and education.
• All employees should be taught the correct methods of how to clean up accidental blood and body fluid spills.
• If necessary, the workplace should be redesigned so that it becomes a safer place.
• All accidents that result in blood and body fluid exposure should be investigated. Counselling should be made available to all health care professionals who need it. Such counselling should be available to both HIV-positive personnel and all health care professionals who work with HIV-positive patients.
• If employees feel that their work environment is not safe, they have the right to refuse to work and to request an inspector from the Department of Labour to look into the matter. Nurses and doctors may also refuse to carry out certain tasks (such as drawing blood or surgical operations) if proper personal protective equipment is not supplied.