Blood-Borne Infection Risk Assessment Unit
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In Québec, you can offer health care, or pursue training to do so, while being a blood-borne infection carrier (HIV, HBV, or HCV) provided you have your situation assessed by SERTIH and follow the recommendations as approved by your professional order or educational institution.
Who is eligible for the service
The Blood-Borne Infection Risk Assessment Unit (Service d’évaluation des risques de transmission d’infections hématogènes – SERTIH) is intended for healthcare professionals and students in Québec (hereinafter referred to as “caregivers”) who have one or more blood-borne infections and who perform exposure-prone procedures.
Do you have a blood-borne infection?
If you are a caregiver who performs or will perform exposure-prone procedures, you have the ethical and professional obligation to know whether you are a blood-born infection carrier:
- Human immunodeficiency virus (HIV)
- Hepatitis B virus (HBV)
- Hepatitis C virus (HCV)
If you have had a positive diagnosis in the past or recently, you must immediately communicate with SERTIH in order to obtain a risk assessment and recommendations for your professional practice.
Benefits of a SERTIH assessment
- SERTIH does not aim for zero risk, but instead a transmission risk that is low enough to ensure safe training and practice.
- The SERTIH assessment reassures you, your employer, and any other authorities that the acts you are authorized to perform are safe for patients.
Implications
- In compliance with legal obligations for the protection of personal information, your professional order, educational institution, or employer will be notified that you have been diagnosed with a blood-borne infection, without specifying which one.
- The SERTIH recommendations may partially or completely restrict your practice or training activities, temporarily.
Professions concerned
The following professions and training programs may involve exposure-prone procedures:
- Medicine
- Dental medicine
- Dental hygiene
- Midwifery
- Nursing and auxiliary nursing care
- Surgical podiatry
- Pre-hospital emergency care (paramedics)
Exposure-Prone Procedures
Exposure-prone procedures are therefore performed in body cavities where you can't see your hands or fingers well and when a needle or other sharp or pointed instrument is being used. SERTIH retains the Public Health Agency of Canada’s (2019) definition of an exposure-prone procedure:
“Exposure-prone procedures (EPPs) are invasive procedures where there is a risk that injury to the HCW [healthcare worker] may result in the exposure of the patient’s open tissues to the blood of the HCW. For transmission of a BBV [blood-borne virus] from an infected HCW to patient to occur during an EPP, three conditions are necessary:
- HCW must sustain an injury or have a condition that allows for exposure.
- HCW’s blood must come in contact with a patient’s wound, traumatized tissue, mucous membranes, or similar portal of entry.
- HCW must be sufficiently viremic.
EPPs with risk of transmission include:
- Digital palpation of a needle tip in a body cavity (a hollow space within the body or one of its organs); or the simultaneous presence of the HCW’s fingers and a needle or other sharp instrument or object (such as bone splinters, sternal wires etc.) in a blind or highly confined anatomic site, e.g., as may occur during major abdominal, cardiothoracic, vaginal, pelvic and/or orthopedic operations.
- Repair of major traumatic injuries.
- Cutting or removal of any oral or perioral tissue, during which the patient’s open tissues may be exposed to the blood of an injured infected HCW.”
Studies of virus transmissibility have shown that healthy skin provides an effective barrier against most agents. Only blood contacts with injured skin (e.g. cut skin) or mucous membranes (e.g. eye, mouth) or by percutaneous exposure (through the skin) have been associated with contamination and infection. As long as the basic precautions appropriate to the procedure (e.g. wearing gloves) are rigorously applied, the risk of a patient coming into contact with your blood remains extremely low.
To find out more, consult our reference guide (in French only). It presents a list of exposure-prone procedures for each profession and medical specialty covered by SERTIH and aim to guide the recommendations made to caregivers.
To contact us
SERTIH receives requests for assessment and information from Monday to Friday, 8:30 a.m. to 4:30 p.m. at this confidential toll-free number: 1 866 680-1856 or by email: [email protected].
You can leave a voicemail message. The SERTIH team has sole access to the mailbox.
Training capsules (in french)