Police work and blood borne viruses (BBVs): providing information and guidance about risks and responsibilitiesadmin
Police work and blood borne viruses (BBVs): providing information and guidance about risks and responsibilities
HIV Australia | Vol. 14 No. 1 | March 2016
By Karen Seager
Providing information and guidance about risks and responsibilities.
ASHM (Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine) is a professional, not-for-profit, member-based organisation. It supports its members, sector partners and collaborators to generate knowledge and action in clinical management, research, education, policy and advocacy in Australasia and internationally.
For some years, ASHM has been producing a series of profession-based booklets tailored to meet the specific needs of particular workforce groups in relevant blood borne virus disciplines.
Initially the series focused primarily on hepatitis C and was targeted at primary care providers, generally doctors and nurses. In 2008, ASHM expanded the suite of resources to include booklets for other professional groups. These new booklets focused on paramedics and BBVs, and general practitioners and HIV.
By 2010, through research and surveys in various workplace settings, ASHM had identified a growing need for basic information about hepatitis B, hepatitis C and HIV right across the community.
Interest in resources and information was no longer limited to primary care providers caring for people with a blood borne virus.
Other groups that have an occupational risk of exposure to BBV infections, such as the police and correctional officers, were seeking more information about BBVs.
In response to the growing demand for information, ASHM developed the booklets Police and Blood-Borne Viruses (BBVs) (2008) and Correctional Officers and Blood-Borne Viruses (2010), both of which were updated in 2015.
ASHM has also produced booklets on BBVs for pharmacists, aged care workers and professional interpreters and translators.
Police and BBVs: resource rationale
Members of law enforcement agencies, such as the police, often undertake work where exposure to blood and body fluids can occur.
While the risks of such exposure vary according to particular circumstance, police officers may be exposed to infectious agents including BBVs while conducting searches and arrests or during the collection of bodily samples.1
Although there is increased occupational risk of BBV exposure for police officers, it is important to stress that the risk is arguably less than for other emergency service providers such as paramedics or hospital workers. Also, if exposure does occur, it tends to be less serious.
Nevertheless, it is understandable that police officers may express concern about the occupational risks of contact with BBVs, highlighting a clear need for access to accurate information about BBV transmission and exposure risks.
Accordingly, ASHM has produced a resource designed to provide information and guidance to police officers about BBVs, including how the viruses are spread, how to protect against infection and what to do if there is a possible exposure.
The booklet, Police and Blood-Borne Viruses, includes information about exposure risks, BBV transmission, BBV prevention methods, and appropriate emergency management following exposure to a blood borne virus.
ASHM believes it is crucial for police officers to understand the true potential risk of infection – blood exposure, needle-stick injury, and sexual contact (without a condom) – and that they also have a clear understanding of what behaviours do not present a risk of infection.
Importantly, police officers must also have a thorough understanding of an individual’s rights relating to BBV disclosure. ASHM advocates that standard infection control procedures should be maintained at all times, regardless of a person’s suspected or actual BBV status.
This approach ensures that people with a BBV do not face unnecessary stigma and discrimination, while also ensuring police officers are protected during the course of their regular duties.
Broad content areas
Police officers and Blood-Borne Viruses was developed to provide basic information on BBVs, dispel myths, and outline key facts about hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV). It was first published in 2008, and was subsequently updated in 2010 and 2015.
The resource discusses the prevalence of each virus within the community and explains the similarities and differences between these viruses.
Importantly, the booklet clearly outlines how the viruses are transmitted, how to protect against possible infection, and what steps to take in the event of a possible exposure.
The 2015 updated edition also contains brief information on prevention of transmission, treatment, and environmental risk management.
Although the primary focus of the booklet is about how police officers can mitigate their occupational risk and protect themselves from possible infection, another critical area outlined is legislation designed to protect and uphold the rights of people living with a BBV infection.
This includes an individual’s right to confidentiality regarding BBV status, as well as the right to access treatment and medical care while being held in police custody.
The booklet stresses that police officers must not record a person’s suspected BBV status – or other confidential information, such as sexual orientation – on police records unless it is directly relevant to a crime for which the individual has been arrested.
Police officers are also advised that there is no need to isolate individuals with, or suspected of having, a BBV infection. Furthermore, the booklet highlights the importance of not discriminating against any individual based on the notion that they might have a BBV.
Officers are further advised to follow local policies and procedures relating to the provision of medication, and access to medical care, for those who are held in custody.
Where disease testing orders may be in place, officers are advised not to wait for the outcome of such testing before seeking their own risk assessment from an appropriately qualified health professional. Waiting for an individual’s test result is not necessary and may delay treatments that need to be started as soon as possible.
Throughout the booklet, key messages are highlighted and clear subject headings allow officers to find relevant information quickly and easily.
For each resource that ASHM develops, an Advisory Group is established to guide the project. An Advisory Group for each edition of the Police and Blood-Borne Viruses booklet was convened comprising representatives from state and territory police agencies, representatives from Australia and New Zealand Policing Advisory Agency (ANZPAA) Safety Committee, Australian Federal Police and the Police Federation of Australia.
This Advisory Group also included doctors, nurses, trainers, and police officers nominated by their agencies who had some responsibility for the health and safety of officers in their jurisdiction.
In addition to this advisory group, ASHM clinical advisors reviewed the content to ensure clinical accuracy and relevance. Funding was provided by the Commonwealth Department of Health. The booklet was accepted by police services in all jurisdictions and endorsed by ANZPAA.
During the development process, discussions highlighted a range of procedural differences that exist in each state and territory.
These differences can be quite significant, or relatively minor, and stem mainly from differences in state and territory laws. As an example, some states and territories have prohibited the use of torches during a mouth inspection, while others haven’t.
One highly contentious difference was the 2014 introduction of mandatory testing laws for communicable diseases, including BBVs.
The passage of this legislation meant that individuals accused of certain offences (offences differ in each jurisdiction) in South Australia and Western Australia are subject to mandatory testing. This allows for the testing of an individual who has spat at, or bitten, an officer.
Currently, Western Australia and South Australia are the only states and territories to have adopted this legislation.
It is important to note that although the booklet acknowledges there are jurisdictional differences between agencies, it does not attempt to argue the appropriateness of them.
The booklet was developed only to provide essential information on BBVs for police officers, and is not an advocacy tool.
As a national resource, it is beyond the scope of the booklet to address precise jurisdictional differences that exist; police officers are advised to consult their local process and procedural documentation, where necessary, and to follow the relevant protocols.
Police officers living with a BBV
The booklet also provides information for police officers who themselves have a BBV infection. It is recommended that all officers know their own status with regard to BBVs.
Knowing their status means they can get the right care for themselves. Having a BBV infection does not prevent officers from performing their usual duties. All officers are advised to adhere to standard infection control precautions, regardless of their BBV status. Doing so will protect them and others from a possible exposure to a BBV.
Like most other workplaces, officers are not required to inform their employer about their BBV status and the employer must not discriminate against their employees on the basis of their BBV status.
Police officers have the same rights to confidentiality and privacy as anyone else and these rights need to be protected and respected.
The booklet contains contact details of helplines and other resources that are specifically designed to support police officers in the event of an exposure to, testing for, diagnoses of, and treatment for a BBV infection, regardless of how or where the exposure occurred.
Officers are not compelled to use these specific services and have the right to choose their own medical practitioner. However, the helplines are available 24 hours a day (with the exception of Tasmania) and can provide immediate confidential advice and support in the event of an accidental exposure.
If officers choose not to utilise the specific helplines, they are advised to contact the emergency department at local hospitals who can provide services such as counselling, risk assessments, testing and immediate treatment if it is deemed necessary by a qualified health professional.
Take up and feedback
Since the booklet Police and Blood-Borne Viruses was first published in 2008, over 10,000 hard copies have been distributed (including 2,000 copies of the 2015 version) through police services in each state and territory.
The booklet is used as a training resource with each new intake in Police Academy Training Institutes around the country. It has become essential reading for police officers during recruitment and training, as well as being made available once they are deployed to a police station.
Interest in the resource has also been shown in New Zealand, where it contributed to the development of a resource tailored to the New Zealand context.
In 2011, an associated e-learning module based on the booklet was developed in response to requests for more support material. The module highlights the key messages from the booklet but primarily focuses on standard procedures for infection prevention and what to do in the event of an accidental exposure.
The module is a mix of information, interactive activities and mini quizzes, and takes about 20 minutes to complete. The module, which can be accessed at any time, is used as an additional tool during officer training or as a revision exercise at a later date.
The module is available through the training section of the ASHM website and access is not restricted to police officers.
Copies of Police and Blood-Borne Viruses are available free of charge in all jurisdictions. The booklet can also be downloaded from the ASHM website.
The Police and BBVs e-learning module is available at: www.ashm.org.au/Pages/Elearning/Police-and-BBVs.aspx
Karen Seager is Senior Project Officer, National Policy and Education Division, at ASHM.