HEPATITIS C

in the Workplace
HEPATITIS C
Basics

The word “hepatitis” means inflammation of the liver. Hepatitis is caused by viruses,
which are small organisms that can cause disease. There are many different types of
viruses that cause hepatitis, and it is possible to be infected with more than one hepatitis
virus at the same time. Each virus is completely different from the other viruses, all are
prevented and transmitted differently, and each causes different symptoms.

Hepatitis A
Hepatitis A is transmitted through the fecal-oral route. It is often caught by eating food or
drinking water that is contaminated with the feces (stools) of a hepatitis A-infected person,
so hepatitis A is a big concern within the food industry. Once someone’s immune system
clears the virus, he or she cannot catch it again. There is a vaccine available to prevent
hepatitis A.

Hepatitis B
Hepatitis B is found in the blood, saliva, vaginal fluid or
semen of an infected person. It can be transmitted through
unprotected sexual contact, human bites, and through blood-
to-blood contact. Ninety percent of people infected with
hepatitis B clear the virus from their system without treatment.
There is a vaccine available to prevent hepatitis B.

Hepatitis C
Hepatitis C is transmitted only through blood-to-blood
contact. Eighty percent of those infected with the hepatitis C
virus will develop chronic (lifelong) symptoms, and about
20% of the people who have chronic symptoms will eventually
develop liver cirrhosis (scarring of the liver). It is important to
know that hepatitis C does not always make people sick (one
out of five people will actually get rid of the virus without any
treatment), and for those who do experience illness, it can take
many years for symptoms to develop. There is no vaccine for
hepatitis C.

Hepatitis D, E and G are not common in Canada.

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HEPATITIS C
Transmission
The hepatitis C virus (Hep C) is transmitted only through blood-to-blood contact.
In order for the virus to be passed on, blood from an infected person must enter
the bloodstream of another person.

A person can get infected with Hep C by:

A Sharing equipment to inject or ingest drugs (needles, water, cookers, filters, pipes,
straws, etc.);
B Sharing body piercing equipment, tattoo machines and ink, or acupuncture needles;
C Sharing a razor, toothbrush, or nail clippers;
D Accidental occupational exposure (being poked by a needle or other
sharp object that has infected blood on it).

Sexual transmission of Hep C is rare, but there is still some risk –

unprotected sexual intercourse (vaginal or anal sex without a condom)
is considered a low-risk activity.

Some Canadians were infected with Hep C through blood transfusions

before screening was implemented in 1990. Since then, blood safety
has become a top priority, and the World Health Organization has
said that Canada’s blood system is among the safest in the world.

No one has ever been infected with

Hep C through:
• sharing eating utensils, dishes or glasses
• consuming food or drink prepared by an infected person
• being coughed or sneezed on (Hep C is not airborne)
• using the same bathroom or toilet, shower or sink
• sharing water fountains or coffee pots
• sharing office supplies, computers, tools,
telephones, desks, or uniforms
• shaking hands, hugging, kissing or other
casual contact
• swimming in public pools

Hepatitis C in the Workplace 3

HEPATITIS C in the
Workplace
Since Hep C is not spread through ordinary workplace
activities, in most situations, there is no reason to
disclose one’s Hep C status at work.
It is possible that an employee with Hep C may never become ill
during the period of employment. Many people with Hep C have
been living with the virus for many years, have normal-functioning
livers, and are actively engaged in full-time work. For some, it can
take over 20 years before symptoms develop.

Employers consider it important for employees to meet performance

standards, and to be mentally and physically able to perform the
essential duties of their work in a safe, efficient and reliable manner.
If these standards are being met, it doesn’t matter whether an
employee has Hep C or not.

When Hep C becomes an issue…

• Hep C may become an issue if an employee who is infected with the virus begins to
experience symptoms of liver disease. These include: extreme fatigue, muscle, joint or
abdominal discomfort, loss of appetite and weight loss, sleep disturbance, and depres-
sion. Due to these symptoms, job performance may be hindered if the employee is not
able to carry out the required work tasks or has to take medical leave.

• Another challenge facing an employee living with Hep C is the decision to undergo
treatment. Treatment for Hep C can last up to a year, and cause many side effects
including nausea, flu-like symptoms, hair loss, fatigue and depression. In some cases,
these side effects can be so difficult that some people have to take medical leave
from work.

• An employee living with Hep C is under no legal obligation to tell people at work
about his or her infection. If work is or will likely be affected by illness, the employee
may choose to inform his or her supervisors that there is a health condition or
illness and that he or she may require accommodation.

• Even though an employee is not required to reveal Hep C status to anyone in

the workplace, physicians may need to reveal the specific conditions to disability
insurance companies. An employee who needs to take medical leave will need to
notify supervisors, and provide a letter from a physician in order to apply for
disability insurance.

4 Hepatitis C in the Workplace

• When an employee submits an insurance claim, sometimes the paperwork passes
through the workplace human resources personnel before it is sent to the insurer. In
order to protect confidentiality, an employee may wish to submit claims directly to the
insurance company to prevent anyone in the workplace from reviewing the details.

• If an employee feels he or she cannot handle full-time work and is considering switching
to part-time hours, it may be a good idea to consult with the insurance company beforehand.
Employees seeking disability benefits may find that these benefits from a part-time income
are much less than they would have been if they had applied for disability while on a full-time
income.

• All insurance companies have strict policies regarding the confidentiality of client information
and are required by law to keep claim information private. Insurance companies must have
written permission from the person to discuss medical information with any other person who
works outside of the insurance company. Employees should note that application forms for
disability benefits may contain consent clauses that allow the employer and the insurance
company to share information about an employee’s medical condition and ability to work.

• If an employee chooses to disclose his or her Hep C status to an employer,

the employer is obliged to keep this information confidential. Legally, the
employer cannot disclose information about an employee’s Hep C status
(or other medical information) to third parties (other employees,
other employers, etc.) without the employee’s consent.

Hepatitis C in the Workplace 5

HEPATITIS C and
Human Rights

Canada and each province and territory have anti-discrimination laws that protect people living
with disabilities. For example, the Canadian Human Rights act states:

“For all purposes of this Act, the prohibited grounds of discrimination are race, national
or ethnic origin, colour, religion, age, sex, sexual orientation, marital status, family status,
disability and conviction for which a pardon has been granted.”
It also states:

“It is a discriminatory practice, directly or indirectly,

(a) to refuse to employ or continue to employ any individual, or
(b) in the course of employment, to differentiate adversely in relation to an employee
on a prohibited ground of discrimination.”
Hepatitis C infection and liver disease caused by Hep C are considered disabilities under Canadian
anti-discrimination law, and every employer has a duty to accommodate an employee with a
disability. To accommodate an employee means to remove barriers (physical, policy or attitudinal)
so that a person is able to do the essential duties of his or her job, despite the fact that he or she
has a disabling medical condition. For example, a simple accommodation might be changing an
employee’s work schedule to permit him or her to go for treatment and medical appointments.

An employee living with Hep C who needs accommodation, in order to continue working or to
return to work, has a responsibility to cooperate with his or her employer. This may mean informing
their employers of their needs, obtaining necessary information including medical or other expert
opinions, participating in discussions about work duties, and working with the employer on an
ongoing basis to manage the accommodation process.

One area where anti-discrimination law does not fully protect an employee with a disability is
employment-related insurance. Anti-discrimination laws often make exceptions that permit
employers and insurance companies to exclude employees with disabilities from particular
insurance coverage or benefits, either altogether or for a certain period of time.

For more detailed information about human rights and Hep C as a disability in your province or
territory, consult provincial legislation or, provincial human rights commissions, or talk to a lawyer.

6 Hepatitis C in the Workplace

HEPATITIS C
Precautions
Food Preparation
Hep C does not pose a danger to health in kitchens,
restaurants, or other premises where food is prepared.
In all workplaces where food is handled or prepared,
however, employers and employees should consider
these points:

• Transmission of Hep C does not occur through oral

ingestion or food-borne contamination. Always discard
food that has had blood spilled on it, regardless of the
employee, as it has been contaminated (it is illegal to
sell contaminated food).
• To prevent the potential transmission of other bacteria
or viruses (like Hep A), all employees should be performing
proper hand-washing and safe food-handling techniques.
For more information, please talk to your local health unit
about food preparation.

First Aid
When administering first aid, remember that Hep C is
transmitted only through blood-to-blood contact. Follow
universal precautions when possible and think of
the following:
• All workplaces should be equipped with first aid kits
that contain a pair of gloves, latex barriers and mouth
guards to protect both the person giving and the person
receiving first aid.
• First aid should be administered without delay. If required,
perform mouth-to-mouth resuscitation with a mouth
guard to avoid coming into contact with blood.
• Report any workplace accidents to a supervisor as soon
as possible.

Hepatitis C in the Workplace 7

HEPATITIS C
Universal Precautions

Like many viruses, Hep C is a blood-borne virus, which means that it is transmitted through blood.
You can’t tell by looking at someone whether or not he or she is infected, and people who are infected
with viruses like Hep C may not even know it. That’s why it is important to use the same precautions
when dealing with blood or other body fluids – assume that everyone is infected. That is the premise
of universal precautions.

Here is a list of universal precautions that can be put into

practice in the workplace:
1 Bandage all cuts right away to avoid contact with other people.
2 Blood and other body fluid should be cleaned using a solution of 1 part bleach, 9 parts water.
3 Do not use bare hands to clean up items soiled with blood or other body fluids; wear gloves.
4 Put sharp items into a solid, sealable container that won’t puncture garbage bags to prevent
those handling garbage from pricking themselves.
5 Wash your hands with soap and hot water for at least 20 seconds after you have had contact
with blood or other body fluids, after going to the bathroom, before preparing or eating food,
and after removing latex gloves.
6 Use hand lotion to help keep your hands from becoming
chapped or irritated. Intact skin is your first defence
against infection!
7 Flush eyes, nose or mouth with water if exposed to
another person’s blood or body fluid.

8 Hepatitis C in the Workplace

HEPATITIS C
Workplace Policy
A good way to deal with Hep C in the workplace is to develop workplace
policies and procedures that can lead to a protected and educated workforce.

Topics that the policy should include, but are not

limited to, are:
1 the employee’s right to work as long as his/her health allows it
2 the employee’s right to workplace accommodations and to confidentiality
3 the employee’s eligibility for benefits
4 references to relevant legislation
5 responsibilities of the employer, the employee, and co-workers
6 the company’s responsibility for educating employees about Hep C, including the risks
of transmission
7 the steps the company will take to provide a supportive environment for people with
Hep C or other chronic or life-threatening illnesses.

A Sample Policy
Here is an example of a policy statement that can be adopted in a variety of workplaces.

(Name of organization) believes that employees infected with hepatitis C are valued employees
who do not pose a health risk to others in the workplace. Employees living with hepatitis C are
encouraged to remain productive at work as long as possible. They will receive the support
and consideration of the employer, and will not be subjected to any discriminatory practices.
An employee’s hepatitis C status and details of his or her medical condition will be kept
strictly confidential.

No employee or candidate for employment will be required to take a

test for hepatitis C infection.
Education
(Organization name) will provide education on hepatitis C prevention for all employees, with
the support of the (name of responsible unit in organization or the local public health unit or
community organization). Confidential referrals to other agencies and on-site educational
resources are available through (title of responsible person in the organization).

Hepatitis C in the Workplace 9

HEPATITIS C
Workplace Policy
(continued)

Support to the employee

For employees who are, or may become, infected with hepatitis C or any other chronic or life-
threatening disease, (organization’s name) will:
• ensure confidentiality about the condition;
• ensure continued employment as long as the employee is able to perform the essential
duties of his/her job or has been reasonably accommodated to the point of undue hardship;
• ensure continued coverage under the terms and conditions of the current benefit package
and (name of organization) personnel policies (and, if applicable, collective agreement);
• provide a supportive workplace environment that responds to hepatitis C as it would to
any long-term chronic illness;
• prohibit discrimination in the workplace; and
• post information indicating whom employees should contact within the workplace if they
feel harassed or discriminated against due to their condition.

Informing the employer

A An employee is under no obligation to disclose that he or she is living with hepatitis C.
B Anyone who has any illness or disability should inform his or her supervisor when he or she
is no longer able to perform essential duties of his or her job.
C Anyone wishing to claim benefits for medical expenses (such as prescriptions) or disability
through the benefits package will be required to provide complete medical information to
the insurance company supplying the benefits.
D An employer is required by law to keep employees’ medical information confidential. It is up
to the employee to decide whether or not to disclose details of his or her medical condition
to coworkers.
E A supervisor may need information about the employee’s capacity to work in order to
accommodate an employee’s disability.

For more copies of this brochure or other documents on hepatitis C, contact:

Canadian Hepatitis C Information Centre
400-1565 Carling Avenue • Ottawa, ON K1Z 8R1
Tel: 1-866-804-4372 • Fax: 613-725-1205
E-mail: [email protected] • www.hepc.cpha.ca
Published by the Canadian Hepatitis C Information Centre, a program of the Canadian Public Health Association,
in co-operation with service providers and people living with or affected by hepatitis C throughout Canada. March 2006.

Production of this document has been made possible by a financial contribution from the Public Health Agency of Canada.
The views expressed herein do not necessarily represent the official policy of the Public Health Agency of Canada.

10 Hepatitis C in the Workplace