Dental healthcare providers should be aware of their health status. They must be aware of their responsibility to their own self as well as other people that they may come in contact with.

Certain medical conditions may make them more susceptible to infection. In some instances, infection control materials may have a negative impact on some DHCP. One example of this is latex sensitivity or frequent application of hand hygiene products. They may have infections that may be transmitted to patients if they are given jobs that encourage that risk. For obvious reasons attendant to such risks, the DHCP may be restricted from performing tasks that may aggravate their conditions or otherwise put other persons at risk of transmission.

The decision to exclude the DHCP from certain tasks or from patient contact is based on the mode of transmission and infective period of the disease. The policies regarding exclusion should be:
• In the form of a written policy
• Based on an authority who can exclude the DHCP (eg, physicians)
• Clearly understood by the DHCP

With increasing concerns regarding blood-borne pathogens and introduction of universal precautions, use of latex gloves among HCP has increased markedly. Increased use of these gloves has been accompanied by increased reports of allergic reactions to natural rubber latex among HCP, DHCP and patients, as well as increased reports of irritant and allergic contact dermatitis from frequent and repeated use of hand-hygiene products, exposure to chemicals and glove use.

DHCP should be familiar with the signs and symptoms of latex sensitivity. A physician should evaluate DHCP exhibiting symptoms of latex allergy, because further exposure could result in a serious allergic reaction. A diagnosis is made through medical history, physical examination and diagnostic tests. Procedures should be in place for minimizing latex-related health problems among DHCP and patients while protecting them from infectious materials. These procedures should include 1) limiting exposures to materials that are harmful to a DHCP, 2) training and educating DHCP, 3) monitoring symptoms, and 4) substituting latex products where appropriate (see Contact Dermatitis and Latex Hypersensitivity).

RECOMMENDATIONS:

1. Develop and have readily available to all DHCP comprehensive written policies regarding work restriction and exclusion that include a statement of authority defining who can implement such policies.

2. Develop policies for work restriction and exclusion that encourage DHCP to seek appropriate preventive and curative care and report their illnesses, medical conditions, or treatments that can render them more susceptible to opportunistic infection or exposures; do not penalize DHCP with loss of wages, benefits or job status.

3. Develop policies and procedures for evaluation, diagnosis and management of DHCP with suspected or known occupational contact dermatitis.

4. Seek definitive diagnosis by a qualified healthcare professional for any DHCP with suspected latex allergy to carefully determine its specific etiology and appropriate treatment, as well as work restrictions and accommodations.