Occupationally-Acquired Infections in Healthcare Settings

Protecting Healthcare Personnel

Healthcare personnel can be exposed to pathogens and subsequent infections while they are working. Occupationally-acquired infections in healthcare settings are infections caused by pathogens transmitted to healthcare personnel following exposures that occur in their workplace. Exposures could occur as a result of contact with coworkers, patients, visitors, environmental surfaces, medical devices (e.g., needlestick injury), or other healthcare sources. The resources on this page are intended to support occupational infection prevention and control in healthcare settings and to protect the health and safety of healthcare personnel, patients, and visitors.

Novel and Emerging Pathogens:

Infection Prevention and Control (IPC) Guidance for novel and emerging pathogens is usually provided on an individual pathogen basis, as IPC processes for novel pathogens may vary from standard practices. The webpages below are examples of novel- or emerging-pathogen specific guidance that contains occupational infection prevention and control recommendations for healthcare personnel.

• Infection Control: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) | CDC
• Infection Control: Healthcare Settings | Mpox | Poxvirus | CDC
• Infection Prevention and Control Recommendations for Hospitalized Patients Under Investigation (PUIs) for Ebola Virus Disease (EVD) in U.S. Hospitals | Ebola Virus Disease | Clinicians | Ebola (Ebola Virus Disease) | CDC

Occupational Infection Prevention and Control:

Guideline for Infection Control in Healthcare Personnel
The recommendations in this guideline are intended for leaders, administrators, and staff of occupational health services who provide occupational infection prevention and control services to healthcare personnel and prevent transmission of infections between healthcare personnel and others. This includes recommendations about:

• the infrastructure and routine practices necessary to provide occupational infection prevention and control services to healthcare personnel, and
• controlling the work-related spread of selected pathogens to and from healthcare personnel, including work restrictions and postexposure prophylaxis.

Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007
This guideline provides recommendations on infection control precautions for preventing the transmission of pathogens in healthcare settings.

Core Infection Prevention Practices for Safe Healthcare Delivery in all Settings
This document contains CDC’s core infection control practices. These practices are  considered standards of care and/or accepted practices (e.g., aseptic technique, hand hygiene before patient contact) for all  healthcare settings.

Bloodborne Pathogen Exposures and Infections:

Bloodborne pathogen exposures:

Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis
This guideline provides recommendations for managing occupational exposures to Human Immunodeficiency Virus (HIV), including postexposure prophylaxis regimens and timing and duration of follow-up testing.
Infographic: Exposed to HIV? The clock is ticking! Take Action! [PDF – 1 Page]

CDC Guidance for Evaluating Health-Care Personnel for Hepatitis B Virus Protection and for Administering Postexposure Management
This guidance provides recommendations for assessing Hepatitis B Virus (HBV) protection in healthcare personnel who were previously vaccinated and evaluating and testing personnel after occupational HBV exposures.

Updated CDC Guidance for Testing and Clinical Management of Health Care Personnel Potentially Exposed to Hepatitis C Virus
This guidance provides recommendations for testing and management of occupational exposures to Hepatitis C Virus (HCV), including duration of follow-up testing.

National Clinicians Post-Exposure Prophylaxis Hotline (PEPline)
This hotline provides clinicians with expert consultation on managing occupational exposures to HIV, HBV, HCV, and other bloodborne pathogens.

Bloodborne pathogen infections:

Guidance on the management of healthcare personnel with chronic bloodborne pathogen infections (i.e., human immunodeficiency virus, hepatitis B, hepatitis C) is available from:

CDC: Updated CDC Recommendations for the Management of Hepatitis B Virus–Infected Health-Care Providers and Students

Society for Healthcare Epidemiology of America (SHEA): Management of Healthcare Personnel Living with Hepatitis B, Hepatitis C, or Human Immunodeficiency Virus in US Healthcare Institutions (cambridge.org) [PDF – 9 Pages]

Personal Protective Equipment (PPE):

CDC Healthcare Respiratory Protection Resources
This website provides healthcare worker respiratory protection resources, including the National Institute for Occupational Safety and Health (NIOSH) toolkit on requirements for an effective hospital respiratory protection program.

Sequence for Donning and Removing Personal Protective Equipment [PDF – 3 Pages]
This poster demonstrates one option for safely donning (putting on) and doffing (removing) PPE.

PPE 103: Training Frontline Health Care Professionals and Auditing Practices [PDF – 45 pages]
This training reviews strategies to coach and train frontline health care workers in the use of PPE and strategies for auditing appropriate PPE use to identify gaps and improve PPE adherence. See additional courses at: CDC/STRIVE Infection Control Training.

Immunization:

Healthcare personnel are at risk for exposure to vaccine-preventable diseases because of their contact with infectious patients or related materials. Immunization of healthcare personnel remains a critical part of an occupational infection prevention and control program. Recommendations for immunization of healthcare personnel and resources include:

Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP) [PDF – 48 Pages]
This website contains guidance on recommended immunizations for healthcare personnel from 2011. Please also visit the ACIP homepage for updated recommendations on immunizations for healthcare personnel.

Aerosol Generating Procedures:

Some procedures performed on patients are more likely to generate higher concentrations of infectious respiratory aerosols than coughing, sneezing, talking, or breathing. These aerosol generating procedures (AGPs) potentially put healthcare personnel and others at an increased risk for pathogen exposure and infection.

There is neither expert consensus, nor sufficient supporting data, to create a definitive and comprehensive list of AGPs for healthcare settings.

Commonly performed medical procedures that are often considered AGPs, or that might create uncontrolled respiratory secretions, include:

• open suctioning of airways
• sputum induction
• cardiopulmonary resuscitation
• endotracheal intubation and extubation
• non-invasive ventilation (e.g., BiPAP, CPAP)
• bronchoscopy
• manual ventilation

It is uncertain whether aerosols generated from some procedures may be infectious, such as:

• nebulizer administration*
• high flow O2 delivery

*Aerosols generated by nebulizers are derived from medication in the nebulizer. It is uncertain whether potential associations between performing this common procedure and increased risk of infection might be due to aerosols generated by the procedure or due to increased contact between those administering the nebulized medication and infected patients.

Education and Training:

Infection Control Training and Education Resources Webpage
This website includes webinars, training courses, and activities designed to educate healthcare personnel on infection control principles and practices.

Project Firstline: CDC’s National Training Collaborative for Healthcare Infection Control
This website provides resources for frontline healthcare personnel, including educational modules on infection control, injection safety, PPE use, and environmental cleaning and disinfection.