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Mandatory blood testing for care receiver not needed if body fluid touches care giver
Open letter to Norm Letnick, MLA for Westside-Kelowna:
Living Positive Resource Centre, Okanagan strongly opposes your private member’s bill that would court order blood-testing of individuals whose bodily fluids come in contact with emergency service providers. We feel that the introduction of such a bill perpetuates the fear, stigma and misinformation associated with blood-borne infections where a more effective response would involve education rather than a legislated violation of Human Rights.
The occupational risk for contracting a blood-borne infection is very low. There have been no documented cases of occupational transmission of HIV involving firefighters, ambulance attendants, police or correctional staff in Canada.
When considering a needle-stick injury which, unlike most exposures that would be addressed within this bill, involves direct exposure through a wound which punctures the skin, the risk of contracting HIV from a needle known to contain the HIV virus is only 0.3 per cent. The risk for hepatitis C is slightly higher at approximately three per cent and the risk for hepatitis B, which all responders should be vaccinated against, is the highest at approximately 30 per cent.
Again, these numbers represent needle-stick injuries. Exposures that do not involve puncture wounds carry significantly less risk.
There is no benefit to mandatory testing for either the emergency workers or those receiving their help. The possibility of exposure to a blood-borne infection can be a stress-filled situation for anybody to endure and individuals should receive adequate counselling and support to assist them through the process, however knowing the status of the source person will neither increase nor lessen the chances of transmission taking place.
Instead, workers should be given the knowledge and tools needed to prevent such exposures from taking place and information regarding the risks and procedures should an incident occur.
Within the various articles addressing your justification of this bill, references have been made to the post exposure prophylaxis for HIV, a series of medications with harsh side-effects used to reduce the risk of HIV infection after an exposure. If an exposure was serious enough to warrant the initiation of these drugs, they should not be discontinued based on a negative HIV-antibody test of the source person. In some instances, it may take up to six months from the time of infection for an accurate result to be attained through the test and it is during this period of seroconversion that an individual has the highest concentration of virus in their blood.
This means that it is possible for the source person to be HIV positive, but receive a negative test result.
There is no such prophylaxis for hepatitis C exposure and the procedure for addressing a potential hepatitis B exposure in unvaccinated individuals is to administer an appropriate dose of hepatitis B immune globulin along with the vaccination as soon as possible.
The test results of the source person should have no bearing on how these instances are handled.
In most cases, individuals are willing to give their consent for testing in the case of an accidental exposure. Testing can be a difficult emotional process for anybody to undergo. There may be many important impacts on the source person that need to be considered. Viruses such as HIV, hepatitis B and hepatitis C still carry a large amount of stigma and those known or presumed to be infected have faced discrimination in employment, housing, insurance and service access.
Nobody should feel hesitant about calling for help in an emergency out of fear of being tested without consent.
While we support and encourage testing for all individuals, Living Positive Resource Centre, Okanagan urges you to understand how the bill you have introduced threatens an individual’s rights to privacy and their ability to consent to and have control over actions that affect their health and wellness, while offering no benefit to those exposed.
Living Positive also urges you to understand that the introduction of such a bill furthers the fear associated with these viruses and the people who are affected by them and the misconceptions concerning transmission risks. We therefore ask that you reconsider moving forward with this bill.