- Purpose
The number of HIV (human immunodeficiency virus) infected persons (hereinafter
referred as "infected persons") is not very large by international
standards, at least at the moment in Japan, in terms of the number reported.
In all likelihood, however, that number will increase in the future and
accordingly it is necessary to take positive steps as preventive measures
against AIDS (acquired immunodeficiency syndrome) before it occurs.
It is crucial to take AIDS preventive measures at workplaces for all workers
in order to lead healthy lives as workers, as currently the majority of
infected persons within Japan are in their twenties to forties, or largely
the working age population. Therefore, in addition to supplying correct
information on AIDS, including causative viruses and infection routes,
to workers at workplaces and advising them to avoid carrying out risky
actions which may infect them, AIDS education is required, including instructions
on appropriate measures to take in the event that a worker turns out to
be HIV positive.
On the other hand, it is of urgent necessity to create an environment,
in which HIV positive persons and AIDS patients are properly accepted,
at workplaces. To this end, workers must thoroughly understand that HIV
is not spread during the course of daily routines in workplaces and to
prevent scientifically groundless fears, misunderstandings, discrimination
and disorder from arising out of biases among colleagues and to enable
HIV positive persons and AIDS patients to continue to work in accordance
with their occupational aptitudes.
The above explanation has led to the conclusion that it is desirable
for employers to determine fundamental policies on AIDS issues and
work out AIDS measures voluntarily in reference to the fundamental
concept of AIDS measures at workplaces set forth in Section 2.
These guidelines are not intended for medical institutions where workers
carry great risk of exposure to blood, etc., containing HIV in the course
of regular work.
- Fundamental concept of
AIDS measures to be taken in workplaces
(AIDS education)
(1) Employers should provide AIDS education to workers and correct information
on AIDS at a workplace.
(2) Employers should engage an industrial physician to play a central
role in the planning and implementation of AIDS education and consultation,
etc.
(HIV test)
(3) Employers should not carry out HIV tests on workers at the workplace
since there is little need for test examinations for HIV infections (hereinafter
referred to as "HIV test") in terms of industrial health management.
HIV tests may also create an atmosphere of apprehension in a workplace
when the general public's understanding of AIDS is still insufficient.
(4) Employers should not carry out HIV tests when recruiting workers.
(5) If a worker undergoes an HIV test at his/her own will at a hospital
or clinic of his workplace, the person who conducts the test should maintain
strict confidentiality and provide sufficient explanation and counseling
to him/her before the test as well as at the time of informing him/her
of the test results.
(Keeping HIV infections in confidence)
(6) Employers should keep worker health information in regards to HIV infections
in strict confidence.
(Employment management, etc.)
(7) Employers should treat a worker, who is in good physical condition
despite an HIV infection, in the same way other workers are treated. Employers
should treat workers, who develop AIDS-related complex, including AIDS,
in the same way as workers having other diseases are treated.
(8) An HIV infection itself does not fall under Prohibition of Employment
of the Sick as stipulated in Article 68 of the Industrial Safety and
Health Law.
(9) An HIV infection itself is not a reason for dismissal.
(Prevention of infection at the time of accidental bleeding, etc.)
(10) An employer should take necessary measures, including education on
first-aid treatment and the supply of rubber gloves, for the purpose of
preventing workers from becoming infected with HIV at the time of unexpected
bleeding accidents of workers etc., in the workplace.
Interpretation of Guidelines
on AIDS issues in workplaces
Regarding Section 1
Section 1 states the purpose
of the guidelines on AIDS issues in workplaces.
Regarding Section 2 (1)
The target and contents of AIDS education in workplaces includes the following
examples.
Examples of target and contents of AIDS education in workplaces
- To provide all workers except manager with education on the following matters
- General information
on the disease called AIDS
Its cause, pathology, treatment and prognosis
- Information on the
prevention against infection
- Infection route
of HIV
- The fact that
one does not get infected with HIV in the course of daily
routines in workplaces
- Actions carrying a high risk of infection
- Methods for minimizing
the risk of infection
- Access to AIDS information
- Tests that examine
infection
Methods and timing of tests and how tests are conducted
- Measures taken in
the event that an HIV infection is found
- Necessity of keeping
health information in workplaces in strict confidence
- Necessity of preventing
unfair discrimination against infected persons and AIDS patients
in the workplace
- Fundamental policies
concerning AIDS issues in workplaces
- Other
- In addition to the matters set forth in [1] above, the following contents
should be taught to manager.
- Significance of tackling
AIDS issues in workplaces
- Various guidelines
concerning AIDS issues in workplaces
- Measures for preventing
disorder in workplaces
- Manager's role in tackling AIDS issues
- The present AIDS situation
and AIDS-related laws in overseas workplaces
Regarding Section 2 (2)
When workplaces tackle AIDS issues, systematic handling is required and
a large number of departments and persons in charge of issues are expected
to become involved. In this case, it is desirable for industrial physicians
to play a central role in planning and implementing AIDS education and
counseling, etc., as leaders of industrial health departments and to maintain
close cooperation with all concerned departments.
For workplaces that do not require the appointment of an industrial physician,
it is preferable to appoint a person or an organization in charge of playing
a central role in AIDS education from time to time and to make good use
of external medical doctors specializing in such fields. At the same time,
it is preferable to make effective use of Local Occupational Health Consulting
Center.
Regarding Section 2 (3)
Implementation of HIV tests in workplaces embraces the following problems.
First of all, since during daily routines at workplaces, it is very unlikely
to become infected with HIV, in terms of industrial health management,
it is groundless to carry out HIV tests where there is no risk of becoming
infected with HIV when one is on duty. Further, social understanding of
HIV and AIDS in general is still insufficient and there is the possibility
of HIV tests creating apprehension in workplaces. In addition, special
measures for the protection of privacy regarding HIV positive persons are
needed. Therefore, if HIV tests are carried out without the consent of
a worker this infringes his/her privacy and even if HIV tests are carried
out after his/her consent is obtained, it is unknown whether or not truly
voluntary consent is obtained. A conclusion drawn from the above facts
is that it is desirable for employers not to give his workers HIV tests
in the workplace.
Even in the event that a certificate showing negative results of an HIV
antibody test is required when a worker is dispatched overseas, it is necessary
for an employer to notify the worker of the necessity of such a certificate
in advance and confirm his/her desire to be dispatched. In this case, an
HIV test should never be carried out if a worker is unaware of such a test
or a test should never be forced. It is better for the worker to have the
test on his own free will.
Regarding Section 2 (4)
From the standpoint of promoting recruitment and screening on the basis
of one's aptitude and competence, a medical examination for recruitment
and screening should be conducted within the limits of reasonably and objectively
recognized requirements of determining the competence and aptitude of applicants.
In this case, applicants should be informed of the contents and requirements
of an examination in advance and an examination should never be carried
out until are completely informed.
In a general sense, an HIV infection itself has nothing to do with
the competence and aptitude of applicants and HIV tests should not
be conducted, in principle, for recruitment and screening.
Under particular circumstances where a person is recruited in a country
that requires a certificate showing negative results for an HIV antibody
test, it is preferable to notify applicants in advance by pointing
out the necessity of the certificate showing negative results of an
HIV antibody test at the time of recruitment.
Regarding Section 2 (5)
If a worker particularly desires to take an HIV test at a hospital or a
clinic in the workplace, it is necessary for such a medical institution
giving the test to maintain strict confidentiality of test information.
Also, an institution providing tests must establish a counseling system,
for which sufficient explanation is given to those taking the tests, wherein
a counselor listens to their worries and fears and gives appropriate advice
before a test as well as at the time of notifying test results, if necessary,
so that those taking tests may deepen their understanding of AIDS and the
meaning of the test results.
Regarding Section 2 (6)
If an employer is aware of an HIV positive worker due to a circumstance
where the worker informs the employer, the employer shall maintain strict
confidentiality.
Also, an employer shall maintain worker secrecy of health information in
general for the purpose of strictly controlling information on HIV infections
since worker health information including the results of medical examinations
may contain disclosure of HIV infection.
Regarding Section 2 (7)
HIV positive persons must not undergo prejudicial treatment since an HIV
infection itself does not harm work aptitude. Reasonable consideration
should be given to workers having an AIDS related complex, including AIDS,
like workers having other diseases, in accordance with the conditions of
disease and aptitude for work on the basis of consultation with industrial
physicians, if necessary.
Also, suspension of work arising from an HIV infection and AIDS should
be treated in the same way as a suspension of work resulting from
other diseases.
Regarding Section 2 (8)
The Industrial Safety
and Health Law stipulates that an employer is prohibited from employing
those who have contagious diseases that may be transmitted during
daily routines in workplaces or those whose condition of disease is
likely to significantly deteriorate due to work, for they threaten
to aggravate not only the condition of their own health but also the
health of other workers or exert adverse effects (Industrial Safety
and Health Law, Article 68 and the Ordinance on Industrial Safety
and Health, Article 61).
Measures under these provisions are not taken uniformly for any disease
contracted by workers, but taken appropriately in accordance with the condition
of a disease. Measures may deprive workers of an opportunity to work and
hence the application of provisions should be determined cautiously after
the opinions of industrial physicians and other specialists are considered
in advance.
An HIV infection itself is not transmittable during daily routines
in workplaces and, consequently, an HIV infection cannot be referred
to as a contagious disease, which prohibits employment. An employer
cannot immediately prohibit an HIV positive person from employment
on the grounds of an HIV infection. After AIDS symptoms appear, employment
should sometimes be prohibited, for employment may extremely aggravate
the condition of the disease or pathological condition. In these cases,
too, an employer must determine the prohibition of employment after
taking the opinions of industrial physicians and other specialists
into consideration in advance.
Regarding Section 2 (9)
An HIV infection itself
does not harm the aptitude for work and therefore an HIV infection
itself is not reason for dismissal.
Accordingly, an HIV infection should not be specified as a reason for dismissal
in a labour contract, etc.
Regarding Section 2 (10)
If an accident accompanied by bleeding occurs in a workplace, an industrial
physician, an industrial health supervisor or a co-worker is expected to
provide first aid treatment in many cases. Skin contact with blood containing
HIV does not generally result in infection, but there is a fear of infection
through a wound or mucous membrane. Therefore, for prevention of an HIV
infection, all workers must be made aware that any blood must be treated
as if it contained hematic pathogenic organisms, such as the hepatitis
B virus, hepatitis C virus and ATL virus, apart from HIV. In this case,
if measures based on those against the infection of the hepatitis B virus,
which is more infectious than other viruses, are made known to all, HIV
infection can be prevented.
To be concrete, if first-aid treatment is administered to the injured
undergoing bleeding, it is preferable to avoid direct contact with
blood and wear disposable vinyl or rubber gloves and a mask if there
is the possibility of blood, etc., being sprayed. If blood should
contact skin, wash it off with soap under running water or have the
skin sterilized with an antiseptic solution of hypochlorous acid.
Further, a blood stained work jacket should immediately be changed
and washed.
Education of first-aid treatment for workers is required, particularly
for those who often administer first aid.
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