A job applicant who tests positive for the Hepatitis B virus (HBV) should not be turned down for a position he or she is qualified for, solely on the basis of their HBV status, according to Dr Jade Jamias, a gastroenterologist and currently vice president of the Hepatology Society of the Philippines.

Under the guidelines issued by the Department of Labor (Advisory No. 95, series 2010), employers and recruiters are prohibited from discriminating against applicants simply based on their Hepatitis B status, from pre- to post employment, from hiring to promotion or assignment.

Rather, a physician’s medical evaluation and recommendations should be considered, along with qualifications for the position, before rejecting or hiring an applicant.

Employer concerns

Dr Jamias cited two concerns employers with regards to an individual testing positive for an HBsAG test. The first is the probability of the person developing complications from the virus infection, which includes liver cirrhosis, liver failure and the most dangerous, liver cancer.

The second concern is the possibility they would transmit the disease in the workplace. While very valid concerns, Dr Jamias pointed out that employers simply had to determine the risk of transmission based on the kind of work being sought.

HSP has categorized occupations into high, medium- and low-risk, with the first being high-risk jobs that are mostly in the healthcare setting, as well as those with a potential to exchange bodily fluids such as sex workers.

The medium-risk category also includes healthcare workers, but those not performing exposure prone procedures or EPP. The final category includes occuopations that are with low to negligible risk of EPP.

Further, he added that no documentation has been found to indicate that the Hep B virus is transmissible through the following: a) ordinary workplace activities, b) food preparation, c) coughing and sneezing, d) sharing of utensils and plates, e) sharing lavatory seats, or computers and office supplies. Neither is it transmitted through handshaking, hugging or kissing, using public water fountains, in swimming pools or crowded dining areas.

Policy Statements on HBV testing

- A positive Hepatitis B surface antigen (HBsAG) result should not be a basis to discriminate, restrict, or disqualify a job applicant from being gainfully employed.
- A Hepatitis B positive applicant should not be declared unfit to work and denied employment without appropriate medical evaluation and counseling.
- Hepatitis B screening in the pre-employment setting should not be made mandatory. Screening should be performed only if applying for occupations at high risk for transmission in the workplace.

Medical clearance

The final determination of whether an applicant can be accepted or not must be based on a medical clearance to be issued by physicians, and it is with this document where doctors play an important role, Dr Jamias explained.

He said the certification must contain the following: the state of the individual’s chronic Hepatitis B infection; the risk of transmission based on the category of occupation; recommendations of employability for the applicant.

It must also state how the HBsAG positive individual will be monitored, whether they are candidates for treatment or not.

Further, a medical specialist must make clear the potential for employment be it with restrictions or no restrictions based on the HBV status.

Other than the medical certification, the minimum requirements for a confirmed HBsAG positive individual undergoing pre-employment evaluation should include a Serum HBeAG and anti-Hbe; Serum ALT; and an ultrasound of the liver.

Dr Jamias said outright denial of employment for an otherwise qualified applicant due to HBV infection adds to the stigma for infected individuals and is obviously a form of discrimination.

The practice of Hepatitis B testing started when foreign employers demanded it, based on their labor and health laws, but it was eventually adopted by local employers.

It is best that recruiters and human resource personnel study the labor department guidelines to avoid being accused of discrimination because of HBV. MIMS

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