‘Hepa B is not hindrance for work’

Electron micrograph of hepatitis B virus. Image by Centers for Disease Control and Prevention

Employers should neither isolate nor discriminate workers who are Hepatitis B virus (HBV) positive.

The Hepatology Society of the Philippines (HSP) strongly voiced out this concern on how employers hire workers for their company or organization by restricting those who are inflicted with HBV.

The “Guidelines on the Evaluation of Hepatitis B Surface Antigen (HBsAg) Positive Workers for Employment” by  HSP intends to balance out the risk of spreading the HBV transmission and losing skilled workers because of this hindrance. Many HBV-positive workers are denied employment because of the misconceptions and lack of knowledge about the disease.

Grave discrimination

“That’s a very grave discrimination against Hepa B [positive] workers because they are capable of working. Nothing in the disease will burden them from working unless complications arise,” Dr. Stephen Wong of HSP said.

The guidelines are basically targeted on healthcare professionals because they are responsible for clearing patients for employment. It sets what is needed to be checked and assessed for a Hepa B-positive worker to be qualified for work.

“If the patient is [applying for] a health-related work, then the policy would apply differently because of the exposure involved and the risk of infectivity that can be caused,” Wong said.

In 2010, the Department of Labor and Employment (DOLE) issued an advisory with a similar intention as HSP’s guidelines. However, Wong said it was only to remind the employers not to discriminate the workers with HBV.

“The DOLE advisory is just an advisory telling the employers,  ‘You cannot do this to Hepa B positive workers,’” Wong said. He explained that the guidelines set by HSP are for medical purposes and it gives out recommendations to the potential employers.

Prevalence

Based from the study by HSP published in the World Journal of Hepatology on 2013, the prevalence of HBV in the Philippines is 16.7 percent, which can be translated to 7 million Filipinos inflicted. Most of these patients come from the marginalized sector.

“But unlike other viruses, there’s nothing so special about it. Hepatitis B is a DNA virus with a different mode of infection. It can be transmitted through blood contact or sexual interaction,” Dr. Jade Jamias of HSP explained.

Meanwhile, Wong said that in the Philippines, the common mode of infliction is through vertical transmission of mother to infant. Not like in Western countries where it is usually acquired through sexual interaction.

“It’s not really genetic, but there is a possible transmission of virus during child birth because of the exposure of the child with the blood of the mother,” Wong said.

Since most of the patients are from the marginalized sectors, there is a high probability that these people are unaware of the disease.

Misconceptions

“Perhaps these patients are restricted from employment because of the misconception of transmitting the virus. For example, when you use the utensils of the Hepa B-positive person, there is a possibility that the virus will be spreading around,” Wong said.

Wong explained that acquiring virus from unclean food like those sold in the streets often causes Hepatitis A or E. These are self-limited diseases that will “go away on its own.”

Hepatitis B, however, may already be present even during birth but there may no symptoms manifested by the patient.

“About 90 percent of the time a Hepa B patient won’t even turn ‘yellow’ automatically. You won’t have symptoms until you develop a complication like cirrhosis or cancer. That’s the time when they become yellow,” Wong said.

Jamias explained that it may take up to 40 years before the patient develops manifestations of the virus. That is why they advise people to have regular checkups every six months if they want to be sure they do not have HBV.

“Hepatitis B is vaccine-preventable. But, it’s not the virus that kills you. It’s the complications that will do,” Jamias said.

Both Jamias and Wong advised patients not to fret because they are HBV positive. There are several tests which will be given to them before they will be actually treated. The treatment for HBV is offered to those who really need it and will greatly benefit from it.

“Most of the patients get depressed when they knew they are Hepa B positive. Some are even told they are going to die in five months. That’s not true,” Wong said.

“We have what we call ‘inactive carriers’ which means they can live for longer years and die of something else [than Hepa B]. It doesn’t mean it’s a death sentence,” he added.

Corrected

Jamias said that with the help of the guidelines, all these misconceptions can be corrected for the workers and employers to understand more about the disease.

“Hepa B positive workers should not be treated differently. It’s unfair [for them specially] when people with diabetes or hypertension get to be hired when they have higher risks of fainting or getting a heart attack at the workplace,” Jamias said.

Wong, meanwhile, believes that testing applicants for non-healthcare-related work of Hepatitis B positivity is quite unnecessary.

“When the virus is inactive, there’s no question, they can hire these patients,” he said.

The complete set of guidelines from HSP may be downloaded from their official website, https://liverphil.org.