symbol for biohazardProtecting Workers from Hepatitis A

Hepatitis A is a highly contagious liver disease caused by the hepatitis A virus. It can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months resulting in death. Hepatitis A virus is usually spread when a person ingests fecal matter—even in microscopic amounts—after contact with objects, food, or drinks contaminated by the feces of an infected person. For more information, please see the Centers for Disease Control and Prevention Hepatitis A fact sheet.

A large hepatitis A outbreak occurred in California in 2017. In particular, outbreaks occurred in San Diego, Santa Cruz, Monterey, and Los Angeles Counties. Hepatitis A virus is very hardy in the environment and can live for months outside the human body. Please see the websites of the following agencies for further information:

The following measures will help reduce the spread of hepatitis A in workplaces:

  • Maintain a clean and sanitary workplace. Employers must clean and sanitize work areas contaminated by decaying waste such as fecal matter (title 8 section 3362). Employees should report any unsanitary conditions to their employer immediately.
  • Clean toilet facilities. Employers must ensure that workplace restrooms are kept clean and sanitary (title 8 section 1526 in construction and section 3364 for other workplaces). Additional cleaning may be needed if persons outside of the workplace who are at greatest risk for hepatitis A infection (i.e., homeless persons or persons using illicit drugs) have used or have had access to workplace restrooms. The County of San Diego Department of Environmental Health has posted Hepatitis A Disinfection Guidelines.
  • Provide handwashing facilities. Employers must provide handwashing facilities at construction sites (title 8 section 1527) and at other worksites (title 8 section 3366). Employees should wash their hands with soap and water after using the toilet, touching any object that may have been contaminated with fecal matter, and prior to eating, drinking, or smoking.
  • Provide appropriate personal protective equipment. Employers must provide gloves and other necessary personal protective equipment to employees who clean up or otherwise come into contact with hazardous materials such as fecal matter (title 8 sections 3380 and 3384).1 Employees should wash their hands after disposing of used gloves.
  • Provide training. Employers must provide training to employees when a new hazard is presented in the workplace (title 8 section 1509 in construction and section 3203 for other workplaces). For example, when a hepatitis A outbreak occurs that could affect employees, the employer must provide information and training to the employees on how hepatitis A is transmitted and how to prevent infection.1 Employees should follow the training they have received on how to prevent infection.
  • Offer hepatitis A vaccinations. In locations that have experienced recent outbreaks, employees who come into close contact with homeless persons or persons using illicit drugs or who handle materials or objects potentially contaminated with hepatitis A virus have an increased risk of being infected with hepatitis A virus. Outside of health care and laboratory settings, these employees include (but are not limited to) the following:
    • Staff at homeless services providers and substance use treatment agencies
    • Public safety and emergency medical services workers
    • Sanitation and janitorial workers
    As part of their duty to correct unsafe or unhealthy conditions in the workplace (title 8 section 3203), employers should ask their local health departments whether hepatitis A vaccinations should be offered to employees who are at increased risk and if so, whether the local health department is available to assist.

1Employers whose employees may come into contact with blood and certain other human body fluids must also comply with title 8 section 5193.

May 2018