Sports Medicine Handbook - NCAA

70
Blood-Borne Pathogens and Intercollegiate Athletics
The identity of individuals
infected with a bloodborne
pathogen must
remain confidential. Only
those persons in whom
the infected studentathlete
chooses to
confide have a right to
know about this aspect of
the student-athlete’s
medical history. This
confidentiality must be
respected in every case
and at all times by all
college officials, including
coaches, unless the
student-athlete chooses
to make the fact public.
excellent health and productive life
during its natural history. During this
period of preserved health, the team
physician may be involved in a
series of complex issues surrounding
the advisability of continued
exercise and athletics competition.
The decision to advise continued
athletics competition should involve
the student-athlete, the studentathlete’s
personal physician and the
team physician. Variables to be
considered in reaching the decision
include the student-athlete’s current
state of health and the status of his/
her HIV infection, the nature and
intensity of his/her training, and
potential contribution of stress from
athletics competition to deterioration
of his/her health status.
There is no evidence that exercise
and training of moderate intensity is
harmful to the health of HIVinfected
individuals. What little data
that exists on the effects of intense
training on the HIV-infected
individual demonstrates no evidence
of health risk. However, there is no
data looking at the effects of longterm
intense training and
competition at an elite, highly
competitive level on the health of the
HIV-infected student-athlete.
Disease Transmission—Concerns
of transmission in athletics revolve
around exposure to contaminated
blood through open wounds or
mucous membranes. Precise risk of
such transmission is impossible to
calculate, but epidemiologic and
biologic evidence suggests that it is
extremely low (see section on
comparison of HBV/HIV). There
have been no validated reports of
transmission of HIV in the athletics
setting 3,13 . Therefore, there is no
recommended restriction of studentathletes
merely because they are
infected with HIV, although one
court has upheld the exclusion of an
HIV-positive athlete from the contact
sport of karate 19 .
Administrative Issues
The identity of individuals infected
with a blood-borne pathogen must
remain confidential. Only those
persons in whom the infected
student-athlete chooses to confide
have a right to know about this
aspect of the student-athlete’s
medical history. This confidentiality
must be respected in every case and
at all times by all college officials,
including coaches, unless the
student-athlete chooses to make the
fact public.
Athletics Health-Care
Responsibilities
The following recommendations are
designed to further minimize risk of
blood-borne pathogens and other
potentially infectious organisms
transmission in the context of
athletics events and to provide
treatment guidelines for caregivers.
In the past, these guidelines were
referred to as “Universal (blood and
body fluid) Precautions.” Over time,
the recognition of “Body Substance
Isolation,” or that infectious diseases
may also be transmitted from moist
body substances, has led to a
blending of terms now referred to as
“Standard Precautions.” Standard
precautions apply to blood, body
fluids, secretions and excretions,
except sweat, regardless of whether
or not they contain visible blood.
These guidelines, originally
developed for health-care, have
additions or modifications relevant to
athletics. They are divided into two
sections — the care of the studentathlete,
and cleaning and disinfection
of environmental surfaces.