Ciuffa et al,1 in moving from the article by Cody et al,2 pose the problem of the management of health care workers (HCWs) with blood-borne infections. The risk of transmission of blood-borne pathogens from worker to patient is one of the most controversial topics in occupational medicine. A number of organizations have proposed guidelines,3-7 most of which are advisory in nature, and their enforcement is generally poor owing to practical difficulties in defining the authority who can effectively manage the problem.