Background: Working in health care increases the probability that an impaired worker be hazardous for third persons.
Methods: A literature review concerning identification, intervention, and treatment of hazardous health care workers is here reported.
Results: Published reports of health care worker-to-patient transmission of bloodborne infections, and papers concerning the so-called "impaired physician", have been reviewed.
Discussion: According to European directives on workers' health and safety, the occupational health physician charged of medical surveillance of hospital workers is often mandated to manage impaired professionals.
Conclusions: Strategies for early identification, treatment and rehabilitation of impaired physicians are reviewed and suggestions for preventive action are given.