Major article
Risk of infection in health care workers following occupational exposure to a noninfectious or unknown source

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Background

The major concern after occupational exposures is the possible transmission of blood-borne pathogens, especially hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). This study was undertaken to evaluate the risk of infection after exposure to blood or body fluids of an unknown or an HBV-, HCV-, and HIV-negative source and to determine the epidemiologic characteristics of these incidents in health care workers.

Methods

The survey was conducted over a 6-year period at a university hospital in Turkey, using a questionnaire to elicit demographic and epidemiologic information. Serologic tests for HBV, HCV, and HIV were performed and repeated after 3 months.

Results

Of the 449 incidents, complete follow-up was achieved in 320 (71.3%), and no seroconvertion was observed for HBV, HCV and HIV. Most of the incidents occurred in medical (34.7%) and surgical (25.4%) work areas. The most frequent type of exposure was percutaneous injury (94%), most commonly caused by handling of garbage bags (58.4%), needle recapping (16.5%), and invasive interventions (13.4%).

Conclusion

Infection risk seems to be extremely low for HCV and HIV, because of low endemicity, and for HBV in groups immunized against HBV.

Section snippets

Setting

This prospective follow-up study was performed at Dokuz Eylul University Hospital, Izmir, Turkey, between January 2001 and January 2007. This facility is a 966-bed tertiary care hospital.

Study population

The study population comprised HCWs working at the Dokuz Eylul University Hospital who were referred to the hospital's Department of Infectious Diseases and Clinical Microbiology after an occupational exposure to blood or body fluids. In HCWs with more than 1 ccupational exposure, each exposure was considered a

Study population

A total of 565 incidents were recorded during the study period. Of these incidents, 116 exposures with a known source patient positive for HBsAg, anti-HCV, or HIV Ag/Ab were excluded from the study. Thus, the study population comprised 374 HCWs exposed to blood or body fluids in a total of 449 incidents. The mean age was 30.11 ± 7.97 years (range, 18 to 60 years), and most were female (70.3%). Table 1 summarizes demographic and epidemiologic data for 449 exposure incidents in 374 HCWs. Some of

Discussion

Occupational exposure to potentially infectious materials is not uncommon in HCWs. In 2002, the WHO World Health Report reported that 2.5% of HIV cases and 40% of HBV and HCV cases among HCWs worldwide were the result of occupational exposure.2 Although the risk for HIV infection is very low, the risk of infection with hepatitis (especially hepatitis B) is very high in nonimmunized HCWs. According to the WHO, in some areas of the world, > 80% of HCWs have not been immunized against HBV despite

References (16)

  • D.M. Bell

    Occupational risk of human immunodeficiency virus infection in healthcare workers: an overview

    Am J Med

    (1997)
  • C.H. Collins et al.

    A review: microbiologicl hazard of occupational needlesticks and “sharp” injuries

    J Appl Bacteriol

    (1987)
  • World Health Organization. World health report 2002: reducing risks, promoting healthy life. Geneva: World Health...
  • J.C. Hersey et al.

    Use of infection control guidelines by workers in health care facilities to prevent occupational transmission of HBV and HIV: results from a national survey

    Infect Control Hosp Epidemiol

    (1994)
  • A. Pruss-Üstun et al.

    Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers

    Am J Ind Med

    (2005)
  • S.P. Clarke et al.

    Effects of hospital staffing and organizational climate on needlestick injuries to nurses

    Am J Public Health

    (2002)
  • Z. Kuruuzum et al.

    Occupational exposures to blood and body fluids among health care workers: a questionary survey

    Mikrobiyol Bult

    (2008)
  • R. Marcus

    Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus

    N Engl J Med

    (1988)
There are more references available in the full text version of this article.

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