Under-reporting of occupational blood and infectious fluid exposure in a teaching hospital

Abstract number: P1097

Pirs M., Poljak M., Seme K., Maticic M.

Background and Objectives: Occupational blood and infectious fluid exposure (OBE) poses a risk to healthcare workers (HCW). Implementation of safety precautions is crucial in preventing the transmission of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) in healthcare settings. Other key factors are HBV immunisation and appropriate post-exposure management.

The objective of the present study was to determine the proportion of HCW experiencing OBE, post-exposure managing and the proportion of vaccinated HCW in the largest tertiary and teaching hospital in Slovenia. The knowledge of HCW's hepatitis B surface antibody (anti-HBs) status was also assessed.

Methods: 251 HCW from surgical and non-surgical wards and laboratories completed a confidential questionnaire. All categories of HCW were assessed (doctors, nurses, laboratory workers and support personnel).

Results: 124 HCW (49.4%) experienced at least one OBE and only 63 of them (50.8%) reported the incident. HBV, HCV and HIV serology was performed in 44 cases for HCW (69.8%) and in 47 cases for the index patient (74.6%). Our personal observations as well as several studies showed that the most common reasons for non-reporting the OBE are the belief that the patient involved was not infected with HIV or HCV and that the wound was adequately disinfected. Significant amount of time and paperwork involved in reporting the incident are also a factor. Another important reason is the fear of being judged as well as the anxiety they would suffer while waiting for the test results. The data was further analysed according to category of HCW as shown in table 1.

Table 1. The analysis of the results of confidential questionnaire among HCW according to job category.

While the majority of HCW received HBV immunisation (91.2%), the serum concentration of anti-HBs following immunisation was assessed in 106 (46.3%) HCW only. 15 (6.6%) HCW were non-responders and 73 (31.9%) reported adequate serum levels. Surprisingly, over one third of HCW (36.2%) did not know their serum levels of anti-HBs, while for 56 (24.5%) their response to immunisation was never confirmed.

Conclusion: The rate of OBE in this pilot study and inadequate post-exposure measures are disturbing. Our data has shown that better educational programs are needed to increase awareness about the risk and prevention of OBE among the HCW. HCW should be encouraged to undergo testing to determine adequate response to HBV vaccination and most importantly to improve the compliance with the recommended measures following OBE.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Location: Barcelona, Spain
Presentation type:
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