Academic journal article Central European Journal of Public Health

Occupational Exposures in Healthcare Workers in University Hospital Dubrava - 10 Year Follow-Up Study

Academic journal article Central European Journal of Public Health

Occupational Exposures in Healthcare Workers in University Hospital Dubrava - 10 Year Follow-Up Study

Article excerpt

SUMMARY

Occupational hazardous exposure in healthcare workers is any contact with a material that carries the risk of acquiring an infection during their working activities. Among the most frequent viral occupational infections are those transmitted by blood such as hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Therefore, they represent a significant public health problem related to the majority of documented cases of professionally acquired infections. Reporting of occupational exposures in University Hospital Dubrava has been implemented in connection with the activity of the Committee for Hospital Infections since January 2002. During the period of occupational exposures' monitoring (from January 2002 to December 2011) 451 cases were reported. The majority of occupational exposures were reported by nurses and medical technicians (55.4%). The most common type of exposure was the needlestick injury (77.6%). 27.9% of the accidents occurred during the blood sampling and 23.5% during the surgical procedure. In 59.4% of the exposed workers aHBs-titer status was assessed as satisfactory. Positive serology with respect to HBV was confirmed in 1.6% of patients, HCV in 2.2% of patients and none for HIV. Cases of professionally acquired infections were not recorded in the registry. Consequences of the occupational exposure could include the development of professional infection, ban or inability to work further in health care services and last but not least a threat to healthcare workers life. It is therefore deemed necessary to prevent occupational exposure to blood-bome infections. The most important preventive action in respect to HBV, HCV and HIV infections is nonspecific pre-exposure prophylaxis.

Key words: healthcare worker, HBV, HCV, HIV, needlestick injury, occupational exposure

INTRODUCTION

Occupational exposure in healthcare workers is considered any contact with a material that carries the risk of acquiring an infection, which occurs during the working activities, either in direct contact with patients or with body fluids or tissues (1,2). Professional or nosocomial infections are infections acquired during the working hours in health institutions (3). They can be transmitted by any form of direct or indirect contact (4, 5). However, the main route of transmission is via blood, which implies contact with blood and other biological materials (tissue or fluid) that may contain blood and pathogens that are transmitted by blood (6). Viral infections are the main blood transmitted infections, and the most frequent among them are hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). These viruses can be permanently present in the infected host blood. These infections are characterized by a potentially significant morbidity and mortality, and consequently, they represent a significant public health problem related to the majority of documented cases of professionally acquired infections (6).

According to the previously reported cases of professional infections in healthcare workers, the total risk for transmission of infection after occupational exposure is not high (7). The greatest risk for transmission of HCV, HBV or HIV occurs after a percutaneous injury, such as needlestick injury and cuts with sharp objects (scalpels, needles etc.) (7, 8). The possibility of an infection transmission after occupational exposure to blood-bome pathogens by percutaneous injury is 2^40% for HBV, 3-10% for HCV and 0.2-0.5% for HIV (7). Mucocutaneous incidents include exposure of mucosa and injured skin areas to potentially infectious body fluids (7, 8). The possibility of an infection transmission after occupational exposure to blood-bome pathogens by mucocutaneous injury is described as confirmed for HBV and HIV, and possible for HCV (7). Transmission of infections by a bite is also described and can result in infection of a bitten person and also a person who inflicted the bite (7). …

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