Incidence of occupational exposure to blood and body fluids and measures taken by health care workers before and after exposure in regional hospitals of a developing country: A multicenter study

doi:10.1016/j.ajic.2015.05.010

American Journal of Infection Control

Volume 43, Issue 10, 1 October 2015, Pages 1137-1138

https://doi.org/10.1016/j.ajic.2015.05.010 Get rights and content

Highlights

The study has been done in the domain of occupational exposure in regional hospitals of Northern Khorasan province in Iran showed that:
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The incidence of exposure to sharp objects was 44% and the incidence of contact with blood or other secretions of patients was 31%.
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Among healthcare workers (HCWs) who had needle stick injuries, 82 had a positive hepatitis B surface antibody titer measured after injury.
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35.9 % HCWs washed their hands before and after examining patients, and 41.5 % used gloves while working in hospitals.

This cross-sectional study was conducted on 371 health care workers working in government hospitals in the Northern Khorasan province of Iran. Exposure to sharp objects was 44% and 31% of participants had a history of being in contact with blood or body fluids of patients. Among health care workers who had needlestick injuries, 82 had a positive hepatitis B surface antibody titer measured after injury.

Section snippets

Materials and methods

This cross-sectional study was conducted from January to June 2013 among 371 HCWs, and included physicians, paramedics, and cleaning personnel. Personnel with <1 year of experience were not considered as a statistical population. The sampling method was stratified so that each public hospital in North Khorasan was considered as a group (6 hospitals from 4 cities in the Northern Khorasan province). Then, based on the personnel population ratio in each group, samples of personnel were selected

Results

Three hundred seventy-one HCWs participated in this study, and all answered the survey questions. The incidence of exposure to sharp objects was 44%, and the incidence of contact with blood or other secretions of patients was 31%. Responses indicated that 91% of HCWs always used a safety box to deposit used needles, 35.9% washed their hands before and after examining patients, and 41.5% used gloves while working in hospitals.

Fifty-eight percent reported attending training classes on handling

Discussion

There are no precise statistics on incidence of the occupational exposure to blood and body fluids in Iran. However, several studies have reported different figures in different regions of Iran. Incidence of NSI among HCWs within other regions of Iran (eg, Tehran) was reported at 53%, which is higher than the rate found in our study.⁵ HCWs with <1 year of working experience and students were not included in our study. This may have influenced the incidence rate.

The incidence of NSI in countries

Conclusions

Due to the high incidence of NSI, measures taken to prevent injury were not at an acceptable level and there were no consistent quality measures after NSI.

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Cited by (14)

Occupational exposure to blood and body fluids among prehospital emergency medical services workers in Mashhad, Northeast of Iran
2023, American Journal of Infection Control
This study aimed to assess occupational exposure to blood and body fluids (BBFs) and the use of protective equipment among prehospital emergency medical services (EMS) workers in Mashhad, Iran.
This cross-sectional questionnaire survey-based study was conducted from July 2020 to March 2021 in Mashhad. All prehospital EMS workers of Mashhad were invited to participate in the study using the census technique. The questionnaire was about occupational exposure to BBFs, infection control, protective measures, health program, and demographic information.
In total, 442 participants answered the questionnaire (response rate: 82.77%). Based on the findings, 420 (95.2%) and 402 (91.2%) participants had been exposed to BBFs as prehospital EMS workers. Moreover, 31.5% and 38.5% of these exposures were caused by contaminated needles and lancets, respectively. The BBFs incidents have occurred despite 98% of the EMS workers reporting there is a needle safety disposable box in the ambulance. The relationship between awareness of precaution measures after exposure to BBFs and training course completion was significant (P < .0001).
This study demonstrated the high prevalence of occupational exposures to BBFs among prehospital EMS workers. Considering the significant relationship between the completion of standard precautions courses and awareness of BBFs’ postexposure measures, it is recommended to consider multi-faceted strategies for continuous monitoring, training, and follow-up of prehospital EMS workers.
Multicenter cross-sectional study on the reporting status and influencing factors of needlestick injuries caused by insulin injection devices among nurses in Peking, China
2020, American Journal of Infection Control
Citation Excerpt :
There was less study to identify the reporting incidence of NSIs caused by insulin injection syringes, insulin pen needles, and other devices and its associated factors, including nurse characteristics and questions about reporting NSIs, as well as the reasons for reporting or not reporting these injuries. The results of our study demonstrated that 19.33% of the total participants were exposed to NSIs at work, which was much lower than in other studies,12,18-21 but was slightly higher than in a study performed in the Awi Zone.9 Prior studies showed that insulin syringe needle was the second most frequent cause of NSIs.12
Needlestick injuries (NSIs) most commonly occur in conjunction with insulin injections, and nurses had the highest rate of NSIs among different occupational groups. However, only few nurses have the awareness to report these incidents. We aimed to investigate the current reporting status and influencing factors of NSIs caused by insulin injection pen devices among nurses and nursing interns in Peking, China.
The study consisted of 4,609 nurses and nursing interns in different hospital departments, namely endocrinology wards, medical (except endocrinology) and surgical departments, emergency, outpatient departments, operation theaters, intensive care units, and other departments from 16 districts of Peking, China. A researcher-devised questionnaire was designed to assess the rate of reporting of accidental NSIs and its influencing factors. Descriptive statistics, the χ² tests, and univariate and multivariate regression were used to analyze the independent influencing factors of reports on NSIs caused by insulin injection pen devices.
Among all participants, most of them were women (97.61%). More than half of the participants had been working as nurses over 5 years (59.58%). Approximately 63.66% of participants had been trained to prevent and deal with accidental NSIs within 1 year. Approximately 19.33% of the participants experienced NSIs before, but only 30.30% of them reported the injury to the management department or director. The main reasons for not reporting were complex/cumbersome reporting procedure (317 of 621; 51.05%), being too busy at work at the time of injury (301 of 621; 48.47%), and low-risk for personal health (197 of 621; 31.72%). Multivariate analysis showed that age (P = .014; odds ratios [OR; 1.063, 1.736]), prior needlestick training education (P = .018; OR [0.406, 0.917]), and written system for preventing (P < .001; OR [0.289, 0.622]) were independent factors associated with reporting of NSIs caused by insulin injection pen devices.
NSIs caused by insulin injection pen devices are common among nurses and are often not reported. It is necessary to provide nurses with regular training to prevent and deal with NSIs. Hospital management departments should adopt a simpler reporting procedure to understand the actual occurrence of NSIs to develop better prevention and improvement measures.
Seroconversion rates among health care workers exposed to hepatitis C virus–contaminated body fluids: The University of Pittsburgh 13-year experience
2017, American Journal of Infection Control
Citation Excerpt :
The seroconversion rate reported by the CDC is 1.8% (range, 0%-7%),3 but relies on an average rate calculated from only a few studies conducted in the 1990s, which are small, do not consider mucocutaneous exposures, and two-thirds of which are not based in the United States. More studies have been published since, and the seroconversion rate ranges from 0% to 5.4%.12,14-18,20-22 Our study found an overall seroconversion rate of 0.1% (n = 2) after occupational exposure to the blood of HCV-positive source patients.
Hepatitis C virus (HCV) transmission to health care personnel (HCP) after exposure to a HCV-positive source has been reported to occur at an average rate of 1.8% (range, 0%-10%). We aimed to determine the seroconversion rate after exposure to HCV-contaminated body fluid in a major U.S. academic medical center.
A longitudinal analysis of a prospectively maintained database of reported occupational injuries occurring between 2002 and 2015 at the University of Pittsburgh Medical Center was performed. Data collected include type of injury and fluid, injured body part, contamination of sharps, resident physicians' involvement, and patients' hepatitis B virus (HBV), HCV, and HIV status.
A total of 1,361 cases were included in the study. Most exposures were caused by percutaneous injuries (65.0%), followed by mucocutaneous injuries (33.7%). Most (63.3%) were injuries to the hand, followed by the face and neck (27.6%). Blood exposure accounted for 72.7%, and blood-containing saliva accounted for 3.4%. A total of 6.9% and 3.7% of source patients were coinfected with HIV and HBV, respectively. The HCV seroconversion rate was 0.1% (n = 2) because of blood exposure secondary to percutaneous injuries.
This study provides the largest and most recent cohort from a major U.S. academic medical center. The seroconversion rates among HCP exposed to HCV-contaminated body fluids was found to be lower than most of the data found in the literature.
Effect of modifying the information and training structure on the occupational safety of health care workers in exposure to blood and body fluids: A quasi-experimental study
2017, American Journal of Infection Control
Citation Excerpt :
It seems that the training should be done outside of these times, which can indicate the necessity to revise the manner of holding and teaching in-person training classes. Therefore, lack of sufficient attention to its nature and participation in class just to meet the task and get administrative privileges can be the main cause of noneffectiveness of these classes, which is confirmed by the study of Sabermoghaddam et al.10 Therefore, in this study, the necessary information on standard precautions along with its main principles was made available using a Web-based information system. One of the limitations of the present study was the time limitation for investigating before and after the intervention, this was because of the impossibility of controlling other programs related to infection prevention and control in both the intervention and control hospitals for a longer time period.
This study was a quasi-experimental design to assess the effect of a Web-based information system on the occupational exposure to blood and body fluids (BBFs) among health care workers (HCWs). The outcome was the number of exposure incidents with BBFs among HCWs in both hospital A (intervention) and hospital B (control). The findings showed that the implementation of the Web-based information system about infection prevention and control in hospital A decreased exposure incidents with BBFs among the HCWs (P < .001).
Knowledge, attitude and practice of infection prevention and control precautions among laboratory staff: a mixed-methods systematic review
2023, Antimicrobial Resistance and Infection Control
Exposure to needle stick injuries among health care workers in hemodialysis units in the southwest of Iran: a cross-sectional study
2023, BMC Health Services Research

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: Conflicts of interest: None to report.

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Brief reportIncidence of occupational exposure to blood and body fluids and measures taken by health care workers before and after exposure in regional hospitals of a developing country: A multicenter study

Highlights

Section snippets

Materials and methods

Results

Discussion

Conclusions

Am J Infect Control

J Hosp Infect

J Hosp Infect

The prevalence of needle stick injuries in medical, dental, nursing and midwifery students at the university teaching hospitals of Shiraz, Iran

Indian J Med Sci

Injury or body fluid splash incidence rate during three months period in elective surgery procedures, at Dicle University Hospital, Diyarbakir, Turkey

Ulus Travma Acil Cerrahi Derg

Brief report
Incidence of occupational exposure to blood and body fluids and measures taken by health care workers before and after exposure in regional hospitals of a developing country: A multicenter study