Occupational blood and infectious body fluid exposures in a teaching hospital: a three-year review.

Background And Purpose: Blood and infectious body fluid (BBF) exposures are common safety problems for health care workers (HCWs). We analyzed reported BBF exposures during a 3-year period at a teaching hospital.

Methods: We collected reports of BBF exposures among HCWs occurring from January 2001 to December 2003 at a 2000-bed tertiary care medical center in northern Taiwan. HCWs were requested to report BBF exposures immediately after each exposure, which required completing a report sheet of questions concerning the exposure. The HCW was also required to visit an infectious diseases specialist who would decide on the appropriate management in each case.

Results: Needlestick injuries were the most commonly reported BBF exposure, accounting for 80% of reported cases. The total incidence density of BBF exposures was 1.96 per 100 person-years. BBF exposures were most common in December and least common in September. Nurses had the highest percentage (60.6%) of BBF exposures and other job categories including physicians, technicians, cleaning staff, and interns accounted for around 10% each. Injuries occurred most commonly during the daytime (57.0%). Three-quarters (74.9%) of the injured HCWs had appropriate immediate care. Interns had the highest incidence density (4.48 per 100 person-years) of BBF exposures and technicians the lowest (0.50 per 100 person-years). Among the exposed HCWs, 1 received hepatitis B vaccine, 1 received both hepatitis B vaccine and hepatitis B immune globulin, 1 received zidovudine/lamivudine due to a needlestick injury when treating an HIV-positive patient, and 4 received penicillin due to exposure to syphilis. No HCW developed infections after BBF exposure during the study period.

Conclusions: Measures which may be effective in reducing BBF exposures include education of HCW, increased use of standard precautions, improved administrative support, and enhanced reporting of BBF exposures.