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Evolution and factors associated with biological-risk accidents reported in a university hospital in Spain, 1989 to
I Failde1, F J López, J A Córdoba
1Servicio Medicina Preventiva y Salud Pública, Hospital Universitario "Puerta del Mar," Cádiz, Spain.
Background:
The objective of this study was to describe the profile and evolution of accidents involving risk of transmission of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) reported in a large Spanish hospital, together with the preventive measures administered and the factors associated with high-risk accidents.
Methods:
Data used were the accidents recorded in the hospital during the period from January 1989 to December 1995. A logistic model, using age, gender, service, occupation, and year of accident as independent variables was constructed to study the factors associated with these accidents.
Results:
The study included 1,009 accidents. Accidents were more common among nurses, female doctors, younger workers, and persons who worked in surgical settings. Of the total sources of infection studied, 11.6% were positive for HBV, 28.2% for HCV, and 24.4% for HIV. No seroconversions were detected in the partial follow-ups conducted. The factors associated with high-risk accidents were gender (relative risk [RR], 2.01; 95% confidence interval [CI95], 1.24-3.60); occupation as physician (RR, 2.57; CI95, 1.54-4.29) or as nursing staff (RR, 1.80; CI95, 1.12-2.89); and working in a surgical service (RR, 2.01; CI95, 1.27-3.18). Younger workers had more accidents overall, but older workers were more likely to have high-risk exposure. In the multivariate analysis, the occupation (physician and nursing staff) was the most important variable when adjusted by the other factors.
Conclusions:
Our results suggest that a greater effort still is required in the application and evaluation of preventive measures. New safety systems, with clearly proven cost-effectiveness, should be developed and applied.