Medical students' occupational exposures to potentially infectious agents

To describe the epidemiology of occupational exposures sustained by third-year medical students at a state university medical school, and identify associated factors that may be modified to decrease exposure risk.

The cohort consisted of all third-year students after completion of each third-year clerkship rotation. At the end of each clinical rotation (a total of six for each student during the year), questionnaires were distributed to the 119 students. Demographic information, type of exposure, rotation, circumstances, compliance with CDC universal precaution recommendations, and post-exposure prophylaxis (PEP) were assessed. Inferential statistics were used to describe the results.

Of a total of 714 questionnaires, 644 (90.2%) were returned. Of the 644, there were 60 reports (9.3%) of one or more exposures to blood or body fluids. The incidence of exposure varied with clerkship: 23 on surgery, 18 on obstetrics-gynecology, eight on outpatient medicine, four on psychiatry, four on pediatrics, and three on internal medicine. Thirty-six (60%) were skin or mucous membrane exposures to blood, body fluid, or respiratory secretions, and 24 (40%) were percutaneous exposure by instrument. Ten (17%) of the exposures resulted in official incident reports and seven accepted PEP recommendations.

Medical students are often exposed to body fluids during their initial clerkship year, primarily in their surgical rotations. Additional education on these rotations may be useful in reducing exposure risk.