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

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.

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.

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.

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.