Effect of time of day and duration into shift on hazardous exposures to biological fluids

To determine whether hospital employee biological hazardous exposure rates varied with time of day or increased with time interval into shift.

This was a retrospective occurrence report review conducted at a university hospital with an emergency medicine residency program. Health care worker biological hazardous exposure data over a 30-month period were reviewed. Professional status, date, time, and type of exposure (needlestick, laceration, splash), time interval into shift of exposure, and hospital location of exposure were recorded. Hourly employee counts and risky procedure counts were matched by location with each reported exposure, to determine hourly rates of biological hazardous exposures.

Analysis of 411 recorded exposures demonstrated that more people were exposed between 9:00 AM and 11:00 AM (p < 0.05), yet the exposure risk did not vary significantly when expressed as the number of exposures per worker or per procedure. Of the 393 exposures with data describing time interval into shift when the exposure occurred, significant numbers of exposures occurred during the first hour and at shift's end [when corrected for exposures per worker (p < 0.05) or exposures per procedure (p < 0.05)].

While the number of exposures are increased in the AM hours, the exposure rate (as a function of workers or procedures) does not vary with time of the day. However, the exposure rate is increased during the first hour and last 2 hours of a shift. Efforts to increase worker precautions at the beginning and end of shifts are warranted.