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[Underreporting and follow up of exposure to blood among Danish physicians]
S Nelsing1, T L Nielsen, J O Nielsen
1Infektionsmedicinsk afdeling, H:S Hvidovre Hospital.
Insights
Danish doctors underreport blood exposures, with few seeking follow-up testing or vaccination. Reasons include perceived low risk and time constraints, indicating a significant gap in occupational health surveillance.
Area of Science:
- Occupational Health
- Infectious Disease Epidemiology
- Medical Practice
Background:
- Percutaneous (PCE) and mucocutaneous (MCE) blood exposures pose risks to healthcare professionals.
- Underreporting of occupational blood exposures hinders accurate risk assessment and intervention.
Purpose of the Study:
- To investigate the frequency and reasons for underreporting of PCE and MCE among Danish doctors.
- To assess compliance with initial follow-up procedures, including serological testing and vaccination.
Main Methods:
- Nation-wide questionnaire survey distributed to Danish doctors.
- Analysis of reported exposures, reasons for underreporting, and follow-up actions.
- Inclusion of 6005 valid questionnaires from 9384 doctors.
Main Results:
- Only 3.5% of PCE and 0.4% of MCE were reported.
- Key reasons for underreporting: 'considered unnecessary' (37.1%) and 'too time-consuming' (19.3%).
- Low rates of follow-up: anti-HIV testing (5.0%), anti-Hbs testing (4.8%), and hepatitis B vaccination (3.7%).
Conclusions:
- Current reporting of occupational blood exposures among Danish doctors is very low, failing to reflect the true incidence.
- Barriers to reporting and follow-up include perceived low risk and time constraints.
- Emphasizing the importance of serological follow-up and vaccination is crucial for improving occupational safety.
Abstract:
In a nation-wide questionnaire survey concerning percutaneous (PCE) and mucocutaneous (MCE) blood exposure among Danish doctors, the frequency of and reasons for underreporting and compliance with initial follow-up were studied. Of 9384 doctors, 6256 (67%) responded and 6005 questionnaires were included. Only 3.5% of 3755 PCE and 0.4% of 4847 MCE had been reported. Major reasons for underreporting were "considered unnecessary" (37.1%) or "too time-consuming" (19.3%). Of 1712 PCE and MCE that were described in detail, the doctors were tested for anti-Hbs in 4.8%, anti-HIV in 5.0%, and received hepatitis B vaccination in 3.7%. Major reasons to refrain from anti-HIV test was "felt that there was no risk of HIV-transmission" (49.1%), "the risk so low that testing was unnecessary" (48.8%) or "too time-consuming" (18.9%). In conclusion, only a few percent of the exposures are reported, and the reports do not give a valid impression of the problem. The importance of initial serological follow-up and vaccination should be emphasized.