Skin sepsis in meat handlers: observations on the causes of injury with special reference to bone.
Outbreaks of wound infection with Streptococcus pyogenes and Staphylococcus aureus occurred in a abattoir and a pork-processing factory in Autumn 1980. Investigations showed that staff handling the meat before de-boning were particularly affected and that bone was the cause of 48% of the wounds which became clinicially infected. Of the total isolates of Strep. pyogenes and Staph. aureus from wounds of known cause 75% were from lesions caused by bone. In one outbreak streptococcal infection was seen principally in newly-employed staff. Group L streptococci were found in several sites in the pork factory and were isolated from infected lesions in two workers. Strep. pyogenes and Staph. aureus were cultured from tap handles in the lavatories. Sixty-six workers were examined in a non-epidemic period and 59% were found to have current wounds on the hand or wrists; 13% of wounds were infected but Strep. pyogenes was not isolated. Bone was the commonest of the many causes of injury, accounting for 31% of all wounds. Butchers had the highest rates of wounding and most bone-inflicted injury was seen in this group. Packers were the only group to wear protective gloves regularly. Damaged fingernails were found in 50% of workers, including a high proportion of nail-biters (33% of all workers). The epidemic strain of Staph. aureus was cultured from bitten fingernails. Three of four infected workers carrying epidemic organisms in the throat were examined and all were nail-biters. Sharp-edged bone was produced by rotary saws early in the production line and bone dust contaminated the carcasses and adjacent surfaces. It is suggested that bone fragments could contaminate wounds and that this might have implications for the initiation of infection and the development of outbreaks.