PubMed · 16050156
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A E Williams. 2005. Testing, inactivation or both?. https://pubmed.ncbi.nlm.nih.gov/16050156/
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The risk of blood-borne virus transmission with an inadequately decontaminated endoscope during gastrointestinal endoscopy remains unclear, although it is likely to be low. A systematic review of the literature was undertaken to determine previous episodes of blood-borne virus transmission in these circumstances. In total, 31 articles were included in this review. No articles relating to possible transmission of human immunodeficiency virus were identified. The articles included were generally case series or case reports and were written prior to the comprehensive endoscope decontamination guidelines in use today. The results suggest that hepatitis B and hepatitis C transmission are low during endoscopy with an inadequately decontaminated endoscope.
To examine work-related blood and body fluid exposure (BBFE) among health-care workers (HCWs), to explore potential risk factors and to provide policy suggestions, a 6-year retrospective study of all reported BBFE among HCWs (1998-2003) was conducted in a 430-bed teaching hospital in Australia. Results showed that BBFE reporting was consistent throughout the study period, with medical staff experiencing the highest rate of sharps injury (10.4%). Hollow-bore needles were implicated in 51.7% of all percutaneous injuries. Most incidents occurred during sharps use (40.4%) or after use but before disposal (27.1%). Nursing staff experienced 68.5% of reported mucocutaneous exposure. Many such exposures occurred in the absence of any protective attire (61.1%). This study indicated that emphasis on work practice, attire, disposal systems and education strategies, as well as the use of safety sharps should be employed to reduce work-related injuries among HCWs in Australia.
PURPOSE: A number of immunoglobulin intravenous (IGIV) products have been approved by the Food and Drug Administration (FDA) and are available commercially. Factors that need to be taken into consideration when selecting an appropriate IGIV product are discussed. SUMMARY: Pathogen safety is of particular concern in IGIV products. Manufacturers of IGIV products have introduced different steps to ensure pathogen inactivation and clearance. Physical viral inactivation methods include heat and pasteurization. Chemical viral inactivation methods include acidic treatment, solvent/detergent, and caprylate. Viral removal is accomplished via precipitation, chromatography, or nanofiltration. Pathogen inactivation processes may inadvertently affect IGIV product characteristics, including composition, concentration, purity, and yield, which may, in turn, affect tolerability, efficacy, and convenience of usage. Tolerability of IGIV products is dependent on factors such as volume load, osmolarity, IgA content, and stabilizing agent. For example, sucrose, used as a stabilizing agent in some IGIV products, has been associated with an increased risk of IGIV-induced acute renal failure. The qualities of IGIV products that contribute to convenience of usage for patients and healthcare professionals include liquid formulation, longer shelf life, multiple package sizes, and shorter infusion time. Cost effectiveness of therapy is another important consideration in IGIV product selection. Contributing factors to cost effectiveness include acquisition cost, reimbursement, product preparation, storage, shelf life, and adverse event management. CONCLUSION: The various IGIV products differ in terms of production process, tolerability, and convenience. Pharmacists should be cognizant of these differences when ordering IGIV therapy for their patients. Additionally, overall cost-effectiveness of therapy should be an important consideration.