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At least 451 records · Page 25Linked to original sources
PubMed1994

Hepatitis B vaccination: how many doctors are fully covered?

Hepatitis B is an important health hazard to both health care workers and the patients they treat. Concerns over the safety of the original vaccine were reported in early studies as reasons for poor vaccine uptake amongst health workers. In this study, the overall uptake of a safe effective vaccine is still shown to be inadequate. However, a low perception of risk is the main reason stated for this behaviour. Needlestick injuries remain common, and a poor knowledge of action necessary is shown. A vaccine programme for junior housemen is shown to increase uptake substantially and is advocated for other grades.

Consultants↗
PubMed1997

Preventing transmission of blood-borne pathogens: a compelling argument for effective device-selection strategies.

Disease transmission from percutaneous injury occurs in 2% to 40% of health care workers (HCWs) after exposure to the hepatitis B virus (HBV), in 3% to 10% after exposure to the hepatitis C (HCV) virus, and in 0.2% to 0.5% after exposure to the HIV virus. According to a recently published case-control study from the Centers for Disease Control and Prevention, the following factors increase the risk of HIV seroconversion in HCWs after percutaneous exposure to HIV-infected blood: deep injury, visible blood on the device, procedures involving needle placement directly into a vein or artery, and terminal AIDS in the source patient. Postexposure use of zidovudine by HCWs appears to reduce the risk of HIV transmission by 79%. Institutions seeking to reduce the risk of HCW seroconversion should conduct analyses of specific tasks associated with these high-risk factors, and safety interventions should be installed when tasks and devices increase the risk of seroconversion. Although this type of outcome-based strategy may not significantly reduce the total number of needlestick injuries, reducing high-risk exposures minimizes disease transmission and maximizes the cost-effectiveness of the intervention.

Acquired Immunodeficiency Syndrome↗
PubMed1997

HIV and occupational risk. Evolving ways to protect healthcare workers.

HIV has significantly altered the face of healthcare and the lives of virtually everyone in our communities. The risk of transmission, particularly through needlestick injuries, continues to be a major concern for all of us working in healthcare services. Dr Thurn reviews new information about modes of HIV transmission, ways to reduce risks, and guidelines for managing exposures, should they occur.

HIV Infections↗
PubMed2001

One nurse's fight.

The CDC estimates that there are almost 400,000 needlestick injuries annually among hospital-based healthcare workers. Up to 4% develop acute hepatitis C. But nothing brings home the reality of the disease like this nurse's story.

Blood Banks↗
PubMed2006

Patterns in the offering of hepatitis B prophylaxis by US emergency department physicians.

US emergency department physicians surveyed were more likely to offer hepatitis B prophylaxis to patients after unknown hepatitis B status needlestick injuries than sexual exposures, especially consensual sex. There was no difference in willingness to offer prophylaxis with respect to patient occupation or age or with respect to ED physicians' demographic and professional characteristics.

Adult↗
PubMed1997

Contamination incidents among doctors and midwives: reasons for non-reporting and knowledge of risks.

A 6-month retrospective self-administered questionnaire study of 482 doctors and 380 midwives in two NHS Trusts was undertaken. The response rate was 384 (80%) and 293 (77%) respectively. The study revealed that only nine per cent of doctors and 46% of midwives had reported the contamination incidents they had received. The doctors' main reason for non-reporting was 'too time consuming' and midwives' was 'did not consider anything could be done', although their awareness of the active management of contamination incidents by occupational health departments was good. Seventy-seven per cent of doctors and 69% of midwives underestimated the risk of contracting hepatitis B virus from a needlestick injury, whilst 52% of doctors and 36% of midwives underestimated the risks of acquiring infection with HIV (human immunodeficiency virus) infection following such an injury. Strategies for improving the knowledge of the potential risks of contamination incidents and methods for facilitating ease of reporting are discussed.

Attitude of Health Personnel↗
PubMed2004

Nosocomial acquisition of dengue.

Recent transmission of dengue viruses has increased in tropical and subtropical areas and in industrialized countries because of international travel. We describe a case of nosocomial transmission of dengue virus in Germany by a needlestick injury. Diagnosis was made by TaqMan reverse transcription-polymerase chain reaction when serologic studies were negative.

Adult↗
PubMed1997

A descriptive study of blood exposure incidents among healthcare workers in a university hospital in Sweden.

In an attempt to document blood exposure incidents and compliance with recommended serological investigations, universal precautions and incident reporting routines, data was collected from occupational injury reports during a two-year period. In addition, a sample of healthcare workers (HCWs) answered a questionnaire about blood tests and work routines. In a third part of the study some HCWs were asked about the type and actual frequency of incidents, together with the number of reported incidents during the two-year study period. Of a total of 473 reported occupational blood exposures, the majority came from nurses and the minority from physicians. Most reported incidents occurred on hospital wards. The most common incidents were needlestick injuries, and 35% occurred when the needle was recapped. Medical laboratory technicians (MLT) reported significantly more mucocutaneous incidents than other professionals (P < 0.01). In 10% of the incidents, the patient had a known blood-borne infection. Serological investigations post-exposure varied among professional groups, and 35% were not tested. No seroconversion was shown in the HCWs tested. In the third part of the study, respondents recalled 1180 incidents, although only 9% of these had been reported. The majority occurred in operating theatres, and in connection with anaesthesia. There was a significant difference (P < 0.001) between the different professional groups with regard to the frequency of incident reporting. Physicians reported only 3% and MLTs 36% of the incidents. Eighty-one percent believed that the accident could have been avoided. Despite knowledge of universal precautions, professionals continue to behave in a risky manner, which can result in blood exposure incidents.

Adolescent↗
PubMed1997

Control of infection: a survey of general medical practices.

BACKGROUND: The aims of the study were (1) to assess current infection control practice within general medical practices and establish a base line; (2) to identify potential infection control problems; (3) to assess the need for local infection control guidelines or standards related to general medical practice; (4) to assess the need for educational provision. METHODS: A survey was carried out, using questionnaire and structured interviews, of all general practices (92) within a Health Board area with a patient population of 561,300. RESULTS: Forty two (46 per cent) practices participated, serving 67 per cent of the patient population. Only three (7 per cent) practices had written infection control policies and only six (14 per cent) provided training on the subject. Thirty (71 per cent) practices had autoclaves; however, performance monitoring was poor. The majority of high-risk instruments were adequately decontaminated; of the medium-risk instruments, the auriscope speculum was the item most frequently inadequately treated [36 practices (88 per cent)]. Deficiencies were identified in treatment of blood spillage, and protective clothing provision was variable. The majority, 40 (95 per cent) practices, had systems to deal with clinical waste; however, only two (5 per cent) reported use of BS7320 sharps containers on domiciliary visits. Despite the recognized dangers, 23 (55 per cent) practices resheathed needles and only six (14 per cent) had first aid guidance for needlestick injuries. Only eight (19 per cent) practices knew and recorded staff immunity to hepatitis B following vaccination. CONCLUSIONS: Some deficiencies in infection control practice were identified and the need for policy guidance and staff training was highlighted.

Family Practice↗
PubMed2003

Risk of hepatitis C virus transmission from patients to surgeons: model based on an unlinked anonymous study of hepatitis C virus prevalence in hospital patients in Glasgow.

BACKGROUND: The risk of a surgeon acquiring the hepatitis C virus (HCV) through occupational exposure is dependent on the prevalence of HCV infection in the patient population, the probability of a percutaneous injury transmitting HCV, and the incidence of percutaneous injury during surgery. AIMS: To estimate the prevalence of HCV infection in the adult surgical patient population in North Glasgow and thereafter estimate the risk of HCV transmission to surgeons through occupational exposure. METHODS: The prevalence of HCV infection was estimated through the unlinked anonymous testing of samples from male surgical patients, aged 16-49 years, in two North Glasgow hospitals from 1996 to 1997, and adjusting these data for age and sex. Using published estimates of the incidence of percutaneous injury during surgery and percutaneous injury transmitting HCV, the risk of occupational transmission of HCV to surgeons was then derived. RESULTS: The estimated prevalence of anti-HCV infection for all adult patients in the two hospitals combined was 1.4% (cardiothoracic/cardiology 0.8%, orthopaedics/rheumatology 1.4%, general surgery/ENT 2.0%). The estimated probability of HCV transmission from an HCV infected patient to an uninfected surgeon was 0.001-0.032% per annum (0.035-1.12% risk over a 35 year professional career). CONCLUSIONS: The risk of an individual surgeon acquiring HCV through occupational exposure is low, even in an area with an extremely high prevalence of HCV among its injecting drug using population. Surgeons however should be encouraged to observe universal precautions and present for assessment after needlestick injuries to protect themselves and their patients from this insidious infection.

Adolescent↗
PubMed2006

HTLV-II transmission to a health care worker.

Health care workers, mainly in emergency and forensic services, are at risk of exposure to bloodborne pathogens. Human T-cell lymphotropic virus type I and type II (HTLV-I and HTLV-II) are cosmopolitan human delta retroviruses causing endemic infection in Japan, the Caribbean basin, South America, and sub-Saharan Africa, and in clusters among intravenous drug users in Europe and the United States. The seroprevalence of HTLV-I and HTLV-II among Brazilian blood donors ranges from 0.08% to 1.35%. HTLV-I transmission to a Japanese researcher has already been reported. We describe the transmission of HTLV-II infection to a Brazilian laboratory worker caused by a needlestick injury when she was recapping a syringe after collecting material for arterial blood gas analysis. To our knowledge, this is the first report of an occupational transmission of HTLV-II to a health care worker.

Adult↗
PubMedDate not supplied

Hepatitis C nightmare. Interview by Charlotte Alderman.

Sustaining a needlestick injury resulted in nurse Dianne Wright contracting hepatitis C infection in 2003. Despite 24 weeks of gruelling treatment, she continued to work. A blood test taken at six weeks after the injury confirmed hepatitis C. Treatment with ribavirin and interferon lasted 24 weeks. Hepatitis C virus was undetectable half way through treatment. Viral clearing was confirmed at the end of treatment and six and 12 months later.

Accidents, Occupational↗
PubMed2001

Systematic review of adherence to infection control guidelines in dentistry.

OBJECTIVES: The purpose of this study was to determine the knowledge and attitudes of dental health care workers (DHCWs) towards infection control procedures, to examine DHCWs' practising behaviour in respect of infection control, and to determine whether a relationship exists between knowledge, attitudes and behaviour. METHODS: Within this systematic review, study quality was assessed in line with selection criteria relating to study design, participants, interventions and outcome measures. Following data extraction, the heterogeneity of study design, targeted participants, sample size and outcome measures precluded a quantitative analysis. Qualitative data synthesis followed. RESULTS: Overall, the quality of the studies reviewed was poor. Only 71 studies meeting the selection criteria were identified. Data indicated that over the period of the review there have been substantial improvements with compliance in some areas of infection control in dentistry, for example glove wearing. However, other aspects, such as the effective management of needlestick injuries, remain problematic. CONCLUSIONS: More rigorously designed studies are required to assess accurately dental team members' adherence to infection control guidelines.

Attitude of Health Personnel↗
PubMed1991

Risk for HIV infection among health care workers. Nine questions physicians often ask.

Consideration is given to the risk from needlestick injury and other accidental exposure to blood and bodily fluids infected with HIV. Recommendations are made for postexposure prophylaxis with zidovudine: how soon to start administering the drug, optimal dosages, and subsequent monitoring of the person who has been exposed. Also discussed is the possibility of additional risks incurred by pregnant health care workers.

Acquired Immunodeficiency Syndrome↗
PubMed2005

[Occupational exposure to blood and body fluids in haemodialysis health care workers: epidemiological data and prevention in France].

Health care workers (HCW) in haemodialysis units are confronted with a significant risk of occupational exposure to blood and body fluids. The prevalence of bloodborne viruses is high among haemodialysis patients. The data presented here relates to the extraction of 121 occupational exposures notified to occupational health departments by haemodialysis HCW, documented between January 1995 and December 1999 in a network of 54 volunteer hospitals in Northern France. The exposures notified in haemodialysis wards were needlestick injuries in 85 cases (70.2%), splashes to the eyes or non-intact skin in 30 cases (24.8%) and cuts in 6 cases (5.0%). Connection and disconnection of dialysis catheters to fistulae, blood sampling procedures and injections alone were involved in approximately 3 notified exposures out of 4 (46.3, 14.9 and 11.6% respectively for a total of 72.8%). The principal mechanisms for exposure were the handling of blood-soiled needles and instruments or involved the handling of sharps containers. Haemodialysis fistula needles were involved in only 12 (13.2%) of notified percutaneous injuries. Nearly 2/3 (63%) of 91 notified percutaneous injuries could have been avoided by the observance of universal/standard precautions alone and the use of safety devices which were available at the time. The collection and analysis of occupational exposures can serve as basis for an assessment of practices, devices and safety equipment to increase HCW safety in haemodialysis wards.

Blood-Borne Pathogens↗
PubMed2001

Cut and puncture accidents involving health care workers exposed to biological materials.

The first report of occupational acquisition of HIV appeared in 1984, and, by June, 1997, the Centers for Disease Control and Prevention (CDC) had reported 52 documented cases of sero-conversion following occupational exposure to HIV-1 by health care workers of those cases. 47 (90.3%) were exposed to blood. The most frequent type of accident reported was percutaneous needlestick injury. Prospective studies have estimated that the risk of HIV transmission following percutaneous exposure to infected blood is 0.3% (Confidence Interval 95% = 0.2% to 0.5%). Following a mucous membrane exposure, the risk is 0.09% (CI 95% = 0.006% to 0.5%). The risk of hepatitis B acquisition ranges from 6% to 30%, and hepatitis C acquisition, 3% to 10%. Since 1992, the São Paulo Hospital s Hospital Infection Prevention and Control Service (SPCIH) has notified and treated all workers exposed to accidents involving biological materials. In the last six years, we have handled approximately 1,300 cases of reported accidents, of which 90% were percutaneous, most involving needlesticks. Such cases were frequently caused by the inadequate disposal and recapping of needles. In these accidents, 20% of the source patients were HIV positive, 10% were hepatitis C positive, and 7.6% were hepatitis B positive. This review summarizes the guidelines for a standardized response when dealing with accidents involving health care workers. Transmission of hepatitis B and HIV can be reduced if adequate preventive measures are taken in advance. If proper prophylaxis is not being done, it should be initiated immediately.

Accidents, Occupational↗
PubMed1995

Selection of needlestick prevention devices: a conceptual framework for approaching product evaluation.

Needlestick injuries have been associated with blood-borne disease transmission to health care workers. A demand for a safer work environment has contributed to a proliferation of "safety" products. The selection and evaluation of these devices differs from traditional product evaluation in that it considers not only effectiveness in patient care but also health care worker safety and cost-effectiveness in terms of prevention gained. In addition, multiple devices associated with injuries and choices between passive, active, and accessory safety options require that institutions establish priorities for focusing intervention efforts. Selection of products must involve the primary users. Unless new devices are found acceptable for patient care, health care workers are likely to reject them, despite any apparent safety advantages. Five project steps help define a systematic approach for this process: (1) creation of a multidisciplinary team, (2) defining prevention priorities on the basis of collection and analysis of an institution's injury data, (3) development of design and performance criteria for product selection according to needs for patient care and health care worker safety, (4) planning and implementing an evaluation of products in clinical settings, and (5) analyzing product performance and cost-effectiveness to choose the product. Several methodologic issues raise questions for future research in the area of product evaluation, including the selection of study populations, methods of product distribution and data collection, and influence of institutional culture. In addition, there is a need to develop product-specific design and performance criteria by which evaluation teams can measure various technologies under consideration. Standardization of the product evaluation process for needlestick prevention technology should lead to the collection of information that can be compared across institutions. Infection control professionals have an important opportunity to assume a leadership role in this process.

Consumer Product Safety↗
PubMed2006

Variation in blood and body fluids exposure when small-gauge needles or peripheral venous catheters were implicated: results of a 4-year surveillance in France.

The blood and body fluids exposure (BBFE) risk for health care workers varies according to numerous factors. Based on a needlestick surveillance in 13 French hospitals from 1997 to 2000, we evaluated incidence and temporal trends of BBFE according to medical devices causing needlestick injuries. We observed that the BBFE incidence per 100,000 peripheral venous catheters purchased decreased from 12.9 to 4.9, whereas incidence per 100,000 subcutaneous needles purchased increased from 8.7 to 14.3.

Blood-Borne Pathogens↗