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Needle stick injuries: a comparison of practice and attitudes in two UK District General Hospitals.

Hospital staff are at risk from occupational exposure to blood-borne viruses due to needle stick injuries. Occupational health departments have invested considerable resources in the prevention of these injuries, which can be very distressing to the affected individuals. We surveyed health care workers, i.e. doctors, nurses and operating department practitioners, in the operating theatre and critical care units of two UK hospitals located in the Midlands and Merseyside to compare attitudes and experiences. There were significant deficiencies in several aspects of the safe practice of universal precautions. These deficiencies were similar in the two hospitals surveyed and may reflect a national trend. We conclude that every individual, department and trust needs to reflect on their practice and address these deficiencies.

Attitude of Health Personnel↗

Induction of interleukin-10 by HIV antigens in peripheral mononuclear cells of health care workers after occupational exposure to HIV-1-positive blood.

Evaluation of HIV-induced IL-2 production by peripheral blood mononuclear cells (PBMC) and HIV-specific T helper and cytotoxic T lymphocyte (CTL) responses in health care workers (HCW) occupationally exposed to HIV reveals a high rate of response to HIV among non-seroconverters. IL-10 is also known to interfere with HIV infection in vitro. To evaluate the induction of IL-10 by HIV antigens in HCW occupationally exposed to HIV, 18 HCW with percutaneous injury were enrolled in this study, 9 of them exposed to HIV-contaminated blood, and 9 exposed to HIV-negative blood. PBMC were incubated on plates coated with HIV-1 antigens, and IL-10 was measured in supernatants by ELISA. Five of nine HCW exposed to HIV-contaminated blood presented HIV-induced IL-10. Two of nine HCW exposed to HIV-negative source patients also had detectable levels of HIV-induced IL-10, one of them in the sample obtained on the day of accidental exposure. There was a relationship between the type of device involved in injury and IL-10 production. Individuals exposed to hollow needles or scalpels presented HIV-induced IL-10, whereas those exposed to solid needles and to digital puncture did not, suggesting a relationship between infectious load and IL-10. Although occupational exposure to HIV leads to a low rate of seroconversion, these individuals can develop an antigen-specific immune response characterized in our study by induction of IL-10 in PBMC in vitro.

Accidents, Occupational↗

Constant incidence rates of needle-stick injury paradoxically suggest modest preventive effect of sharps disposal system.

Does placement of impenetrable sharps disposal systems in hospitals reduce needle-stick injury? To study this question, annual health questionnaires were distributed on a quarterly basis to all 8000 employees in an academic medical center in a large eastern US metropolitan city asking each employee whether he or she had experienced a needle-stick injury since the last questionnaire. Questionnaires from active floor nurses were separated and hand tallied in 1987, 1989, and 1990, the latter 2 years being after impenetrable sharps disposal systems had been placed at nursing stations and in individual patients rooms. Total needle sticks in staff nurses reported during the 3 years (20.5%, 23.2%, 21.8%, not significant) did not decrease in the last 2 years. Simultaneously, hospital purchases of needle-containing devices increased 13.5%. Thus a constant reported needle-stick incidence rate may paradoxically represent a modest preventive effect of a hospital sharps-disposal system.

Equipment Safety↗

Hepatitis B immunization and exposure to blood among surgical staff.

A questionnaire was sent to all 158 staff of the operating department of a London teaching hospital to confirm their hepatitis B immunization status and establish the number of incidents involving exposure to blood during the preceding 4 weeks. Of these personnel, 104 (66 per cent) were known to be immune to hepatitis B either through immunization (97) or previous infection (seven). A further 23 (15 per cent) had completed a course of immunization but their seroconversion had not been checked. There were 26 sharps injuries sustained by 14 (12 per cent) of 119 staff and 240 other exposures to blood. Four of the sharps injuries had been reported. Staff known to be immune were more likely than those with unknown or negative immunity to report incidents (20 versus 0 per cent (95 per cent confidence interval of difference 2-38 per cent)). Doctors sustained more non-sharps exposures to blood than others (47 versus 23 per cent (95 per cent confidence interval of difference 7-40 per cent)). An important minority of operating department staff remains unimmunized against hepatitis B, although exposure to blood is common. Incidents are rarely reported and staff with unknown or negative immunity seem less likely to report than those known to be immune.

Blood↗

Awareness of post-exposure prophylaxis guidelines against occupational exposure to HIV in Hospital Sungai Petani.

Occupational risk of Human Immunodeficiency Virus (HIV) infection is a matter of concern for health care workers. We conducted a study to gauge the level of awareness amongst HCW (doctors and nurses) working in Hospital Sungai Petani regarding the post-exposure prophylaxis in case of needle stick injuries from confirmed or suspected cases of HIV. Nineteen Doctors (56%) and 13 nurses (25%) were aware of correct risk of transmission. None identified all the four risk fluids correctly. 94% of doctors and 98% of nurses correctly stated that washing the site with soap and water is the initial procedure, but only few (1/10 of doctors and 1/3 of nurses) knew whom to contact immediately after injury. Twenty three doctors (67%) and 41(78%) nurses were aware of the use of Zidovudine but only 10 participants were aware of the use of second drug. Only 6 doctors (17%) and 8 nurses (15%) knew the correct duration of post-exposure prophylaxis. Twenty-three doctors (67%) and 35 nurses (67%) knew that the drugs were available in Hospital Pharmacy and 11 doctors and 12 nurses knew the approximate cost of therapy. On the average about 50% of doctors and nurses have fair knowledge of post exposure prophylaxis against HIV. Ongoing awareness and training are necessary to improve the same.

Clinical Competence↗

Epidemiology of sharp object injuries in a children's hospital.

BACKGROUND: Limited data exist on the frequency, circumstances and management of sharp object injuries (SOIs) in pediatric facilities. METHOD: SOIs reported at a large children's hospital during a 2-year period were reviewed. RESULTS: One hundred thirteen SOIs were reported for an average of 6 injuries per 100 employees per year. The greatest number of injuries occurred among nurses (46%) and physicians (23%), but phlebotomists experienced the highest rate (25.5 injuries per 100 full time equivalent employees per year). Most common locations were the patient room (27%), operating room (25%) and intensive care units (17%). Needles accounted for 71% of injuries and procedural devices accounted for 22%. Forty-eight percent of injuries occurred during use of the item, 42% after use or during disposal and 7% after disposal. Twenty percent were associated with loose sharps and 15% with inadvertent patient movement. Only 2 injuries were associated with recapping. Eighty-eight percent of the objects were contaminated with blood or body fluid. Of 88 known source patients 1 tested positive for hepatitis B surface antigen, 2 for hepatitis C virus and none for HIV. One hundred four employees sought treatment: 36 received tetanus vaccine; 14 received hepatitis B vaccine; 9 received hepatitis B immunoglobulin; and 12 received zidovudine. No employee subsequently tested positive for HIV, hepatitis B virus, or hepatitis C virus. CONCLUSIONS: SOIs represent a frequent occurrence among pediatric health care workers. Minimizing the use of sharps, appropriately restraining patients during procedures and promptly disposing of sharp items after use might decrease the frequency of SOIs.

Health Personnel↗

Emergency prophylaxis following needle-stick injuries and sexual exposures: results from a survey comparing New York Emergency Department practitioners with their national colleagues.

BACKGROUND: Emergency prophylaxis following needle-stick and sexual exposures includes HIV post-exposure prophylaxis, hepatitis B prophylaxis and emergency contraception. The Centers for Disease Control and Prevention endorse HIV post-exposure and hepatitis B prophylaxis for health care workers, and hepatitis B prophylaxis and emergency contraception after sexual assault. The New York State Department of Health advocates HIV post-exposure prophylaxis after sexual assault. This study compares emergency department practitioners in New York State (NYS) with those from other states in their willingness to offer emergency prophylaxis after needle-stick and sexual exposures, and their self-reported history of prescribing and using HIV post-exposure prophylaxis. METHODS: The authors surveyed emergency department practitioners from across the US at the American College of Emergency Physicians 2000 Scientific Assembly. The questionnaire included clinical scenarios describing different patients who present to the emergency department within one hour of a needle-stick injury, sexual assault or consensual sexual encounter, and had questions on the practitioners self-reported prescribing and usage of HIV post-exposure prophylaxis. For each scenario the practitioners were asked to indicate if they would offer emergency prophylaxis to different patients at varied HIV risk levels. The data were processed through SPSS 10.0. RESULTS: Of the 600 respondents, 100 were from NYS. In the clinical scenarios, NYS practitioners were more likely than other US practitioners to offer HIV post-exposure prophylaxis for exposures to unknown and low HIV risk sources (p<0.05) and to offer hepatitis B prophylaxis in most of the sexual exposure scenarios (p<0.01). All practitioners offered HIV post-exposure and hepatitis B prophylaxis less often after consensual sexual encounters than after sexual assault and needle-stick injuries. In most cases, NYS practitioners were more willing to offer emergency contraception after sexual assault and consensual sexual encounters than were other practitioners (p<0.05). In terms of self-reported prescribing of HIV post-exposure prophylaxis, NYS practitioners had prescribed HIV post-exposure prophylaxis after sexual assault (p<0.001) and non-health-care-worker needle-stick injuries (p<0.05) much more often than did other practitioners. CONCLUSIONS: Compared to their national colleagues, NYS emergency department practitioners were generally more willing to offer all forms of emergency prophylaxis after sexual assault. They also reported having had more experience than other practitioners in prescribing HIV post-exposure prophylaxis. Although most practitioners were clearly willing to offer HIV post-exposure prophylaxis for nonoccupational exposures, NYS practitioners were less willing to offer emergency prophylaxis following consensual sex than after sexual assault. These findings suggest that the NYS guidelines for HIV post-exposure prophylaxis after sexual assault may have influenced emergency practitioners willingness to offer and prescribe prophylaxis.

Emergency Service, Hospital↗

The nature and frequency of blood contacts among home healthcare workers.

OBJECTIVE: To estimate the frequency of, and assess risk factors for, percutaneous, mucous membrane, and cutaneous blood contacts sustained by healthcare workers (HCWs) during the delivery of infusion therapy and the performance of procedures involving sharp instruments in the home setting. DESIGN: Prospective surveillance of percutaneous, mucous membrane, and cutaneous blood contacts. SETTING: Eleven home healthcare agencies in the United States and Canada from August 1996 through June 1997. PARTICIPANTS: HCWs who provided home infusion therapy or performed procedures using hollow-bore needles and other sharp instruments in the home setting. METHODS: Each participating worker recorded information about the procedures performed and blood contacts experienced during each of his or her home visits for a 2- to 4-week period using standard questionnaires. HCWs also completed questionnaires regarding job duties, reporting of previous occupational blood contacts, and their use of protective barriers in the home setting. RESULTS: Participating HCWs provided information about 33,606 home visits. A total of 19,164 procedures were performed during 14,744 procedure visits. Fifty-three blood contacts occurred during these visits, for a blood-contact rate of 2.8 blood contacts per 1,000 procedures and 0.6 percutaneous injuries per 1,000 procedures with needles or lancets. Gloves were worn for 52%, masks for 5%, gowns for 3%, and protective glasses or goggles for 2% of all procedure visits. HCWs used barriers for 53% of visits during which at least 1 procedure was performed and for 27% of other visits. CONCLUSIONS: HCWs involved in home health care are at risk for blood contact. Infection control barrier use was low in our study. The majority of skin contacts could have been prevented by glove use.

Blood-Borne Pathogens↗

Reducing percutaneous injuries at an academic health center: a 5-year review.

BACKGROUND: The University of Connecticut Health Center Employee Health Service collected and used National Surveillance System for Hospital Health Care Workers (NaSH) data to (1) improve surveillance of health care worker blood and body fluid exposures (BBFEs) and (2) target specific interventions for higher-risk groups (nursing staff, medical and dental students, and residents). METHODS: All 870 BBFE incidents were abstracted from the NaSH database from the 1997 through 2002 academic years. Incidence rates per 100 full-time-equivalent workers were determined for each targeted occupation group with 95% confidence intervals. RESULTS: The number of percutaneous injuries declined among medical/dental students and nursing staff, and to a lesser degree for residents. The incidence rates decreased from 7.9% in 2000 to 2001 to 2.6% in 2001 to 2002 for students and from 9.2% in 1997 to 1998 to 2.7% in 2001 to 2002 for nursing staff. CONCLUSIONS: Data from a surveillance database provided guidance for administrative, educational, and engineering control interventions. Active surveillance and periodic review of interventions are important aspects to reduce BBFEs in targeted high-risk occupational groups, especially when the workforce has a high turnover, as is typical in academic health centers.

Academic Medical Centers↗

Occupational risk of infection by human immunodeficiency and hepatitis B viruses among health workers in south-eastern Nigeria.

OBJECTIVE: To assess the occupational risk of infection by human immunodeficiency virus (HIV) as well as hepatitis B virus (HBV) among healthcare workers in south-eastern Nigeria. DESIGN: Cross-sectional study. SETTING: Three tertiary health institutions in south-eastern Nigeria. SUBJECTS: Doctors, nurses, laboratory staff and cleaners. MAIN OUTCOME MEASURES: Observation of the availability and use of protective equipment and materials in the various departments of the hospitals. RESULTS: Materials and equipments needed for protective and hygienic practices (adequate water supply, protective clothing and availability of disinfectants) were inadequate in all hospitals. Where available, they were found to be inconsistently used. Health workers in the three institutions were thus constantly exposed unnecessarily to blood and other body fluids which might be potentially infectious as well as injury from used sharps. CONCLUSION: The risk of acquiring HIV and HBV infections by health workers in this region of Nigeria in the course of performing their duties is therefore still apparently high. Though distinct viruses, they share similar mode of transmission and risk factors. Use of personal protective equipment and adoption of standard hygienic practices among health workers must be encouraged. Supply of protective materials and equipment should be greatly improved. It is recommended that reduction of occupational risks among health workers using this approach should form part of control strategies for both infections in the country.

Attitude of Health Personnel↗

Occupational exposure to blood: search for a relation between personality and behavior.

OBJECTIVE: To describe the behavior of French nurses after occupational exposure to blood (OEB); to study the reasons for not reporting an OEB to the occupational medicine service or the hospital authorities, and to explore the links between personality traits and both the risk of having an OEB and the likelihood of reporting it. DESIGN: A descriptive and correlational study using a cross-sectional survey for data collection. SETTING: Six nursing schools (four initial training institutes and two specialty training schools, one for surgical nurses and one for nurse anesthetists) and six hospitals in Lorraine. PARTICIPANTS: 942 nurses and 459 nursing students were approached, and 964 (69%) replied to the questionnaire. METHODS: The participants received an anonymous two-part questionnaire. The first part explored the knowledge of the risk and Standard Precautions and collected details of the history of OEB. Reporting of OEB to the occupational medicine service or the hospital authorities and the nature of serological monitoring after OEB also were explored. The second part was composed of the Zuckerman sensation-seeking scale, exploring four areas: disinhibition, danger- and adventure-seeking, seeking new experiences, and susceptibility to boredom. RESULTS: 947 nurses were vaccinated against hepatitis B, but only 528 (56%) had checked that they were effectively immunized. Only 166 respondents (17%) stated they routinely used gloves during all procedures in which they were exposed to blood. There were 505 recorded OEB during the study period (0.24 per person per year). The most frequently reported OEB were those involving hollow needles (57%). Approximately one half (48.5%) of all OEB were reported. "Good local antisepsis immediately after the accident" was the reason most often given to justify nonreporting. Only 57% of OEB victims sought to determine the serological status of the source patient for human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus immediately after accident. Only 40% and 31% of OEB victims checked their own HIV and HCV serostatus 3 and 6 months after OEB, respectively. Few staff adopted safer-sex measures after OEB, and some continued to donate blood in subsequent months. Logistic regression identified two variables significantly and independently linked to the risk of having at least one OEB in the 27 months preceding the date on which the questionnaire was completed: having a permanent position and having a higher degree of disinhibition. Taking into account the number of OEB during this period (Poisson regression), four variables were significantly and independently linked to the risk of having a larger number of OEB: having a permanent position; having a higher degree of disinhibition; being more susceptible to boredom; and having less nursing experience. In logistic regression, three variables emerged as being significantly and independently linked to reporting all OEB: younger age; having had at least one percutaneous injury (excluding splashes); and having lower susceptibility to boredom. CONCLUSION: Nursing personnel continue to ignore or be unaware of many factors surrounding OEB, meaning that information and counseling must continue unabated. Knowledge of the risk, of the benefit of respecting Standard Precautions, and of the importance of notification and serological follow-up is still inadequate. Finally, certain personality traits, such as a high level of disinhibition and susceptibility to boredom, appear to be linked to the risk of OEB. Subjects strongly susceptible to boredom are less likely to report such accidents.

Acquired Immunodeficiency Syndrome↗

Risk of HIV transmission from patients to surgeons in the era of post-exposure prophylaxis.

The HIV prevalence, among patients either undergoing, or with the potential to undergo, surgery were estimated using data from unlinked anonymous HIV surveys of patients in Glasgow hospitals during 1992-1997 in order to quantify the risk of surgeons acquiring HIV occupationally in the era of post-exposure prophylaxis (PEP) availability. A range of prevalence rates was applied to data on other factors influencing risk; these comprised, i) the probability of a percutaneous injury from a sharp instrument used on an HIV infected patient resulting in HIV transmission, ii) the number of injuries sustained and iii) whether or not PEP was administered. On the basis of, for example, a surgeon sustaining three percutaneous injuries over 12 months and not taking PEP after each, the annual risks ranged from 1 in 2,000,000 for urological/renal surgeons to 1 in 200,000 for those performing general surgery/ENT/gynaecological procedures. The administration of PEP after each injury would reduce these rates to 1 in 10,000,000 and 1 in 1,000,000 respectively. The risk of surgeons acquiring HIV occupationally in a city which has an HIV prevalence typical of most urban areas in the UK, is 'minimal' or 'negligible'. In the context of such low risk and our limited knowledge of the adverse effects of PEP, the risk assessment to decide whether or not to give PEP should be well informed and consistent. Current guidelines to help physicians and affected healthcare workers in their decision making need to be improved.

Adolescent↗

Practical initiatives in the prevention of cross infection.

In Belgium Infection Control Nurses must register postoperative wound infections, sepsis and ventilation associated pneumonia. At the author's hospital, the incidence of pressure sores is scored four times a year and there is a register of new patients with M.R.S.A. (methicillin resistant staphylococcus aureus) and tuberculosis. Procedures for hospital hygiene can be consulted in order to see which patients must be isolated and what kind of precautions must be taken. The microorganisms and diseases are sorted alphabetically and the cause of cross-infection, isolation procedure and duration of isolation are noted. These procedures must be translated to the different departments and individual patients. For instance a patient with M.R.S.A. is strictly isolated in the general hospital, but not in the psychiatric department. As far as the haemodialysis unit is concerned, patients with chronic renal disease are more sensitive to infections. For this reason correct hand hygiene is very important. Hand washing, hand disinfection techniques and the use of gloves must be promoted. A microbiological control of the hands of staff once a year, combined with an educational programme, can motivate staff in a positive way Needle-stick injuries present a serious occupational hazard for health care workers, especially those working in a haemodialysis unit. Information and needleless haemodialysis may reduce the risk of needle-stick injuries and the risk of viral transmission. Can a nurse, at risk of viral contamination and transmission, refuse to treat a patient? Is the use of hats, overshoes, glasses necessary? How many times are these materials changed, etc.? This paper presents the data of 1. years of M.R.S.A. registration at the author's hospital. M.R.S.A. has become a serious problem in many hospitals since the mid 1970s. Strenuous efforts need to be taken to control its spread. Screening of the nose of patients and of staff can be helpful. The carriers can be treated with mupirocin ointment. Body washing with chlorhexidine is preferred. The use of vancomycin and teicoplanin is a decision for the physician.

Belgium↗

Evaluation of safety devices for preventing percutaneous injuries among health-care workers during phlebotomy procedures--Minneapolis-St. Paul, New York City, and San Francisco, 1993-1995.

Health-care workers (HCWs) are at risk for infections with bloodborne pathogens resulting from occupational exposures to blood through percutaneous injuries (PIs). Phlebotomy, one of the most commonly performed medical procedures, has been associated with 13% - 62% of injuries reported to hospital occupational health services and 20 (39%) of the 51 documented episodes of occupationally acquired human immunodeficiency virus (HIV) infection reported in the United States (CDC, unpublished data, 1996). Although safety devices designed to prevent PIs associated with phlebotomy have been available for use in the United States, clinical evaluation of these devices has been difficult because 1) ascertainment of PIs is difficult (many injuries are unreported, and observation of all procedures is impractical because phlebotomy is performed throughout the hospital by different groups of HCWs at all hours), 2) data to calculate PI rates (i.e., the number of phlebotomies performed and devices used) are not routinely available, 3) a large number of phlebotomies must be evaluated because of the low rates of phlebotomy-related PI and 4) rates of safety-feature activation are difficult to assess. This report summarizes a collaborative study by CDC and six hospitals to evaluate safety devices for phlebotomy. The findings indicate that use of safety devices significantly reduced phlebotomy-related PI rates while having minimal clinically apparent adverse effects on patient care.

Accidents, Occupational↗

An overview of occupational hazards among veterinarians, with particular reference to pregnant women.

Veterinarians are challenged by an imposing group of occupational hazards, including exposure to ionizing radiation, injury, infectious agents, and chemicals. In this paper, the health hazards in the typical veterinary practice are inventoried, and the risks of each are assessed. During the past few decades, there has been a significant increase in women entering the veterinary profession. Information is presented concerning the impact of various occupational hazards on the health of female practitioners and paraprofessionals, particularly in regard to the reproductive system. Many of the occupational hazards are exclusively, or more significantly, detrimental to females (particularly when pregnant) and to their unborn. Women must be aware of and avoid these hazards in their clinical environment. The purpose of this review is to assist practitioners in identifying and assessing the hazards in their practice and determining what steps must be taken to eliminate or reduce them.

Animals↗

[Future prospects of emergency laboratory tests--problems of immunoserologic tests].

Regarding problems in emergency and urgent immunoserologic tests, I mainly focused on infectious diseases and CPR and discussed the correspondence of dangerous needle stick injuries, and the significance of emergency CRP measurement in various body fluids using highly sensitive determination methods. The actual conditions and correspondence of infections due to dangerous needle stick injuries (accidental pricking with used needles) such as hepatitis, syphilis, acquired immunodeficiency syndrome (AIDS), adult T-cell leukemia (ATL), herpes simplex, falciparum malaria, tuberculosis, Rocky mountain spotted fever, and human colonic adenocarcinoma are discussed. With regard to emergency CRP measurement, application of highly sensitive determination methods and the significance of CRP measurement of various body fluids (healthy adult blood, cord blood, cerebrospinal fluid, urine and puncture fluid) are described. The reference values for CRP concentrations in various body fluids were established at 15 to 3,063 ng/ml for serum (male; 26 to 3.992 ng/ml, female; 11 to 1,672 ng/ml), 9 to 73 ng/ml for cord blood, 2 to 10 ng/ml for cerebrospinal fluid and less than 2 ng/ml for urine.

Accidents, Occupational↗

The risk of optic nerve injury in retrobulbar anesthesia: a comparative study of 35 and 40 mm retrobulbar needles in 12 cadavers.

PURPOSE: This study was designed to demonstrate the increased risk of optic nerve injury by the 40 mm needle when fully inserted into the orbit. METHODS: Retrobulbar anesthesia needles 35 and 40 mm long were inserted into the orbits of 12 well-embalmed cadavers, as for typical retrobulbar anesthesia. The needle was seen directly through a fenestration of the orbital roof and by dissection of the orbital structures overlying the optic nerve. RESULTS: In all orbits the 40 mm needle reached and in seven cases significantly pushed against the optic nerve and could obviously penetrate its sheaths. The 35 mm needle could just slightly touch the outer optic nerve sheath only in two cases. CONCLUSIONS: We conclude that the 40 mm retrobulbar needle should not be fully inserted into the orbit and the 35 mm retrobulbar needle must be used with caution.

Anesthesia, Local↗

Seroepidemiology of hepatitis B virus markers among hospital health care workers. Analysis of certain potential risk factors.

OBJECTIVES: To determine, the prevalence of hepatitis B virus markers among hospital health care workers, to determine the influence of some risk factors on such prevalence and to outline the specific policies to tackle such problems among hospital health care workers. METHODS: Hepatitis B virus markers including hepatitis B surface antigen, anti-hepatitis B surface antigen and anti-hepatitis B core antigen were determined from sera samples collected from 459 hospital health care workers at different hospital departments. The prevalence of hepatitis B virus among these employees was correlated by a variety of risk factors such as gender, age, blood transfusion, and needle-stick and sharps injuries, and previous history of jaundice using logistic regression analyses. RESULTS: Of the hospital health care workers studied 143 (31%) of employees showed evidence of previous hepatitis B virus infection, including 17 (4%) carriers. The highest incidence was among those who were working at infectious diseases departments where 22 (43%) employees were found to be seropositive, followed by 26 (41%) employees from surgical departments. The risk factors, which were found to influence seropositivity, include age over 40 years old, needle-stick and sharps injuries and previous blood transfusion. Other factors such as gender, and previous history of jaundice were statistically insignificant. CONCLUSION: The hepatitis B virus infection was high among the hospital health care workers studied. This was influenced by certain potential occupational risk factors. As there is emerging evidence that vaccination among health care workers was infective. Specific measures should be implemented to reduce such risk. These may include strict policies on sharps and considering any blood or other body fluids being a potential risk. Education, clinical advice and health insurance should be available for health care workers who are at a higher risk of contracting hepatitis B virus infection.

Adolescent↗