Occupational Exposure to Blood and Body Fluids among Healthcare Workers in a Teaching Hospital: an Experience from Northern Thailand

Abstract

This retrospective study was conducted among healthcare workers (HCWs) in a tertiary care hospital to (i) determine the incidence of exposure to blood and/or body fluids, (ii) describe the characteristics of such exposures, and (iii) describe management after exposure. There were 1,611 episodes of occupational exposure between January 1, 2005 and December 31, 2010. Of those affected, 1,086 (67.4%) were women. The mean age was 27.6 ± 7.2 years. Nurses (483, 29.9%) were the HCWs most frequently exposed to blood and/or body fluids. The incidence was highest among physicians (11%/year). Percutaneous injury by hollow needles was the most common type of injury (576, 35.8%). Of the 1,611 episodes, 142 (8.8%) comprised HCWs being exposed to human immunodeficiency virus-positive sources. One hundred fifty-one HCWs (9.4%) were exposed to hepatitis B surface (HBs) antigen-positive sources. Sixty-one HCWs had indications for both hepatitis B virus (HBV) vaccine and hepatitis B immunoglobulin; 43 (70.5%) received both. Among the 266 HCWs who had no protective antibody against HBV and were exposed to HBs antigen-negative sources, only 1 (0.4%) received HBV vaccine. These findings suggest that guidelines for post-exposure management among HCWs exposed to HBs antigen-positive sources are not regularly followed. HBV immunization is necessary for all HCWs.