Major Article
Occupational exposure to blood and body fluids among health care workers in Ankara, Turkey

https://doi.org/10.1016/j.ajic.2004.08.004Get rights and content

Background

The risk of occupational acquisition of bloodborne pathogens via exposure to blood and body fluids is a serious problem for health care workers in Turkey. Because there are no systematic recording programs in Turkey, national data concerning frequency of exposures are not readily available.

Objective

To determine the risk factors of exposure to blood and body fluids among health care workers (HCWs).

Methods

This study was conducted in the hospitals of Ankara University School of Medicine. A structured survey form was administered by person-to-person interview.

Results

The study included 988 HCWs: 500 nurses (51%), 212 residents (21%), 152 nurse assistants (15%), and others (13%). Six hundred thirty-four (64%) of the HCWs had been exposed to blood and body fluids at least once in their professional life (0.85 exposure per person-year). The most frequent cause of the sharps injuries was recapping the needle (45%). Of the injured HCWs, 60 (28%) were not using any personal protective equipment, and 144 (67%) did not seek any medical advice for injury.

Conclusions

Systematic control measures, including an effective and goal-oriented education program targeting HCWs, prospective record keeping, and instillation of a special unit for the health of HCWs should be implemented in the hospital setting.

Section snippets

Subjects

The study was conducted in 2 tertiary hospitals of the Ankara University School of Medicine. These 2 hospitals have a total of 2100 beds: 1100 in one and 1000 in the other. The study was approved by the research board of the hospital. We intended to reach the maximum number of HCWs. Therefore, HCWs active in patient care (physicians, nurses, nurse assistants, laboratory technicians, dentists, and anesthesiology technicians) were asked to participate to the study. The housekeeping personnel were

Results

Of the 1680 HCWs, 988 (59%) were interviewed. The mean age was 31 years, and 70% were female (Table 1). Six hundred thirty-four (64%) of the HCWs had been exposed to BBFs at least once in their professional life (0.85 exposure per person-year). In the last 6 months, 343 HCWs (35%) had the history of BBF exposure, and 214 (62%) of them claimed SIs, with an average number of injuries per HCWs as 2 (minimum, 1; maximum, 20) (Table 2). Although none was proven, 10 subjects in our study

Discussion

Exposure to blood and other potentially infectious materials has long been recognized as a potential threat to the health of HCWs. NSIs and cuts are the most commonly reported (77% to 83.5%, respectively) routes of BBF exposure in the studies based on voluntary notification to occupational health departments.6, 7, 8 In our study, 62% of the BBF exposures occurring in the last 6 months were related to SIs. It was striking that 150 (15%) HCWs were not protected against HBV infection, and of the

Conclusion

Sharps injuries among HCWs are a widespread occupational problem in our institution. Systematic control measures including an effective and goal-oriented education program targeting HCWs, prospective record keeping, installation of a special unit providing for the health of HCWs, introduction of safety-enhanced devices in clinical practice, and good organization of the work and the work place should be implemented in the hospital settings.

References (14)

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    In our study, we found that 50 (9.3%) of the sharp instruments that caused NSIs were contaminated with HBV, 30 (5.6%) with HCV, 3 with CCHF virus, 1 with HIV, and 2 with concomitant HBV and HCV. In a study by Azap et al11 conducted in Turkey, 17% of the source patients were HBsAg positive, 7% were anti-HCV antibody positive, and 3% were both HBV and HCV positive. In a study by Kuruuzum et al,12 again from Turkey, seropositivity of the source patients for HCV, HBV, and HIV was reported as 7%, 4.7%, and 0.8%, respectively.

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