Frequency of nonparenteral occupational exposures to blood and body fluids before and after Universal Precautions training
Article Abstract:
The Universal Precautions, developed by the United States Public Health Service, recommend that all patients should be considered by health care workers as potential carriers of the AIDS virus or other communicable microorganisms. These recommendations were established due to concern of health care workers over risks of acquiring the human immunodeficiency virus 1 (HIV-1) and hepatitis B virus (HBV) in the workplace. A recent study showed that the risk of HIV infection due to exposure in the health care setting ranged from 0.0 to 0.04 percent. Most cases of HIV infection acquired in the health care setting result from parenteral (nonoral) exposure to contaminated blood and body fluids, such as through accidental injection with contaminated needles or cuts with contaminated sharp instruments. HIV infection is rarely transmitted by nonparenteral exposure to contaminated body substances. One method of reducing the risk of HIV transmission in the health care setting may be to provide medical personnel with education about the Universal Precautions. Hence the frequency of cutaneous, or skin, exposure of health care workers to HIV-infected blood and body substances was assessed 12 months before and after the implementation of a Universal Precautions training program. The study consisted of a first survey of 559 health care workers and a second survey of 269 workers, in which the workers were asked to report their cutaneous exposure to blood, sputum, urine, feces, and other body substances of HIV-infected patients. The average yearly number of blood exposures decreased from 35.8 to 18.1, whereas yearly exposures to other body substances decreased from 77.8 to 40.0. There were no cases of HIV infection in workers who reported cutaneous exposure to contaminated blood or body fluids. The risk of HIV infection due to cutaneous exposure was estimated at 0.04 percent for contaminated blood and 0.02 percent for other infected body substances. These findings suggest that training in Universal Precautions decreased the cutaneous exposure to contaminated blood and body substances. The risk of HIV infection due to cutaneous exposure is lower than that resulting from parenteral exposure. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Universal precautions for preventing occupational exposures to human immunodeficiency virus type 1
Article Abstract:
Of the 150,000 cases of AIDS reported in the US, at least 37 cases of infection with human immunodeficiency virus (HIV) were acquired during occupational exposure in the health care setting. A health care worker may contract the AIDS virus via parenteral (nonoral) exposure to infected blood or body fluids. Most cases result from infection of the blood after accidental injection with contaminated needles or cuts with contaminated sharp instruments. Few cases result from exposure of open skin wounds or mucous membranes to HIV-infected body fluids. A recent study showed that the risk of occupational acquisition of HIV infection ranged from 0.0 to 0.04 percent. The risk of HIV infection after skin exposure to HIV-infected body fluids was estimated to range from 0.0 to 0.02 percent. The factors that determine whether health care work-related exposure to a patient will lead to HIV infection include: the possibility that the patient is infected with HIV; the amount of virus contained in the body fluids; the nature of the body fluid to which the health care worker is exposed; the amount of infected substance to which the health care worker is exposed; and the type of exposure. A policy referred to as the Universal Precautions recommends that all patients should be considered by health care workers as potential carriers of the AIDS virus. Blood and semen contain the highest levels of virus. Generally, health care workers are exposed to much smaller amounts of infected body substances than recipients transfused with infected blood. More extensive injury and exposure results in a greater risk of acquiring HIV infection. The risk of occupationally acquired HIV infection can be reduced by following the Universal Precautions, developing methods to improve safety in health care, and educating health care personnel about the Universal Precautions. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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The occupational history in the primary care setting
Article Abstract:
Occupational, or work-related, exposure to toxic agents can cause acute and chronic illness. In 1984, occupational exposures caused 125,000 illnesses, 5.3 million injuries, and between 4,000 and 12,000 deaths. However, these statistics may be underestimated because of: the delay between exposure to the toxic agent and development of disease; the possibility of several factors causing the disease; the inability of clinicians to recognize the occupational disease; and underreporting of occupational disease. However, the expansion of occupational medicine services has been recommended. There is limited information about the need for, extent of, and type of occupational medicine services. A questionnaire regarding occupational exposures was given to 534 patients who were seen in a primary care clinic. The validity of the questionnaire was tested by comparing chest X-rays of persons exposed to asbestos, coal dust, or silica with those of people who were not previously exposed to these agents. Seventy-five percent of subjects had been exposed to at least one toxic agent, and more than 30 percent were exposed to at least four toxic agents. Exposures reported in the survey were significantly associated with changes in the X-rays, confirming the validity of the questionnaire for agents that are toxic to the lungs. These findings show that persons seen in the primary care setting often have been exposed to toxic agents at work that may be responsible for the development of illness. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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