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Occupational

Taking blood samples

Healthcare workers are at increased risk of acquiring bloodborne viruses through exposures to blood and other body fluids in the occupational setting. The Health Protection Agency collects data on occupational exposures to HIV, hepatitis B surface antigen (HBsAg) and hepatitis C (HCV) positive patients, and all reports where healthcare workers have initiated HIV post-exposure prophylaxis (PEP).
The use of universal precautions can reduce the risk of exposure to bloodborne viruses, with hepatitis B immunisation and post-exposure prophylaxis and HIV PEP used to reduce the risk of transmission following exposure. National policies relating to these prevention and prophylactic strategies are informed and monitored by the data collected through the scheme.

Key findings

Data collected through the Health Protection Agency (HPA) Centre for Infections surveillance scheme indicate that:

  • Since our previous report, a further 914 incidents were reported to the scheme between 2006-2007.
  • Percutaneous injuries involving hollowbore needles remain the most commonly reported occupational exposures in the healthcare setting (between 2000-2007, 68% of all percutaneous exposures).
  • HCV exposures to infected source patients remain the greatest proportion of percutaneous exposures reported (48%, 1113/2296 between 2000-2007).
  • Numerically, between 2000-2007 most occupational exposures involved nursing professionals. However by profession, medical professionals (doctors and dentists) reported a higher number of occupational exposures than nursing professionals in 2007 (200 compared to 191).  About a third of the incidents involving doctors were reported to be in Senior House Officers.
  • Of concern is that over a third of incidents occurring between 2000-2007 in the ward or in Accident & Emergency (A&E) (43% and 37% respectively), and around 20% in intensive care and in operating theatres (22% and 20% respectively) were preventable with proper adherence to universal precautions and safe disposal of clinical waste.
  • HCWs exposed to HCV positive source patients are still not routinely receiving follow-up testing in line with national guidance; only 22% (40/184) in 2007 had the correct type of tests at the correct time points.
  • In 2006-2007, there were a further three patient to HCW HCV transmissions following percutaneous exposure, bringing the total number of HCV seroconversions in HCWs reported between 1997 and 2007 to 14 cases in England. In addition, we have been notified of one case in Scotland. To date, no cases have been reported from Wales or Northern Ireland.
  • Most (78%) HCWs exposed to an HIV positive source patient began HIV PEP after sustaining a significant exposure in 2007. Of these, a third (37%) commenced treatment within an hour of the exposure, and 89% within 24 hours.
  • Since 1999, there have been no new reported cases of HIV seroconversions following percutaneous exposures of HCWs to HIV positive source patients. This brings the total number of UK HIV documented seroconversions reported by 2007 to five.
  • Although it was highlighted that there were difficulties surrounding the reporting of exposures, such as lack of knowledge and logistic aspects, initial analyses of the community OH audit indicate that (where information was given) the majority of reporting centres do provide services to community staff.

Eye of the Needle - United Kingdom Surveillance of Significant Occupational Exposures to Bloodborne Viruses in Healthcare Workers, November 2008 Report

HIV and STIs 2005 - 2010 Reports


Last reviewed: 25 November 2010