Surveillance of occupational exposure to bloodborne viruses in healthcare workers

Key Points

• Trend data collected through the Health Protection Agency Centre for Infections surveillance between 2002 and 2005, indicate:
• The number of occupational exposure incidents reported to the surveillance scheme increased by 49%.
• Percutaneous injuries involving hollowbore needles, the most commonly reported occupational exposures in the healthcare setting, increased by 46% (159 to 232).
• Hepatitis C exposures to infected source patients, accounted for the greatest proportion of percutaneous exposures reported (49%; 369/755) and these increased by 37% (81 to 111).
• Numerically, most occupational exposures involved nursing professionals, (47%; 478/1007), and increased by 47% (102 to 150). However by profession, medical professionals (doctors and dentists) carry a disproportionate burden of significant occupational exposures to bloodborne viruses (41%; 409/1007), and exposures in this group increased by 78% (73 to 130).
• Between 1997 and 2005, almost a half (45%; 425/954) of incidents occurring in the ward, 38% (86/229) in Accident and Emergency, 20% (33/165) in intensive care and 19% (63/324) in operating theatres were preventable with proper adherence to universal precautions and safe disposal of clinical waste.
• In Scotland 58% (551/952) of the injuries reported occurred after a procedure had been completed. Compliance with needlestick injury guidelines and the use of safety devices would have prevented the majority of reported injuries in this Health Protection Scotland study. The single intervention which would probably result in the greatest benefit is the introduction of syringes with retractable or shielded needles for the purposes of taking blood and for administering injections.
• Healthcare workers exposed to hepatitis C positive source patients are still not receiving follow-up testing in line with national guidance, with only 20% (49/242) in 2005 having the correct type of tests at the correct time points.
• In 2005, there were two patient to healthcare worker hepatitis C transmissions following percutaneous exposure, bringing the total number of hepatitis C seroconversions in healthcare workers reported between 1997 and 2005 to 11 cases.
• Seventy-seven per cent (233/303) of healthcare workers exposed to an HIV positive source patient began HIV post-exposure prophylaxis, 34% within an hour of the exposure, and 89% within 24 hours.
• There were no new HIV seroconversions in 2005 following percutaneous exposures of healthcare workers to HIV positive source patients, bringing the total number of UK HIV documented seroconversions reported by 2005 remaining at five cases.
• Eye of the Needle - United Kingdom Surveillance of Significant Occupational Exposures to Bloodborne Viruses in Healthcare Workers. November 2006

Last reviewed: 17 April 2008