Healthcare personnel (HCP) are at risk of occupational exposure to bloodborne pathogens such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) from needlesticks and injuries from sharp objects. Risk factors for transmission of bloodborne pathogens as a result of occupational exposure are related to the source patient (e.g., titer and infectivity of the virus in his/her blood or body fluid), the injury (e.g., quantity of blood or body fluid transferred during the exposure), and the recipient individual (e.g., immunologic status).
Percutaneous exposures are the most common mechanism for transmission of bloodborne pathogens in healthcare settings. Hospital-based HCP in the United States are estimated to sustain an average of 384 325 (range: 311 091 to 463 922) percutaneous injuries annually. Data from several surveillance systems have demonstrated that the majority of reported injuries occur in the acute care setting, particularly medical floors, operating rooms, and intensive care units.
Prevention of bloodborne pathogen transmission through exposure prevention requires a diversified approach, including the development of improved engineering controls (e.g., safer medical devices), work practices (e.g., technique changes to reduce handling of sharp objects), and infection control measures, including use of personal protective equipment. Another important pre-exposure strategy to prevent infection includes HBV immunization.
Although preventing exposures is the primary means of preventing bloodborne pathogen infection, appropriate postexposure management is an important element of workplace safety. Healthcare organizations should have a system that includes written protocols for prompt confidential reporting, evaluation, counseling, treatment, and follow-up of any occupational exposures that may place HCP at risk for acquiring bloodborne infection. Each incident of occupational exposure to blood or body fluid that may contain HBV, HCV, or HIV should be evaluated as rapidly as possible and should include testing of the source patient for the appropriate bloodborne pathogens, testing of the exposed person for prior infection, and prompt administration of prophylactic agents when indicated.