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Hepatitis C Virus Infection in Healthcare Workers: Risk of Exposure and Infection

Published online by Cambridge University Press:  02 January 2015

Bruce P. Lanphear*
Affiliation:
Departments of Pediatrics, Community Medicine, and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
Calvin C. Linnemann Jr
Affiliation:
Departments of Internal Medicine, Pathology and Laboratory Medicine, and Environmental Health, University of Cincinnati
Constance G. Cannon
Affiliation:
Departments of Infection Control, University of Cincinnati Hospital, Cincinnati, Ohio
Martha M. DeRonde
Affiliation:
Medical Center Health Services, University of Cincinnati Hospital, Cincinnati, Ohio
Luann Pendy
Affiliation:
Abbott Laboratories, Abbott Park, Illinois
Lisa M. Kerley
Affiliation:
Abbott Laboratories, Abbott Park, Illinois
*
1425 Portland Ave., Department of Pediatrics, Rochester General Hospital, Rochester, NY 14621

Abstract

Objectives:

To determine the incidence of hepatitis C virus (HCV) infection among healthcare workers (HCWs) at a university hospital, the proportion of HCWs having non-A, non-B hepatitis (NANBH) who were anti-HCV positive, and the rate of HCV transmission following a HCV-positive needlestick injury.

Design:

Longitudinal analysis of a dynamic (cohort) population.

Measurements:

From 1980 through 1989, HCWs who had clinical NANBH were identified, and from 1987 through 1989, HCWs who reported a blood or body fluid exposure and the patients who were the source of the exposure were screened for antibodies to HCV.

Setting:

A 732-bed, university hospital and outpatient clinics.

Results:

Over the 10-year period, six cases of occupationally acquired NANBH were observed, for an incidence of 21 cases per 100,000 HCWs per year (standardized incidence ratio, 2.96; 95% confidence interval [CI95], 1.83 to 4.36). Four of the six cases were confirmed to be HCV infection. From 1987 through 1989, 176 (12.7%) of 1,387 patients who were the source of an exposure were anti-HCV positive. Exposures that occurred in the emergency department were more likely to be anti-HCV positive than were exposures from all other locations (relative risk [RR] = 1.7; P= 0.009). Of HCWs who had an HCV-positive needlestick injury and whose serum had been tested for anti-HCV at least 5 months after the exposure, 3 (6.0%) of 50 seroconverted. From 1987 through 1989, the incidence of HCV infection among HCWs was 54 cases per 100,000 HCWs per year.

Conclusion:

The incidence of clinical NANBH among HCWs in this study is approximately three times higher than that of non-HCWs. HCWs are at significant risk for exposure to and acquisition of HCV.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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