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Surveillance of Occupational Blood and Body Fluid Exposures Among French Healthcare Workers in 2004

Published online by Cambridge University Press:  02 January 2015

A. G. Venier ,
A. Vincent ,
F. L'Hériteau ,
N. Floret ,
H. Sénéchal ,
D. Abiteboul ,
E. Reyreaud ,
B. Coignard  and
P. Parneix
A. G. Venier
Affiliation:
Southwestern France Infection Control Coordinating Center, Bordeaux, Paris, France
A. Vincent
Affiliation:
Southeastern France Infection Control Coordinating Center, Lyon, Paris, France
F. L'Hériteau
Affiliation:
Paris—Northern France Infection Control Coordinating Center, Paris, France
N. Floret
Affiliation:
Reseau Franc-Comtois de Lutte contre les Infections Nosocomiales, Besancon, France
H. Sénéchal
Affiliation:
Western France Infection Control Coordinating Center, Rennes, France
D. Abiteboul
Affiliation:
Groupe d'Etude des Risques d'Exposition des Soignants aux Agents Infectieux, Paris, France
E. Reyreaud
Affiliation:
Southwestern France Infection Control Coordinating Center, Bordeaux, Paris, France
B. Coignard
Affiliation:
Institut de Veille Sanitaire, Saint-Maurice, Paris, France
P. Parneix*
Affiliation:
Southwestern France Infection Control Coordinating Center, Bordeaux, Paris, France
*
Southwestern France Infection Control Coordinating Center (CCLIN Sud-Ouest), CHU Pellegrin, 33076 Bordeaux Cedex, France (pierre.parneix@chu-bordeaux.fr)
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Abstract

Objective.

To estimate the incidence rate of reported occupational blood and body fluid exposures among French healthcare workers (HCWs).

Design.

Prospective national follow-up of HCWs from January 1 to December 31, 2004.

Setting.

University hospitals, hospitals, clinics, local medical centers, and specialized psychiatric centers were included in the study on a voluntary basis.

Participants.

At participating medical centers, every reported blood and body fluid exposure was documented by the occupational practitioner in charge of the exposed HCW by use of an anonymous, standardized questionnaire.

Results.

A total of 375 medical centers (15% of French medical centers, accounting for 29% of hospital beds) reported 13,041 blood and body fluid exposures; of these, 9,396 (72.0%) were needlestick injuries. Blood and body fluid exposures were avoidable in 39.1% of cases (5,091 of 13,020), and 52.2% of percutaneous injuries (4,986 of 9,552) were avoidable (5.9% due to needle recapping). Of 10,656 percutaneous injuries, 22.6% occurred during an injection, 17.9% during blood sampling, and 16.6% during surgery. Of 2,065 splashes, 22.6% occurred during nursing activities, 19.1% during surgery, 14.1% during placement or removal of an intravenous line, and 12.0% during manipulation of a tracheotomy tube. The incidence rates of exposures were 8.9 per 100 hospital beds (95% confidence interval [CI], 8.7-9.0 exposures), 2.2 per 100 full-time—equivalent physicians (95% CI, 2.4-2.6 exposures), and 7.0 per 100 full-time—equivalent nurses (95% CI, 6.8-7.2 exposures). Human immunodeficiency virus serological status was unknown for 2,789 (21.4%) of 13,041 patients who were the source of the blood and body fluid exposures.

Conclusion.

National surveillance networks for blood and body fluid exposures help to better document their characteristics and risk factors and can enhance prevention at participating medical centers.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 10 , October 2007 , pp. 1196 - 1201
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007 

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References

1. May, D, Brewer, S. Sharps injury: prevention and management. Nurs Stand 2001;15:45–52.Google Scholar
2. Sepkowitz, KA. Occupationally acquired infections in health care workers: part II. Ann Intern Med 1996;125:917–928.Google Scholar
3. Perry, J, Jagger, J. Healthcare worker blood exposure risks: correcting some outdated statistics. Adv Expos Prev 2003;6:28–31.Google Scholar
4. Investigation and Surveillance Group, Parneix, P, Abiteboul, D, et al. Surveillance des accidents exposant au sang chez les soignants dans les établissements de santé en France: données du réseau AES-RAISIN, 2002. Available at: http://www.invs.sante.fr/publications/2005/snmi/aes_raisin.html. Accessed September 11, 2006.Google Scholar
5. Sanitary Vigilance Institute (Institut de veillle sanitaire). Available at: http://www.invs.sante.fr/. Accessed July 4, 2006.Google Scholar
6. Centers for Disease Control and Prevention. Recommendations for prevention of HIV transmission in health care settings. MMWR Morb Mortal Wkly Rep 1987;36:1S–18S.Google Scholar
7. Tarantola, A, Golliot, F, Astagneau, P, Fleury, L, Brucker, G, Bouvet, E. Occupational blood and body fluids exposures in health care workers: four-year surveillance from the northern France network. Am J Infect Control 2003;31:357–363.Google Scholar
8. Groupe d'Etude des Risques d'Exposition des Soignants aux agents infectieux (GERES). Available at: http://www.geres.org. Accessed June 15, 2006.Google Scholar
9. Tokars, JI, Marcus, R, Culver, DH, et al. Surveillance of HIV infection and zidovudine use among health care workers after occupational exposure to HIV-infected blood. Ann Intern Med 1993;118:913–919.Google Scholar
10. Jagger, J, Puro, V, De Carli, G. Occupational transmission of hepatitis C virus. JAMA 2002;288:1469.Google Scholar
11. De Carli, G, Puro, V, Ippolito, G, Studio Italiano Rischio Occupazionale da HIV Group. Risk of hepatitis C virus transmission following percutaneous exposure in healthcare workers. Infection 2003;31(suppl 2):22–27.Google Scholar
12. Panlilio, AL, Orelien, JG, Srivastava, PU, Jagger, J, Cohn, RD, Cardo, DM; NaSH Surveillance Group; EPINet Data Sharing Network. Estimate of the annual number of percutaneous injuries among hospital-based healthcare workers in the United States, 1997-1998. Infect Control Hosp Epidemiol 2004;25:556–562.Google Scholar
13. Statistique annuelle des établissements de santé: SAE 2004. Available at: http://www.sae-diffusion.sante.gouv.fr/doc/dwd_sae2004_nomenclatures.pdf. Accessed August 12, 2006.Google Scholar
14. Dement, JM, Epling, C, Ostbye, T, Pompeii, LA, Hunt, DL. Blood and body fluid exposure risks among health care workers: results from the Duke Health and Safety Surveillance System. Am J Ind Med 2004;46:637–648.Google Scholar
15. Hsieh, WB, Chiu, NC, Lee, CM, Huang, FY. Occupational blood and infectious body fluid exposures in a teaching hospital: a three-year review. J Microbiol Immunol Infect 2006;39:321–327.Google Scholar
16. Blazquez, RM, Moreno, S, Menasalvas, A, Guerrero, C, Novoa, A, Segovia, M. Occupational exposures to blood-borne pathogens in health care workers. Enferm Infecc Microbiol Clin 2001;19:156–160.Google Scholar
17. Smith, DR, Mihashi, M, Adachi, Y, Nakashima, Y, Ishitake, T. Epidemiology of needlestick and sharps injuries among nurses in a Japanese teaching hospital. J Hosp Infect 2006;64:44–49.Google Scholar
18. Radecki, S, Abbott, A, Eloi, L. Occupational human immunodeficiency virus exposure among residents and medical students: an analysis of 5-year follow-up data. Arch Intern Med 2000;160:3107–3111.Google Scholar
19. Gerberding, JL, Littell, C, Tarkington, A, Brown, A, Schecter, WP. Risk of exposure of surgical personnel to patients' blood during surgery at San Francisco General Hospital. N Engl J Med 1990;322:1788–1793.Google Scholar
20. McCormick, RD, Meisch, MG, Ircink, FG, Maki, DG. Epidemiology of hospital sharps injuries: a 14-year prospective study in the pre-AIDS and AIDS eras. Am J Med 1991;91:301S–307S.Google Scholar
21. Bowden, FJ, Pollett, B, Birrell, F, Dax, EM. Occupational exposure to the human immunodeficiency virus and other bloodborne pathogens: a 6-year prospective study. Med J Aust 1993;158:810–812.Google Scholar
22. Doebbeling, BN, Vaughn, TE, McCoy, KD, et al. Percutaneous injury, blood exposure, and adherence to standard precautions: are hospital-based healthcare providers still at risk? Clin Infect Dis 2003;37:1006–1013.Google Scholar
23. Elliott, SKF, Keeton, A, Holt, A. Medical students' knowledge of sharps injuries. J Hosp Infect 2005;60:374–377.Google Scholar
24. Druet-Cabanac, M, Szopinski, M, Tibarbache, H, Dumont, D. Analysis of underreporting of occupational blood exposure at Limoges University hospital. Arch Mai Prof 2003;64:453–459.Google Scholar
25. Jagger, J, Pearson, RD. Universal precautions: still missing the point on needlesticks. Infect Control Hosp Epidemiol 1991;12:211–213.Google Scholar
26. Talaat, M, Kandeel, A, El-Shoubary, W, et al. Occupational exposure to needlestick injuries and hepatitis B vaccination coverage among health care workers in Egypt. Am J Infect Control 2003;31:469–474.Google Scholar
27. Pruss-Ustun, A, Rapiti, E, Hutin, Y. Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers. Am J Ind Med 2005;48:482–490.Google Scholar
28. Fisker, N, Mygind, LH, Krarup, HB, Licht, D, Georgsen, J, Christensen, PB. Blood-borne viral infections among Danish health care workers—frequent blood exposure but low prevalence of infection. Eur J Epidemiol 2004;19:61–67.Google Scholar
29. Tarantola, A, Abiteboul, D, Rachline, A. Infection risks following accidental exposure to blood or body fluids in health care workers: a review of pathogens transmitted in published cases. Am J Infect Control 2006;34:367–375.Google Scholar
30. Trim, JC, Elliott, TSJ. A review of sharps injuries and preventative strategies. J Hosp Infect 2003;53:237–242.Google Scholar
31. UK Department of Health. Guidance for clinical healthcareworkers: protection against infection with blood-borne viruses. Recommendations for the Expert Advisory Groupon AIDS and the Advisory Group on Hepatitis. London: Department of Health;1998. Available at: http://www.dh.gov.uk. Accessed April 2, 2002.Google Scholar
32. Dorolle, P. Old plagues in the jet age: international aspects of present and future control of communicable disease. Br Med J 1968;4:789–792.Google Scholar
33. Drucker, E, Alcabes, PG, Marx, PA. The injection century: massive unsterile injections and the emergence of human pathogens. Lancet 2001;358:1989–1992.Google Scholar
34. Ostroff, SM, Kozarsky, P. Emerging infectious diseases and travel medicine. Infect Dis Clin North Am 1998;12:231–241.Google Scholar
35. Porta, C, Handelman, E. A new approach to needlestick injuries among health care workers. Appl Occup Environ Hyg 1999;14:15–17.Google Scholar
36. Vincent, A, Cohen, M, Bernet, C, et al. Accidental exposure to blood by midwives in French maternity units: results of the national surveillance 2003 [in French]. J Gynecol Obstet Biol Reprod (Paris) 2006;35:247–256.Google Scholar