Occupational exposure of interns to blood in an area of high HIV seroprevalence
Objective. To determine the epidemiology of work-related exposure to blood among interns.
Design. Interns were invited to complete anonymously a questionnaire concerning their past percutaneous and mucocutaneous exposures to blood.
Setting. Chris Hani Baragwanath Hospital, Soweto, and Johannesburg Hospital, Gauteng, where HIV infection is common among patients.
Results. Ninety-eight interns (96%) were surveyed. Sixty nine per cent of interns reported one or more percutaneous exposures to blood during the intern year, and 33% of interns recalled accidental percutaneous exposure to HlVinfected blgod. Forty-five per cent recalled a mucocutaneous exposure to IDV-positive blood. Only 28 (64%) of 44 percutaneous injuries from HIV-infected patients were reported. During their student clinical training, 56% of interns had suffered a penetrating injury, and 18% recollected needlestick injuries involving HIV infected patients. The most common mechanisms of injury included unexpected patient movement (23%), needle recapping (17%), and withdrawal of the needle (17%). Half of the injuries occurred during the first 4 months of internship. Only 22% of intern percutaneous exposures could have been avoided by following universal precautions.
Conclusions. Intern and medical student exposure to blood is extremely common, but is markedly underreported. Strict compliance with universal precautions will not prevent the majority of exposures. Priorities should be the introduction of safer techniques and equipment, skills training and methods of reporting blood exposures.
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