Rise in occupational exposures to blood-borne viruses in health workers

Rise in occupational exposures to blood-borne viruses in health workers

Incidents of occupational exposures to blood-borne virus (BBV) among healthcare workers reported to Public Health England increased from 373 in 2004 to 496 in 2013, and 81% of exposures were sustained by doctors, nurses and healthcare assistants.

Over this ten year period, approximately 30% of exposures involved a source patient infected with HIV, 54% involved hepatitis C (HCV), and 9%, hepatitis B (HBV). A total of 65% of incidents occurred during clinical procedures, and 71% of exposures involved a percutaneous needlestick injury, the majority of which were sharps injuries involving a hollow-bore needle.

Dr Fortune Ncube, Head of the BBV Department at PHE, said: “It is a disappointment that we still continue to see injuries to healthcare workers occurring after the procedure, in the period prior to and during disposal. These injuries are entirely preventable.”

He added: “We want to remind all healthcare employers to comply with the regulations regarding safer working conditions and to provide safety devices to healthcare workers in an effort to reduce sharps injuries and protect them from infection.”

The EU Sharps Directive in 2010 and the UK Sharps Regulations in 2013 state that safe working conditions must be created for healthcare workers to help reduce the risk of sharps injury. “Safe working conditions” can range from working hours that reduce tiredness among healthcare workers, to the provision of safety devices to reduce the risk of a needlestick injury before, during or after use, and appropriate training to staff performing clinical procedures.

Jill Holmes, Infection Prevention Control Nurse Specialist and Infection Control Society representative on the Safer Needles Network, said: “Safety-engineered devices are not fool proof. Unless they are used correctly, these devices will not be effective or prevent sharps injuries. It is vital that healthcare providers train new and existing staff in their correct use.

“It is also essential for all staff to remember the importance of basic sharps safety, such as never, ever re-sheathing a used needle, always taking the sharps bin to the point of use, and never filling above the fill line. Safe use and handling of sharps must be embedded into everyday practice."

Between 2004 and 2013, nine healthcare workers were infected with HCV following occupational exposure in England, Wales and Northern Ireland. Eight of the nine healthcare workers received antiviral therapy, of whom seven are known to have achieved viral clearance.

The report also finds that HBV immunisation programmes across England, Wales and Northern Ireland are effectively protecting healthcare workers from HBV infection, with no new cases reported. And 97% of healthcare workers exposed to HIV who commenced post-exposure prophylaxis (PEP) did so within 72 hours of exposure, and no HIV infections to healthcare workers have been reported. 

Dr Ncube said: “We are encouraged that there have been no new HIV infections in healthcare workers and that the immunisation programme for HBV is effective in preventing HBV infections.”

* Eye of the Needle: United Kingdom Surveillance of Significant Occupational Exposures to Bloodborne Viruses in Healthcare Workers. Public Health England, December 2014

by Ingrid Torjesen,

OnMedica, Thursday 11 December 2014

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