Occupational exposure to blood and risk of bloodborne virus in rural India

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Occupational exposure to blood and risk of bloodborne virus

infection among health care workers in rural north Indian health

care settings

Am J Infect Control 2005 Feb;33(1):34-41 (ISSN: 0196-6553)

Kermode M; Jolley D; Langkham B; MS; Crofts N

Background Approximately 3 million health care workers (HCWs)

experience percutaneous exposure to bloodborne viruses (BBVs) each

year. This results in an estimated 16,000 hepatitis C, 66,000

hepatitis B, and 200 to 5000 human immunodeficiency virus (HIV)

infections annually. More than 90% of these infections are occurring

in low-income countries, and most are preventable.

Several studies report the risks of occupational BBV infection for

HCWs in high-income countries where a range of preventive

interventions have been implemented. In contrast, the situation for

HCWs in low-income countries is not well documented, and their

health and safety remains a neglected issue.

Objective: To describe the extent of occupational exposure to blood

and the risk of BBV infection among a group of HCWs in rural north

India.

Methods: A cross-sectional survey of HCWs from 7 rural health

settings gathered data pertaining to occupational exposure to blood

and a range of other relevant variables (eg, demographic

information, compliance with Universal Precautions, perception of

risk, knowledge of BBVs). A mass action model was used to estimate

the risk of occupational BBV infection for these HCWs over a 10-year

period.

Results: A total of 266 HCWs returned questionnaires (response rate,

87%). Sixty-three percent reported at least 1 percutaneous injury

(PI) in the last year (mean no. = 2.3) and 73% over their working

lifetime (mean no. = 4.2). Predictors of PI during the last year

were hospital site, job category, perception of risk, and compliance

with Universal Precautions.

Conclusion: The high level of occupational exposure to blood found

among this group of rural north Indian HCWs highlights the urgent

need for interventions to enhance their occupational safety to

prevent unnecessary nosocomial transmission of BBVs.