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Work Exposures to HIV, Hepatitis B and Hepatitis C Still Rising

A report launched by Public Health England (PHE) warns that healthcare workers continue to be at risk of exposure to bloodborne viruses through occupational sharps injuries, despite the fact that safety-engineered devices to prevent these injuries are now available.

 

SPL injection

Occupational exposures to a bloodborne virus (BBV) that were reported to Public Health England increased among healthcare workers from 373 in 2004 to 496 in 2013. 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). Of these exposures 81% were sustained by doctors, nurses and healthcare assistants and 65% occurred during clinical procedures. 71% of exposures involved a percutaneous needlestick injury, the majority of which were sharps injuries involving a hollow-bore needle.

The report, presented at the 5th Prevention of Occupational Infections, Treatment and Reporting Strategies (POINTERS) Conference in Cardiff City Hall, comes after the EU Sharps Directive in 2010 and the UK Sharps Regulations in 2013, which 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.

Between 2004 and 2013, 9 healthcare workers were infected with HCV following occupational exposure in England, Wales and Northern Ireland. 8 of the 9 healthcare workers received antiviral therapy, of whom 7 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. Furthermore, 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.

“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,” said Dr Fortune Ncube, Head of the BBV Department at PHE. “These injuries are entirely preventable.”

“Despite this, 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 in healthcare workers. 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.”

“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,” said Jill Holmes, Infection Prevention Control Nurse Specialist and Infection Control Society representative on the Safer Needles Network.

“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."

 

Source: Public Health England

 

 

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The Operating Theatre Journal, OTJ, is published monthly and distributed to every hospital operating theatre department in the UK. The distribution includes both the National Health Service and the Private Sector.

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