Accidental exposure to biological material in healthcare workers at a university hospital: Evaluation and follow-up of 404 cases

• Published in: Scandinavian journal of infectious diseases 2005-04, Vol.37 (4), p.295-300
• Main Authors: Gutierrez, Eliana Battaggia, Lopes, Marta Heloísa, Yasuda, Maria Aparecida Shikanai
• Format: Article
• Language: English
• Subjects: Adult; Anti-HIV Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Antiviral Agents - therapeutic use; Biological and medical sciences; Blood-Borne Pathogens; Brazil; Female; Follow-Up Studies; Hepatitis B - prevention & control; Hepatitis B Vaccines; Hepatitis B virus; Hepatitis C - prevention & control; Hepatitis C virus; HIV Infections - prevention & control; Human immunodeficiency virus; Human viral diseases; Humans; Immunoglobulins - therapeutic use; Infectious Disease Transmission, Patient-to-Professional; Infectious diseases; Male; Medical sciences; Middle Aged; Occupational Exposure; Personnel, Hospital; Pharmacology. Drug treatments; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral hepatitis
• ISSN: 0036-5548; 1651-1980
• DOI: 10.1080/00365540410026103

The care and follow-up provided to healthcare workers (HCWs) from a large teaching hospital who were exposed to biological material between 1 August 1998 and 31 January 2002 is described here. After exposure, the HCW is evaluated by a nurse and doctor in an emergency consultation and receives follow-up counselling. The collection of 10 ml of blood sample from each HCW and its source patient, when known, is made for immunoenzymatic testing for HIV, HBV and HCV. Evaluation and follow-up of 404 cases revealed that the exposures were concentrated in only a few areas of the hospital; 83% of the HCWs exposed were seen by a doctor responsible for the prophylaxis up to 3 h after exposure. Blood was involved in 76.7% (309) of the exposures. The patient source of the biological material was known in 80.7% (326) of the exposed individuals studied; 80 (24.5%) sources had serological evidence of infection with 1 or more agents: 16.2% were anti-HCV positive, 3.8% were HAgBs positive and 10.9% were anti-HIV positive. 67% (273) of the study population completed the proposed follow-up. No confirmed seroconversion occurred. In conclusion, the observed adherence to the follow-up was quite low, and measures to improve it must be taken. Surprisingly, no difference in adherence to the follow-up was observed among those exposed HCW at risk, i.e. those with an infected or unknown source patient. Analysis of post-exposure management revealed excess prescription of antiretroviral drugs, vaccine and immunoglobulin. Infection by HCV is the most important risk of concern, in our hospital, in accidents with biological material.