Better Follow-Up Care for Occupational Blood Exposures Is Needed Among HCWs

A large number of HCWs did not complete post-exposure prophylaxis after occupational blood exposure, indicating a national surveillance system may be needed to improve follow-up care.

Results of a study published in The Journal of Hospital Infection suggest there is a need for a national surveillance system to ensure health care workers (HCWs) receive post-exposure prophylaxis and complete follow-up care following an occupational blood exposure.

This retrospective analysis was conducted at a tertiary hospital in South Korea between January 2012 and December 2021. The primary objective was to monitor the incidence of occupational blood exposures and post-exposure prophylaxis and follow-up care completion rates among HCWs. All exposure related to needlestick injuries, percutaneous injuries from sharps, and mucosal exposures to blood were included in the analysis. Descriptive statistics and chi-square testing were used to analyze the data.

A total of 1086 occupational blood exposures were analyzed among HCWs (mean age, 32 years), with more exposures reported by women (71.8%) than men (28.2%). Further analysis of exposures showed most were caused by needlestick injury (88.5%). Exposure rates were highest among nurses (44.6%), followed by interns (14.4%), custodial staff (12.2%), and residents (11.7%).

For the 1086 exposed HCWs, 633 (58.3%) did and 453 (42.7%) did not require PEP. A total of 444 (70.1%) exposed HCWs completed follow-up care, none of whom seroconverted to hepatitis B virus, hepatitis C virus, HIV, or syphilis. Rates of PEP completion were found to significantly differ by gender (P =.024), occupation (P <.001), and exposure frequency (P <.001).

[T]here is a need to establish a national surveillance system for collecting information regarding the types, frequency, situational data, and follow-up care pertinent to occupational blood exposures among healthcare workers…

Among the 189 exposed HCWs who did not complete follow-up care, 99 were exposed to an unknown infection source or Hepatitis C virus. The most commonly reported reasons for follow-up care discontinuation were unknown/unclear (79.9%) and resignation from the health care facility (20.1%).

The mean incidence of occupational blood exposure was 7.82 per 100 beds and 3.0 per 100 HCWs.

Limitations of this study include the possibility that some exposures may not have been reported.

According to the researchers, “[T]here is a need to establish a national surveillance system for collecting information regarding the types, frequency, situational data, and follow-up care pertinent to OBEs among HCWs, which could then inform the development of intervention strategies.”

References:

Lee JB, Choi JS. Healthcare workers’ epidemiology of occupational exposure to blood-borne viruses, post-exposure prophylaxis, and seroconversion over 10 years. J Hosp Infect. Published online February 17, 2023. doi:10.1016/j.jhin.2023.02.003