Investigating the Serologic Status and Epidemiological Aspects of Health Care Workers’ Exposure to HBV and HCV Viruses
DOI:
https://doi.org/10.22100/jkh.v5i4.160Keywords:
Blood, Body fluids, HBS-Ag, HCV-Ab, HBS-Ab, Health worker.Abstract
Introduction: Health care workers who have occupational exposure to blood and body fluids are at increased risk of acquiring blood-borne infections. This study aimed at assessing hepatitis B immunity status of employees as well as determining the epidemiological characteristics of occupational exposure of the workers in Fatemieh Hospital in Shahroud to blood/body fluids.
Methods: In this cross-sectional study, 191 employees (both clerical and health care personnel) of Fatemieh Hospital were studied. After providing the required explanations, 5cc blood sample were taken to examine HBS Ag, HCV Ab and HBS Ab with eliza kits. Demographic features, vaccination history and exposures with blood/body fluid of the participants were simultaneously recorded.
Results: Mean age of the participants was 34 ± 9 years. The highest rate of exposure (needle sticking injury) was for 10-15 year experience group (73.3%). The highest percentage of exposure in different job groups was in general practitioners (100%), obstetricians (82.4%) and anesthesia technicians (75%). 83.8% of the participants reported vaccination history and only 33% of them checked Ab titer. History of exposure with blood/body fluids (BBF) was reported by 54/5% of the participants; the most frequent method of exposure was needle sticking while taking samples or disposing of the waste. (46.5%). Exposure reporting and follow—up activities were very poor (only 12%). 59.2% of the participants reported use of gloves and 79.9% were aware of the occupational hygienic regulations. Fortunately, all participants were negative for HBS Ag and HCV Ab. In 63% of the cases, HBs-Ab level was above 10 and in 31% was above 100 international units in milliliter.
Conclusion: The overall rate of hospital workers to exposure to BBF is high. The rate of unimmunized workers is noticeable and it is necessary to pay attention to the health of the personnel through preventive measures and following the occupational accidents. Starting an Occupational Health Center is also a necessity for every hospital.
References
Centers for Disease Control. Health service guidelines for the management of occupational exposures to hbv, hcv, hiv and recommendations for postexposure prophylaxis. MMWR 2001;50(RR-11):1-52.
Calver J. Occupational health services. Am J Infect Control 1997;25: 363-5.
Beltrami ME, Alvarado-Ramy F, Critchley SE, Panlilio AL,Cardo DM, Bower WA, et al. Updated U.S. public health service guideines for the management of occupational exposures to HBV/HCV/HIV and recommendations for postexposure prophylaxis. MMWR 2001;50(RR-11).Weekly Report.
Prüss-Ustün A, Rapiti E, Hutin Y. Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers. Am J Ind Med 2005;48(6):482-90.
Nguyen M, Paton S, Koch J. Update-survelliance of health care workers exposed to blood, body fluids and bloodborne pathogens in Canadian hospital setting: 1 April, 2000, to 31 March, 2002. Can Commun Dis Rep 2003;29(24):209-13.
[No authors listed]. Needle stick injuries: nurses at risk. Mich Nurse 2000;73(3):8-9.
Dienstag JL, Isselbacher KJ. Acute Viral Hepatitis. In: Kasper D, editors. Harrison's principles of internal medicine. 6th ed. NewYork: McGraw- Hill;2005.p.Chap 285.
Gerberding JL. Management of occupational exposure to blood borne viruses. N Engl J Med 1995;332:444-51.
Daryani N. Viral and autoimmune hepatitis. 1st ed. Tehran: Taeb;1999.[Persian].
SepkowitzAK. Nosocomial hepatitis and other infections transmitted by blood and blood products. In: Mandell GL, Bennett JE, Dolin R. Principles and practice of infectious diseases. 6th ed. Philadelphia: Churchill Livingstone;2005.
Rezvan H, Fayaz-Vasseghi M. Low-Dose hepatitis B vaccination with recombinant vaccine in Iranian health care workers. Archives of Iranian Medicine 2004;7(3):178-181.[Persian].
Merat S, Malekzadeh R, Rezvan H, Khatibian M. Hepatitis B in Iran. Arch Iranian Med 2000;3:192-201.[Persian].
Hadadi A, Haji Abdolbaghi M, Karbakhsh M, Rasoulinejad M, Mohraz M. The effectiveness of prophylaxia following occupational exposure to hepatitis B and HIV in medical professions. Journal of Tropical Infectious Diseases 2007;12(38):33-38.[Persian].
Alter HJ, Seeff LB, Kaplan PM, McAuliffe VJ, Wright EC, Gerin JL, et al. Type B hepatitis: the infectivity of blood positive for e-antigen and DNA polymerase after accidental needlestick exposure. N Engl J Med 1976;295(17):909-13.
Werner BG, Grady GF. Acccidental hepatitis-B-surface-antigen- positive inoculation: use of e-antigen to estimate infectivity. Ann Intern Med 1982;97(3):367-9.
Hanrahan A, Reutter L. A critical review of literature on sharp injuries: epidemiology, management of exposures and prevention. J Adv Nurs 1997;25:144-54.
Gurubacharya DL, Mathura KC, Karki DB.Knowledge, attitude and practices among health care workers on needle-stick injuries. Kathmandu Univ Med J 2003;1(2):91-4.
Shiao JS, McLaws ML, Huang KY, Ko WC,Guo YL. Prevalence of nonreporting behavior of sharps injuries in Taiwanese health care workers . Am J Infect Control 1999;27(3):254-7.
Hadadi A, Afhami SH, Kharbakhsh M, Hajabdoulbaghi M, Rasoolinejad M, Emadi H, et al. Epidemiological determinants of occupational exposure to HIV, HBV, HCV, in health care workers. Tehran University Medical Journal 2007;65(9):59-66.[Persian].
Roy E, Robillard P.Under-reporting of accidental exposure to blood and other body fluids in health care setting: an alarming situation. Adv Exposure Prev 1995;14:11-3.
Falagas ME, Karydis I, Kostogiannou I. Percutaneous exposure incidents of the health care personnel in a newly founded hospital: a prospective study. PLoS One 2007;2(2):e194.
Memish ZA, Almuneef M, Dillon J. Epidemiology of needlestick and sharps injuries in a tertiary care center in Saudi Arabia. Am J Infect Control 2002;30(4):234-41.
Azap A, Ergonul O, Memikoglu KO, Yesilkaya A, Altunsoy A, Bozkurt GY,et al. Occupational exposure to blood and body fluids among health care workers in Ankara, Turkey. Am J Infect Control 2005;33(1):48-52.
Nguyen M, Paton S, Koch J. Update-surveillance of health care workers exposed to blood, body fluids and bloodborne pathogens in Canadian hospital settings: 1 April, 2000, to 31 March, 2002. Can Commun Dis Rep 2003;29(24):209-13.
Hsieh WB, Chiu NC, Lee CM, Huang FY. Occupational blood and infectious body fluid exposures in a teaching hospital: a three-year review. J Microbiol Immunol Infect 2006;39(4):321-7.
Jahan S. Epidemiology of needlestick injuries among health care workers in a secondary care hospital in Saudi Arabia. Ann Saudi Med 2005;25(3):233-8.
Smith DR, Leggat PA. Needlestick and sharps injuries among nursing students. J Adv Nurs 2005;51(5):449-55.
Barone P, Sciacca A, Lupo F, Leonardi S, Murumeci S. Hepatitis B vaccination in young nurses of a general hospital. Ann Ig 1995;7:251-5.
Sharifi MR, Ghoreishian M. Evaluation of vaccine induced immunity to hepatitis B virus among health care workers. Yazd University of Medical Sciences 1997;5(1):1-10.
Habibiyan R. Efficacy of complete hepatitis B-vaccination in health care workers. Journal of shahrkord University 2003;5(1):41-46. [Persian].
Ranjbar M, Keramat F, Keshavarz F. The immunogenic response of hepatitis B vaccine in personnel of SINA hospital of Hamedan. Iranian Journal of Infectous Diseases and Tropical Medicine 2002;7(18):55-58.
Kashi Fard M, Hassanjani Roshan MR. Response to Hepatitis B vaccination in health care workers of Yahyanejad Hospital, Babol, 2002. JBUMS Journal of Babol University of Medical Sciences 2004;6(4):39-42.[Persian].
Talebi Taher M, Akbari M, Rezaei M, Ashaeri N, Omrani Z, Ghaderian H, et al. Determination of anti-HBS titer mean induced by Hepatitis B vaccine among health care workers in Firoozgar Hospital in Tehran. Journal of Iran University 2004;11(43):785-789.[Persian].
Averhoff F, Mahoney F, Coleman P, Schatz G, Hurwitz E, Margolis H. Immunogenicity of hepatitis B Vaccines. Implications for persons at occupational risk of hepatitis B virus infection. Am J Prev Med 1998;15(1):1-8.
Prati F, Lodi V, D'Elia V, Truffelli D, Lalić H, Raffi GB. Screening of health care workers for hepatitis B virus and hepatitis C virus: criteria for fitness for work. Arh Hig Rada Toksikol 2000;51(1):19-26.
Bonanni P, Bonaccorsi G. Vaccination against hepatitis B in health care workers. Vaccine 2001;19:2389-94.
Janbakhsh AR, Hatami H, Sayad B, Eayni P, Hashemian AH. Immunity response against hepatitis B vaccination in health centers of Kermanshah staff in 2002. Behbod 2002;7(1):48-53.[Persian].
Haji Bagheri K, Kanani Sh, Moradi Gh, Yousefi nezhadV. Response to hepatitis B vaccination in hospital medical staff of Kurdistan in 2006. Journal of Tropical and Infectious Diseases 2008;13(40):53-57.[Persian].
Azarhoush R, Borghei NS, Vakili MA, Latifi K. Serologic immunity of Gorgan medical personnels against hepatitis B (2003). Journal of Gorgan University of Medical Sciences 2006;8(1):39-44.[Persian].
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