OCCUPATIONAL EXPOSURE TO THE HUMAN-IMMUNODEFICIENCY-VIRUS AND OTHER BLOOD-BORNE PATHOGENS - A 6-YEAR PROSPECTIVE-STUDY

Objective: To prospectively study occupational exposures to human immunodeficiency virus (HIV) and other blood-borne pathogens. Design and setting: Detailed clinical information was collected and follow-up was performed on all health care workers with occupational exposures to potentially infected substances at Fairfield infectious Diseases Hospital during the period January 1985 to September 1991. Results: There were 230 occupational exposures reported. One hundred and forty-one were considered ''significant'' or ''potentially significant''; these involved exposure (or the potential for exposure) to blood or body fluids by the parenteral route or contamination of non-intact skin or mucous membranes. Needle/syringe assemblies accounted for 59% of the ''significant'' injuries, ''butterfly'' needles for 21% and lancets for 8%. ''Butterfly'' needles were over-represented relative to their degree of use. Seventy-seven of the 230 exposures were HIV-related and 27 of these were considered ''significant''. The number of HIV positive patients attending the hospital increased progressively over the survey period but the rate of HIV-related exposures fell during that time. After 1988, 13 individuals with ''significant'' exposure to HIV received a six-week prophylactic course of zidovudine. No health care workers seroconverted for HIV, hepatitis B or hepatitis C during the survey period. Conclusions: The risk of acquiring HIV (and other blood-borne diseases) through occupational exposure is very low and this risk can be further reduced by adopting safe work practices.