146212 Health care worker risk of bloodborne pathogen transmission: An American public health success story

Monday, November 5, 2007: 10:30 AM

Elayne Kornblatt Phillips, RN, MPH, PhD , International Health Care Worker Safety Center, University of Virginia, Charlottesville, VA
Janine C. Jagger, MPH, PhD , International Health Care Worker Safety Center, University of Virginia, Charlottesville, VA
Occupational bloodborne pathogen infection is a long-recognized risk for health care workers (HCWs), but it was the AIDS epidemic that triggered aggressive prevention initiatives targeting exposures to bloodborne pathogens. The resulting advances produced a major public health success story in the US. Occupational hepatitis B infections have decreased more than 99% since 1983 due to hepatitis B vaccination. Occupational HIV infections have become rare since combination anti-retroviral therapy for patients and HIV post-exposure prophylaxis for HCWs was introduced in 1997; no new cases have been reported since 2001. Some occupational hepatitis C infections have been cured in recent years with interferon therapy. Using multi-hospital EPINet surveillance data at the University of Virginia, we observed an overall reduction in sharps injury (SI) rates greater than 35% since 1993. Reductions for high-risk vascular access procedures exceed 50%. We attribute this to the elimination of unnecessary sharps, a national law requiring adoption of safety-engineered sharp devices, and improved sharps disposal. Standardized surveillance programs such as EPINet have facilitated the sharing of SI data, the identification of device-associated risks, and the efforts of manufacturers to improve device safety. HCWs in developing countries, where the need for protective measures is greatest, have limited access to these advances. Vaccinations, treatments, barrier-garments, safe disposal and safety-devices are relatively unavailable. We propose that global standards for HCW protection be established, and this presentation will outline recommendations. These standards would be a major step toward protecting the health of caregivers in all countries.

Learning Objectives:
1. Identify the changes in bloodborne pathogen transmission observed in the US over the past decade. 2. Describe the factors that influenced this change. 3. List policies which, if implemented, would enhance the likelihood of similar reductions in bloodborne pathogen transmission in developing countries.

Keywords: Health Care Workers, Policy/Policy Development

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.