Low Risk is the New High Risk: Implications of National Policy on Occupational Exposure to Blood and Body Fluids in US Hospitals

Occupational exposure to blood and body fluids (BBF) is a major concern in healthcare creating risk of occupationally-associated infections (OAIs). In 2000, the Needlestick Safety and Prevention Act (NSPA) required OSHA to incorporate into its Bloodborne Pathogens Standard (BPS) additional requirements to protect healthcare workers (HCWs) from exposure to blood and body fluids (BBF).  As a nation, we saw needlesticks or percutaneous sharps injuries (PCSIs) decline but it is uncertain if the decline also represented declines in other BBF exposures, specifically mucotaneous splash and splatter incidents (MSSIs). 

This study measures the implications of the NSPA and its incorporation into the OSHA BPS by determining whether the comparison of MSSIs to PCSIs varied over three study periods; 1995-1999 (prior to NSPA), 2000-2002 (NSPA and OSHA promulgation), and afterwards in 2003-2007; comparing those in high risk to low risk hospital areas.

This study is the largest of its kind, analyzing over 30,000 exposure incidents from nearly 70 U.S. hospitals reporting into the Exposure Prevention Information Network (EPINet™*) were analyzed.  Preliminary analysis of MSSI:PCSI was compared for each time period for high risk and low risk hospital areas.  Additionally, PPE use was analyzed for all MSSIs across the study period.  Appropriate incident-specific PPE use was compared, meaning when eye incidents were identified, so was use of eye-appropriate PPE (e.g., eyeglasses, side shields, faceshields or goggles). 

The results of this study will be shared, as well as its potential implication for assessing the impact of national policy on occupational exposures and OAIs in healthcare.