بررسي جنبه هاي اپيدميولوژيك مواجهه شغلي با ويروس هاي هپاتيت B، هپاتيت C و HIV در پرسنل حرف پزشكي و عوامل موثر بر آن

Epidemiological determinants of occupational exposure to HIV, HBV and HCV in health care workers

Background: Health care work er s (HCWs) are at sub stanti al risk of acquirin g bloodbome path ogen infections through co ntact with blood and other potentiall y in fectiou s materi als . The main objecti ve s of thi s study were to determine the epidemio logica l characte ristics of occupa tio nal exposure to blood/body fluid s, related risk factors of such ex pos ure, and hepat itis B vaccinat ion status among HCWs. Methods: Thi s cross -se ctional study was co nducted from December 2004 to Jun e 2005 at three univer sity hospitals in Tehran, Iran . Using a s tructure d int erview , we questi oned HCWs who had the potenti al fo r high-ri sk exposure during the year preceding the s tudy . Results: With a tot al number of 467 exposures (52.9%) and an annua l rate of 0.5 exposures per HCW, 39 1(43%) of the 900 Hews had at least one occupa tional ex posure to blood and other in fect ed fluid s du ring the previous yea r. Th e highest rate of occ upa tiona l ex pos ure was found among nur ses (26%) and the housek eeping staff (20%). Th ese ex pos ures most commonl y occurred in the medi cal and emergency wards (23% and 21%, resp ecti vely) . The rate of exposure in HCWs with less than five yea rs of expe rie nce was 54%. Percut an eous inju ry was report ed in 280 parti cip ant s (59%). The history of hep ati tis B vacci nation was pos itive in 85.93% of the exposed Hews. Sixty-o ne percent had used gloves at the tim e of exposur e. Hand washing was reported in 9 1.4% and cons ulta tion with an infectious disease specialist in 29.4%. There were 72 expos ures to HIY, HBY and HCY; ex posure to HBY was the most common. In 237 of the enro lled cases, the source was un known . Job type, years of ex pe rience and hosp ital ward were the risk facto rs for ex pos ure. Conclusion: Educa tion, protecti ve barr iers and vacc ination are imp ortant in the prev enti on of viral transmi ssion among HCWs.