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Abdelmalik MA, Alhowaymel FM, Fadlalmola H, Mohammaed MO, Abbakr I, Alenezi A, Mohammed AM, Abaoud AF. Global prevalence of needle stick injuries among nurses: A comprehensive systematic review and meta-analysis. J Clin Nurs 2023; 32:5619-5631. [PMID: 36841963 DOI: 10.1111/jocn.16661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 01/08/2023] [Accepted: 02/06/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Nurses usually provide direct patient care. However, they account for the majority of healthcare workers (HCWs) injured by needles or other sharp objects. OBJECTIVES To assess the prevalence of needle stick injuries (NSI) among nurses worldwide; according to WHO regions, the socioeconomic development index (SDI) of countries, and the developmental status of individual countries, and in the Middle East. DESIGN Systematic review and meta-analysis. METHODS We searched PubMed, Scopus, and Web of Science databases. We calculated the pooled NSI prevalence estimates using a random-effect meta-analysis with the Comprehensive Meta-Analysis software. The report of the study was in accordance with the PRISMA 2020 statement. RESULTS The overall worldwide NSI prevalence pooled from our analysis was 40.97% (95% confidence interval [CI]: 31.29-50.63%, p = .00001). A subgroup analysis of NSI prevalence according to WHO regions revealed the highest prevalence in Southeast Asia (49.9%, 95% CI: [23.4-76.3%]) and the lowest in the United States of America (25.1%, 95% CI: [18.1-32.1%]), respectively. The pooled prevalence in developed and developing countries was 30.5% (95% CI: 27.3-33.8%) and 46.6% (95% CI: 33.7-59.5%), respectively. According to the SDI, NSI prevalence was highest in low-middle SDI countries (48.9% [95% CI: 30.7-67.2%]). CONCLUSION Our results showed a high NSI prevalence among nurses worldwide. Developing countries had a significantly higher NSI prevalence than developed countries, especially low-middle SDI countries. RELEVANCE TO CLINICAL PRACTICE This study highlighted the prevalence of NSI risk among nurses practising in clinical settings worldwide. The study findings suggest that continuous training programs should be implemented for nurses to enhance their knowledge, performance and attitude toward NSI prevention in clinical settings. NO PATIENT OR PUBLIC CONTRIBUTION Contributions from patients or the public are irrelevant because the purpose of this study was to examine the global prevalence of NSIs in nurses.
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Affiliation(s)
- Mohammed A Abdelmalik
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
- Faculty of Nursing, University of El Imam El Mahdi Faculty of Medicine and Health Sciences, Nursing, Kosti, Sudan
| | - Fahad M Alhowaymel
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Hammad Fadlalmola
- Community Health Nursing Department, Nursing College, Taibah University, Almadinah, Saudi Arabia
| | - Mohammaed O Mohammaed
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Ibrahim Abbakr
- Department of Nursing Practice, College of Nursing, Umm Alqura University, Mecca, Saudi Arabia
| | - Atallah Alenezi
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Almoez M Mohammed
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
- College of Medicine and Health Sciences, University of Sinnar, Sinnar City, Sudan
| | - Abdulaziz F Abaoud
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
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Ma KJ, Hung JL, Chou MH, Wang JY. Patterns of Systemic Disease Diagnoses among Medical Professionals in Taiwan: Statistical Analysis and Data Mining. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14017. [PMID: 36360897 PMCID: PMC9657375 DOI: 10.3390/ijerph192114017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Although high-risk work environments and heavy workload expose medical professionals to long-term risks of disease, no comprehensive analysis has been conducted on the corresponding risks of diseases to each type of medical professionals. This study pre-analyzed the risks of medical professionals in developing various systemic diseases in Taiwan to provide a comprehensive examination of the differences between each type of systemic disease. METHODS From the secondary databases of 2002-2013, 15,407 medical professionals were selected for analysis. A chi-squared test and logistic regression were performed to identify the relationship between types of medical professionals and systemic diseases. The life trajectories of diagnosis sequence of the medical professionals were illustrated accordingly. RESULTS The physicians were the most vulnerable to infectious, parasitic, and digestive diseases. This was possibly associated with their work characteristics and occupational risks. CONCLUSION According to the life trajectories, all types of the medical professionals exhibited a similar trend in the orders of risks to each type of systemic disease, which suggests that their work environment exposes them to real risks of health hazard.
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Affiliation(s)
- Kai-Jie Ma
- Department of Public Health, China Medical University, Taichung 406040, Taiwan
| | - Jui-Lien Hung
- Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
| | - Ming-Hsien Chou
- Department of Public Health, China Medical University, Taichung 406040, Taiwan
- Department of Physical Medicine and Rehabilitation, Taichung Armed Forces General Hospital, Taichung 411228, Taiwan
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taipei 114202, Taiwan
- Section of Physical Medicine and Rehabilitation, School of Medicine, National Defense Medical Center, Taipei 114201, Taiwan
| | - Jong-Yi Wang
- Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
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Abadiga M, Mosisa G, Abate Y. Magnitude of Needlestick and Sharp Injury and Its Associated Factors Among Nurses Working at Health Institutions in Western Ethiopia, 2020. Risk Manag Healthc Policy 2020; 13:1589-1602. [PMID: 32982517 PMCID: PMC7501985 DOI: 10.2147/rmhp.s254641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 09/01/2020] [Indexed: 11/30/2022] Open
Abstract
Background Needlestick and sharp injury represent a major occupational hazard in the healthcare environment with nurses experiencing a large proportion of the burden. It is a potential for transmission of bloodborne pathogens including the human immunodeficiency virus, hepatitis B and C virus. Needlestick and sharp injuries are neglected and are often not reported. Few studies have been conducted in Ethiopia, and no study was conducted particularly in the Western part of a country. Therefore, this study aimed to assess needlestick and sharp injuries and associated factors among nurses working at health institutions in western Ethiopia, 2020. Methods An institutional based cross-sectional study was conducted on 297 nurses, from January 15 to 30, 2020. The study participants were selected by a simple random sampling method and data were collected using a self-administered questionnaire. Multivariable logistic regression was used to identify associated factors of needlestick and sharp injury. The association between needle stick and sharp injury and associated factors were measured using the odds ratio at a 95% confidence interval. The statistical significance was made at a p-value of less than 0.05. Results Out of 297 nurses who participated in the study, 100 (33.7%) had encountered needlestick and sharp injury in the past 12 months. Recapping the needle (AOR=3.99 95% CI: 2.20, 7.21), non-utilization of infection prevention guideline (AOR= 2.69, 95% CI: 1.29, 5.60), not taking injection safety training (AOR = 2.25, 95% CI: 1.22, 4.13) and having job-related stress (AOR= 1.93, 95% CI: 1.10, 3.41) were significantly associated with the needlestick and sharp injury. Conclusion In this study, the magnitude of needlestick and the sharp injury was high. The nurse should not recap the needles, should utilize infection prevention guidelines, should minimize stress, and routine injection safety training should be given to minimize needlestick and sharp injuries.
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Affiliation(s)
- Muktar Abadiga
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Getu Mosisa
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Yonas Abate
- Oromia Regional Health Bureau, Nekemte Health Center, Nekemte Town, Ethiopia
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Zhang L, Ai Y, Liu J, Yue N, Xuan J, Bal V, Gala S, Erdal EP, Gao X. Economic burden of needlestick injuries among healthcare workers in China. J Med Econ 2020; 23:683-689. [PMID: 32122187 DOI: 10.1080/13696998.2020.1737534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To estimate the economic burden of needlestick injuries (NSIs) among healthcare workers (HCWs) in China.Design: A model was built to evaluate the economic burden of NSIs.Methods: The cost model was developed from a societal perspective, including both direct and indirect costs, with lifetime horizon. The direct costs were categorized into infection prevention and treatment of infections. The indirect cost included productivity loss of both HCWs and his/her family members due to the blood-borne infections. Sub-group analyses were conducted to estimate the cost per NSI when the source patient (SP) was confirmed with hepatitis B virus/hepatitis C virus/human immunodeficiency virus (HBV/HCV/HIV) infection. One-way and probabilistic sensitivity analyses were conducted for all parameters to examine the robustness of the result.Results: The model projected a total cost of ¥699 for each NSI (direct and indirect cost were ¥553 and ¥146, respectively). The cost per NSI when the SP was confirmed with HBV/HCV/HIV was ¥4,238, ¥18,404, and ¥6,152, respectively. The total economic burden of NSIs among HCWs in China was estimated to be ¥5.8 billion, and about half of the cost was associated with NSIs in nurses, at ¥2.8 billion.Limitations: This study did not incorporate the costs of litigation/psychological, and the prevalence of the infections was based on the general population, so the actual costs per NSI may be underestimated. More real-world studies of treatment cost about HBV/HCV are needed to further supporting this study.Conclusions: The economic burden of NSIs among HCWs in China is substantial. Comprehensive NSI prevention programs, including implementation of safety needles and devices, have high potential for healthcare institutions to achieve downstream cost savings and cost offsets.
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Affiliation(s)
- Lei Zhang
- Shanghai Centennial Scientific, Shanghai, China
| | | | - Jing Liu
- Shanghai Centennial Scientific, Shanghai, China
| | - Ning Yue
- Becton Dickinson, Shanghai, China
| | | | | | - Smeet Gala
- Becton Dickinson, Franklin Lakes, NJ, USA
| | | | - Xiaodong Gao
- Zhongshan Hospital Fudan University, Shanghai, China
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Che Huei L, Ya-Wen L, Chiu Ming Y, Li Chen H, Jong Yi W, Ming Hung L. Occupational health and safety hazards faced by healthcare professionals in Taiwan: A systematic review of risk factors and control strategies. SAGE Open Med 2020; 8:2050312120918999. [PMID: 32523695 PMCID: PMC7235655 DOI: 10.1177/2050312120918999] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 03/17/2020] [Indexed: 11/15/2022] Open
Abstract
Background Healthcare professionals in Taiwan are exposed to a myriad of occupational health and safety hazards, including physical, biological, chemical, ergonomic, and psychosocial hazards. Healthcare professionals working in hospitals and healthcare facilities are more likely to be subjected to these hazards than their counterparts working in other areas. Objectives This review aims to assess current research literature regarding this situation with a view to informing policy makers and practitioners about the risks of exposure and offer evidence-based recommendations on how to eliminate or reduce such risks. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses review strategy, we conducted a systematic review of studies related to occupational health and safety conducted between January 2000 and January 2019 using MEDLINE (Ovid), PubMed, PMC, TOXLINE, CINAHL, PLOS One, and Access Pharmacy databases. Results The review detected 490 studies addressing the issue of occupational health and safety hazards; of these, 30 articles were included in this systematic review. These articles reported a variety of exposures faced by healthcare professionals. This review also revealed a number of strategies that can be adopted to control, eliminate, or reduce hazards to healthcare professionals in Taiwan. Conclusion Hospitals and healthcare facilities have many unique occupational health and safety hazards that can potentially affect the health and performance of healthcare professionals. The impact of such hazards on healthcare professionals poses a serious public health issue in Taiwan; therefore, controlling, eliminating, or reducing exposure can contribute to a stronger healthcare workforce with great potential to improve patient care and the healthcare system in Taiwan. Eliminating or reducing hazards can best be achieved through engineering measures, administrative policy, and the use of personal protective equipment. Implications This review has research, policy, and practice implications and provides future students and researchers with information on systematic review methodologies based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy. It also identifies occupational health and safety risks and provides insights and strategies to address them.
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Affiliation(s)
- Lin Che Huei
- Department of Pharmacy and Master Program, Tajen University, Pingtung, Taiwan
| | - Lin Ya-Wen
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Yang Chiu Ming
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Hung Li Chen
- Department of Public Health, China Medical University, Taichung, Taiwan.,Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Wang Jong Yi
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Lin Ming Hung
- Department of Pharmacy and Master Program, Tajen University, Pingtung, Taiwan.,Department of Public Health, China Medical University, Taichung, Taiwan
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Medical Waste-Sorting and Management Practices in Five Hospitals in Ghana. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020; 2020:2934296. [PMID: 32190061 PMCID: PMC7073495 DOI: 10.1155/2020/2934296] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/26/2019] [Accepted: 01/21/2020] [Indexed: 01/13/2023]
Abstract
Hospital waste management in Ghana faces the risk of cross-contamination from the lack of thorough sorting of the waste at the points of generation, codisposal of hazardous and nonhazardous waste types, and use of open-fire pits and substandard incinerators for burning infectious waste. This has increased the potential for the spread of infections and chemical pollutants. A cross-sectional study was conducted in five hospitals in Ghana to assess behavioral patterns on waste sorting and the effectiveness of hospital waste management in Ghana. A total of 250 questionnaires were distributed purposively to some staff of the five hospitals to assess workers' perceptions on medical waste sorting and handling. Additionally, focused group discussions and transect walks were adopted to examine the current collection, storage, treatment, and disposal methods used in the health facilities. Chi-square analyses showed significant differences in waste-sorting behavior based only on occupation (p < 0.0001, n=180) and not on gender, education, or experience in the health sector. Even though contaminated sharps were separated into brown safety boxes, color coding for other infectious waste containers was inconsistent across the health facilities. The study revealed that incineration is still the modal method of treatment in Ghanaian hospitals and therefore new approaches such as an engineering approach were required to minimize its environmental effects. It is recommended that periodic in-service training workshops be held for healthcare staff on the right source-segregation of medical waste, in order to facilitate the effective and safe handling, transport, treatment, and disposal of waste from health facilities.
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Hepatitis B Knowledge, Testing, and Vaccination History among Undergraduate Public Health Students in Ghana. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7645106. [PMID: 31485444 PMCID: PMC6710783 DOI: 10.1155/2019/7645106] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 06/01/2019] [Accepted: 07/29/2019] [Indexed: 12/22/2022]
Abstract
Background Hepatitis B virus (HBV) infection is a serious public health problem in many parts of the world. The risk of acquiring the infection through exposure to blood, semen, and other bodily fluids is highest among health care workers (HCW) including trainees. Ghana is considered a high risk country for HBV; however little is known about the knowledge and prevention practices of the infection in the country. This study assessed the knowledge, testing, and vaccination history of HBV and their related factors among undergraduate public health students of University of Health and Allied Sciences in Ghana. Methods A cross-sectional study was conducted among 226 students using a pretested questionnaire to assess Hepatitis B knowledge, testing, and vaccination history of the students. We performed logistic regression analysis to examine the relationship between Hepatitis B testing and vaccination history and participants' characteristics. Data was analysed using Stata Version 12. Results Majority 169 (73.9%) of the 226 participants studied had moderate knowledge regarding HBV infection. About half 114 (50.4%) of them had never been tested for HBV infection, and 100 (44.2%) had received at least a single dose of Hepatitis B vaccine. The completed vaccination rate among the students was 30.5%. Students in their 2nd year (Adjusted Odds Ratio [AOR]: 3.13; 95% Confidence Interval [CI]: 1.13, 7.52; p<0.011) and those with moderate (AOR: 4.76; 95% CI; 1.35, 16.82; P=0.015) and good (AOR: 5.40; 95% CI: 1.31, 22.36; P=0.020) level of knowledge were more likely to be tested for HBV. With regard to vaccination, females (AOR: 1.85; 95%CI: 1.04-3.29; P=0.037) and regular students (AOR: 0.37; 95%CI: 0.19, 0.70; p=0.002) were associated with receiving the full dose of Hepatitis B vaccine. Conclusion This study highlights the urgent need for continued health education on HBV infection and strategies that ensure that health trainees are screened and fully vaccinated against the infection to prevent potential future exposure to the virus. The students' representative council can organize free HBV testing and vaccination for all fresh students.
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Expanding the applications of microneedles in dermatology. Eur J Pharm Biopharm 2019; 140:121-140. [DOI: 10.1016/j.ejpb.2019.05.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 12/14/2022]
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Tian J, Tan F, Lai L, Deng Y, Chi X, Geng H, Zhu Q. Anesthesiologists' acquisition of hepatitis B virus infection: Risk and prevention. Medicine (Baltimore) 2019; 98:e16416. [PMID: 31335690 PMCID: PMC6709291 DOI: 10.1097/md.0000000000016416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Occupational exposure remains a serious problem for medical staff, especially those working in operation rooms. Hepatitis B virus (HBV) is prevalent in patients undergoing surgery, and anesthesiologists are at risk of occupational acquisition of blood-borne HBV infection. To the best of our knowledge, there are no data about HBV prevalence and vaccinations, as well as attitudes toward sharp injuries and gloving among anesthesiologists in China, where the HBV prevalence is high. To clarify these, the present study was conducted.An electronic questionnaire including HBV markers, gloving during practice, and reporting patterns of sharp injuries was created and sent to anesthesiologists.After excluding 10 uncompleted questionnaires, 1739 questionnaires were included in the final analysis. Of all analyzed anesthesiologists, 1599 (91.9%) had experienced sharp injuries, and 1313 (75.5%) had experienced >1 sharp injury. Considering HBV vaccination histories, 1381 anesthesiologists (79.4%) received 3 vaccination doses, and only half of the immunized anesthesiologists received reminder HBV vaccination doses after work before exposure. There were 696 anesthesiologists (40.0% of all participants) who were ever exposed to HBV, and nearly two-thirds of them (440) were exposed to HBV more than once. There was a more positive attitude toward gloving and double-gloving to reduce HBV exposure.The incidence of occupational HBV exposure among anesthesiologists is high, and its threat should be considered. HBV vaccinations and adherence to postexposure guidelines are recommended. The high prevalence of sharp injuries during anesthesia practice highlights the importance of safe anesthesia practices, such as gloving or double-gloving, especially when in contact with high-risk body fluids.
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Affiliation(s)
- Jingling Tian
- Department of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen City
| | - Fang Tan
- Department of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen City
| | - Lifei Lai
- Department of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen City
| | - Yingqing Deng
- Department of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen City
| | - Xinjin Chi
- Department of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen City
| | - Hongfang Geng
- Department of Anesthesiology, Henan Provincial People's Hospital of Zhengzhou University, Zhengzhou City, China
| | - Qianqian Zhu
- Department of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen City
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Kebede A, Gerensea H. Prevalence of needle stick injury and its associated factors among nurses working in public hospitals of Dessie town, Northeast Ethiopia, 2016. BMC Res Notes 2018; 11:413. [PMID: 29954450 PMCID: PMC6022488 DOI: 10.1186/s13104-018-3529-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 06/22/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Nurses are exposed to dangerous and deadly blood borne pathogens through contaminated needle stick injuries. This study was designed to assess prevalence of needle stick injury and its associated factors among nurses working in hospitals. Institution-based cross-sectional study design was used among 258 randomly selected nurses. Collected data was entered into Epi-Data version 3.1 and transferred to SPSS Version 20.0 for analysis. The degree of variables were assessed using adjusted odds ratio and its 95% confidence interval with P value (< 0.05). RESULTS Eighty-nine (34.5%) nurses self-reported receiving a needle stick injury in the previous 12 months. Work experience, working hour, personal protective, infection prevention guide line utilization and infection prevention training were significantly associated to needle stick injury. CONCLUSIONS The needle stick injury in this study area was prevalent. The contributing factors to the injury were duration of working hours, experience, use of personal protective equipment and training.
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Affiliation(s)
- Awoke Kebede
- School of Nursing, College of Health Sciences and Referral Hospital, AKsum University, Axum, Ethiopia.
| | - Hadgu Gerensea
- School of Nursing, College of Health Sciences and Referral Hospital, AKsum University, Axum, Ethiopia
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Knowledge, Attitude, and Practice of Use of Safety Precautions Among Health Care Workers in a Nigerian Tertiary Hospital, 1 Year After the Ebola Virus Disease Epidemic. Ann Glob Health 2018; 82:897-902. [PMID: 28283144 DOI: 10.1016/j.aogh.2016.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Several studies have found that compliance with universal precautions (UP) reduces the risk of exposure to diseases transmitted through blood and body fluids. Several efforts were made during the 2014 Ebola virus disease (EVD) outbreak in Nigeria to ensure a better behavioral change toward the practice of UP. OBJECTIVES This study assessed knowledge, attitude, and practice of the use of universal safety precautions among health care workers in a tertiary hospital in Osun State in southwestern Nigeria, 1 year after the containment of the EVD epidemic in Nigeria. METHODS Descriptive cross-sectional study among 274 health care workers of LAUTECH Teaching Hospital Osogbo, selected using systematic sampling method. Data collected using semistructured, pretested questionnaires were analyzed using SPSS software version 17.0 (Chicago, IL, SPSS Inc.). FINDINGS Two hundred twenty (80.3%) washed their hands regularly after procedures, 256 (93.4%) used gloves regularly when caring for all patients, 100 (36.5%) said they occasionally recap needles carefully, and 250 (91.2%) said they properly handled and disposed sharp instruments and wastes. About 224 (81.8%) had good mean knowledge score, 154 (56.2%) had a positive attitude score, and 192 (70.1%) had a good mean practice score for UP among respondents. The practice of UP was statistically significantly associated with gender, years of work experience (P = .002), and knowledge of (P = .039) and attitude about UP (P = .007). CONCLUSIONS The good knowledge and practice scores of UP were associated with better attitude toward handwashing and the use of gloves during the post-EVD period compared with the pre-EVD period. A significant proportion still recap used needles just like during the pre-EVD period.
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Kashyap B, Tiwari U, Prakash A. Hepatitis B virus transmission and health care workers: Epidemiology, pathogenesis and diagnosis. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2018. [DOI: 10.1016/j.injms.2018.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Huang SL, Lu Q, Fan SH, Zong ZY, Hou TY, Chen BY, Qin JA, Suo Y, Gao XD, Wang NN. Sharp instrument injuries among hospital healthcare workers in mainland China: a cross-sectional study. BMJ Open 2017; 7:e017761. [PMID: 28882927 PMCID: PMC5722084 DOI: 10.1136/bmjopen-2017-017761] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To determine the prevalence of sharp instrument injuries in hospital-based healthcare workers (HCWs) in mainland China and the contributing factors. DESIGN Cross-sectional study. SETTING The data were derived from public hospitals. PARTICIPANTS A total of 360 hospitals were recruited in the study, including 289 general hospitals and 71 specialised hospitals. Among them, 194 are tertiary-level hospitals and 166 are secondary level. The study population finally consisted of 223 149 hospital HCWs. PRIMARY OUTCOME MEASURES A questionnaire was designed based on the aim of the study. Profession of HCWs, workplace, circumstance and medical apparatus and instrument were covered in the survey. HCWs completed a self-administered questionnaire regarding details of sharp instrument injuries within the previous month. Prevalence estimates for the injuries were calculated for the overall HCWs and for subgroups according to profession, workplace, circumstance or instrument. RESULTS Within the included HCWs, the prevalence of sharp instrument injuries was 0.08 per person-month. Only 4.6% of the HCWs reported to their hospitals after injury. The highest number of injuries occurred in nursing staff (10.3%). Injuries took place most frequently on general wards (44.5%). The circumstances that involved most frequent injuries include surgical needle insertion, removing an arteriovenous needle from a patient and recapping the needle. Single-use syringe caused more injuries incidents than other instruments. CONCLUSIONS These results indicate that sharp instrument injuries have become a major occupational problem of HCWs in mainland China. Attentions need to be paid to the issue and strategies for preventing such injuries are needed.
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Affiliation(s)
- Sheng-Li Huang
- Department of Infection Control, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
- Department of Orthopeadics, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Qun Lu
- Department of Infection Control, Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Shan-Hong Fan
- Department of Infection Control, Tangdu Hospital, Fouth Military Medical University, Xi’an, China
| | - Zhi-Yong Zong
- Department of Infection Control, West China Hospital, Sichuan University, Chengdu, China
| | - Tie-Ying Hou
- Department of InfectionControl, Guangdong General Hospital, Guangzhou, China
| | - Bai-Yi Chen
- Department of Infection Control, First Hospital of China Medical University, Shenyang, China
| | - Jin-Ai Qin
- Department of Infection Control, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yao Suo
- Department of Infection Control, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Xiao-Dong Gao
- Department of Infection Control, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ning-Ning Wang
- Department of Infection Control, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
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Ghasemi M, Khabazkhoob M, Hashemi H, Yekta A, Nabovati P. The incidence of needle stick and sharp injuries and their associations with visual function among hospital nurses. J Curr Ophthalmol 2017; 29:214-220. [PMID: 28913514 PMCID: PMC5587247 DOI: 10.1016/j.joco.2017.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 05/24/2017] [Accepted: 06/07/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose To determine the one-year incidence of needle stick and sharp injuries (NSIs and SIs) and their associations with visual function among Iranian nurses. Methods In this cross-sectional study, 278 nurses working at one hospital were selected through stratified random sampling. After applying the exclusion criteria, the final analysis was performed on the data of 267 nurses. The data of occupational injuries were collected through a researcher-administered questionnaire. Visual function indices including distance and near best corrected visual acuities (BCVAs), color vision, stereoacuity, distance and near heterophorias, accommodative amplitude and facility, contrast sensitivity (CS) for high and low spatial frequencies (SFs), near point of convergence (NPC), saccadic and pursuit eye movements, distance and near convergence and divergence fusional reserves and peripheral vision were evaluated through optometric examinations using standard protocols. Results The one-year incidence of NSIs and SIs was 41.2% [95% Confidence interval (CI): 35.3–47.1] and 19.1% (95% CI: 14.4–23.8), respectively. Color vision deficiency, pursuit deficiency, abnormal near heterophoria, and decreased CS for high SF had a significant association with the increased incidence of NSIs with odds ratios of 3.26, 2.32, and 1.35, respectively. Moreover, saccadic deficiency, abnormal near heterophoria, and decreased near fusional divergence reserve were significantly associated with the increased incidence of SIs with odds ratios of 2.42, 2.40, and 1.27, respectively. Conclusions Our findings showed a relatively high incidence of NSIs and SIs in Iranian nurses and their associations with some visual function indices. Therefore, pre-employment and periodic visual examinations are recommended to detect and remove the corresponding visual risk factors. Moreover, preventive strategies should be adopted to decrease the occurrence of the aforementioned injuries.
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Affiliation(s)
- Mohammad Ghasemi
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Abbasali Yekta
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Payam Nabovati
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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La Fauci V, Riso R, Facciolà A, Ceccio C, Lo Giudice D, Calimeri S, Squeri R. Response to anti-HBV vaccine and 10-year follow-up of antibody levels in healthcare workers. Public Health 2016; 139:198-202. [PMID: 27600791 DOI: 10.1016/j.puhe.2016.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 07/14/2016] [Accepted: 08/08/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite improvements in public health and antiviral treatments, vaccination is still the most effective means of prevention of hepatitis B virus (HBV) infection. However, little is known about the duration of protection given by the anti-HBV vaccine. Healthcare workers represent a category at risk not only of contracting infection but also of being a source of contagion to patients. OBJECTIVES To assess individual responses to the anti-HBV vaccine and duration of protection 10 years after its administration in a cohort of healthcare workers employed by the University Hospital 'G. Martino' in Messina, Italy. METHODS One hundred and seventy medical staff who had been vaccinated following an incident carrying risk of HBV infection were included in this study. The group was followed over a 10-year period, and HBV antibody levels were assessed using an automated microparticle enzyme immunoassay. RESULTS Protective antibody levels (≥10 mIU/ml) were found in 65% of subjects who had completed the full vaccine schedule (three doses) and in 35% of subjects who had only received one or two doses of anti-HBV vaccine. Moreover, 10 years after vaccination, HBV antibody levels were inversely related to age at vaccination (P < 0.001). No differences were found between males and females. CONCLUSIONS This study, in line with the literature, shows the importance of completing the full vaccine schedule (three doses). Moreover, in order to have an effective and durable antibody response and avoid the risk of contracting HBV after an injury at work, it is important to recommend anti-HBV vaccination at a young age, ideally during childhood in accordance with the national vaccination policy.
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Affiliation(s)
- V La Fauci
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
| | - R Riso
- Postgraduate Medical School in Hygiene and Preventive Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - A Facciolà
- Postgraduate Medical School in Hygiene and Preventive Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - C Ceccio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - D Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - S Calimeri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - R Squeri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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Borzooy Z, Jazayeri SM, Mirshafiey A, Khamseh A, Mahmoudie MK, Azimzadeh P, Geravand B, Boroumand MA, Afshar M, Poortahmasebi V, Hosseini M, Streinu-Cercel A. Identification of occult hepatitis B virus (HBV) infection and viral antigens in healthcare workers who presented low to moderate levels of anti-HBs after HBV vaccination. Germs 2015; 5:134-40. [PMID: 26716102 DOI: 10.11599/germs.2015.1081] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 12/01/2015] [Accepted: 12/01/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Worldwide, healthcare workers (HCWs) show different levels of response to hepatitis B virus (HBV) vaccine. One of the factors associated with vaccine unresponsiveness may be the existence of current or past HBV infection. Regardless of the presence of HBsAg (overt infection), occult HBV infection (OBI, defined as presence of HBV DNA in the absence of HBsAg) might also account for some non- or hypo-response cases. METHODS Sera from 120 HBsAg-negative HCWs with low and moderate levels of anti-HBs, <10 IU/mL (group I) and <100 IU/mL (group II) respectively, were selected and were examined for OBI by sensitive real-time PCR regardless of HBV serological profiles. Direct sequencing on surface genes was carried out in OBI-positive cases. RESULTS Four (3.3%) were positive for OBI. All were negative for anti-HBc. Two of the positive cases had moderate levels of anti-HBs (>10 to <100 IU/mL). No significant differences were found between the two groups in terms of risk factors or serological data. No mutations were found in surface proteins of OBI cases. CONCLUSION OBI in these subjects might be due to other factors rather than presence of "a" determinant mutations. Healthcare workers with inadequate to moderate levels of anti-HBs (<100 IU/mL) following vaccination, regardless of their serological profile for HBV, should be tested for the presence of HBV DNA by sensitive molecular tests. Anti-HBc is not a reliable marker for suspicion of OBI, especially in high-risk group individuals.
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Affiliation(s)
- Zohreh Borzooy
- PhD student, Ms, Department of Infectious Diseases, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Department of Immunology and Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Jazayeri
- MD, PhD, Clinical virologist, Hepatitis B Molecular Laboratory, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbass Mirshafiey
- Ms, PhD, Head of the Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Khamseh
- Bs, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Karkhaneh Mahmoudie
- Bs, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Pedram Azimzadeh
- Ms, Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Babak Geravand
- Ms, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Ali Boroumand
- MD, Pathologist, Department of Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Afshar
- Bs, Tehran University of Medical Sciences, Mirza Kouchak Khan Hospital, Tehran, Iran
| | - Vahdat Poortahmasebi
- Ms, PhD student, Virologist, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Hosseini
- Ms, PhD, Department of Epidemiology and Biostatistics School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Adrian Streinu-Cercel
- MD, PhD, Professor, Department of Infectious Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Institute of Infectious Diseases, "Prof. Dr. Matei Balş", Bucharest, Romania
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Wang YJ, Meng ZH, Zheng XF, Tang XX, Sang LY, Du XM, Cheng YZ. The status of occupational blood and infectious body fluids exposures in five blood centres in China: a 5-year review. Transfus Med 2015; 25:399-405. [DOI: 10.1111/tme.12262] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 10/27/2015] [Accepted: 10/27/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Y.-J. Wang
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang People's Republic of China
| | - Z.-H. Meng
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang People's Republic of China
| | - X.-F. Zheng
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang People's Republic of China
| | - X.-X. Tang
- Blood Center of Ninbo city; Ningbo People's Republic of China
| | - L.-Y. Sang
- Blood Center of Shaoxin city; Shaoxin People's Republic of China
| | - X.-M. Du
- Blood Center of Jinhua city; Jinhua People's Republic of China
| | - Y.-Z. Cheng
- Blood Center of Huzhou city; Huzhou People's Republic of China
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Abstract
Reporting of percutaneous injuries (PIs) to the Chinese Exposure Prevention Information Network (EPINet) became mandatory for all public and tertiary referral hospitals in Taiwan in 2011. We have estimated the number of microbially contaminated PIs and the national PI incidence using a retrospective secondary data analysis approach to analyse 2011 data from the Chinese EPINet to determine the types of PI, mechanisms of occurrence and associated risks. The results revealed a national estimate of PIs between 6710 and 8319 in 2011. The most common incidents for physicians were disposable syringes, suture needles, and disposable scalpels; while for nurses they were disposable syringes, intravenous catheters, and lancets. About 13·0% of the source patients were seropositive for hepatitis B virus (HBV) surface antigen, 13·8% were seropositive for hepatitis C virus (HCV), and 1·1% seropositive for human immunodeficiency virus (HIV). From these results we estimate that annually 970 full-time healthcare workers (HCWs) would be exposed to HBV, 1094 to HCV, and 99 to HIV. This study improves our understanding of the mechanisms and risks of PIs and informs the development of more efficient preventive measures to protect HCWs from such injuries.
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Omar AA, Abdo NM, Salama MF, Al-Mousa HH. Occupational injuries prone to infectious risks amongst healthcare personnel in Kuwait: a retrospective study. Med Princ Pract 2015; 24:123-8. [PMID: 25531906 PMCID: PMC5588218 DOI: 10.1159/000369462] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 10/30/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The study aimed at determining the prevalence of incident occupational exposure to blood and other potentially infectious materials (OPIM) among healthcare personnel (HCP) during 2010 and at evaluating the factors associated with these incidents. SUBJECTS AND METHODS An epidemiological, retrospective, record-based study was conducted. All self-reported incidents of occupational exposure to blood and OPIM among HCP from all healthcare settings of the Kuwait Ministry of Health during 2010 were included. RESULTS The total number of the exposed HCP was 249. The prevalence of incident exposure was 0.7% of the HCP at risk. Their mean age was 32.31 ± 6.98 years. The majority were nurses: 166 (66.7%), followed by doctors: 35 (14.1%), technicians: 26 (10.4%) and housekeeping personnel: 22 (8.8%). Needle stick injury was the most common type of exposure, in 189 (75.9%), followed by sharp-object injury, mucous-membrane exposure and contact with nonintact skin. The majority of needle stick exposures, i.e. 177 (93.7%), were caused by hollow-bore needles. Exposure to blood represented 96.8%, mostly during drawing blood and the insertion or removal of needles from patients [88 (35.4%)] and when performing surgical interventions [56 (22.6%)]. Easily preventable exposures such as injuries related to 2-handed recapping of needles [24 (9.6%)] and garbage collection [21 (8.4%)] were reported. Exposures mainly occurred in the inpatient wards [75 (30.1%)] and operating theaters [56 (22.6%)]. Among the exposed HCP, 130 (52.2%) had been fully vaccinated against hepatitis B virus (HBV). CONCLUSION Needle stick injuries are the most common exposure among HCP in Kuwait, and nurses are the most frequently involved HCP category. A good proportion of exposures could be easily prevented. HBV vaccination coverage is incomplete.
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Affiliation(s)
- Abeer A. Omar
- Infection Control Directorate, Ministry of Health, Kuwait City, Kuwait
- Microbiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
- * Dr. Abeer Aly Omar, Infection Control Directorate, Ministry of Health, Kuwait, PO Box 12414, Al-Shamiya 71655 (Kuwait), E-Mail
| | - Naglaa M. Abdo
- Infection Control Unit of Kuwait Cancer Control Center, Ministry of Health, Kuwait City, Kuwait
- Department of Community Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mona F. Salama
- Infection Control Unit of Mubarak Al- Kabeer Hospital, Ministry of Health, Kuwait City, Kuwait
- Department of Microbiology and Medical Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Du Toit M, Claassen D, Le Roux A, Nel E, Van Biljon W, Joubert G, Louw VJ. Percutaneous injuries in doctors in the School of Medicine, University of the Free State: incidence, reporting and adherence to precautionary and management procedures. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2009.10873827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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21
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De Villiers HC, Nel M, Prinsloo EAM. Occupational exposure to bloodborne viruses amongst medical practitioners in Bloemfontein, South Africa. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2007.10873522] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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22
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Lee JJ, Kok SH, Cheng SJ, Lin LD, Lin CP. Needlestick and sharps injuries among dental healthcare workers at a university hospital. J Formos Med Assoc 2014; 113:227-33. [DOI: 10.1016/j.jfma.2012.05.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Revised: 05/17/2012] [Accepted: 05/18/2012] [Indexed: 10/28/2022] Open
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Amoran O, Onwube O. Infection control and practice of standard precautions among healthcare workers in northern Nigeria. J Glob Infect Dis 2014; 5:156-63. [PMID: 24672178 PMCID: PMC3958986 DOI: 10.4103/0974-777x.122010] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Healthcare-associated infections (HAIs) have been reported to be a serious problem in the healthcare services as they are common causes of illness and mortality among hospitalized patients including healthcare workers (HCWs). Compliance with these standard precautions has been shown to reduce the risk of exposure to blood and body fluids. Aims: This study therefore assesses the level of knowledge and compliance with standard precautions by the various cadre of HCWs and the factors influencing compliance in hospital environment in Nasarawa State, Northern Nigeria. Settings and Design: Nasarawa State has a current human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) prevalence rate of 10.0%, which was higher than most states in Nigeria with a high level of illiteracy and ignorance. Majority of the people reside in the rural areas while a few are found in the towns, informal settlements with no direct access to healthcare facilities are common. Materials and Methods: This study is an analytical, cross-sectional study. Proportional sampling technique was used to obtain a representative sample and a structured self-administered questionnaire was used to collect relevant information from the healthcare providers working in Nasarawa State from January to February 2009. Statistical analysis used: To describe patient characteristics, we calculated proportions and medians. For categorical variables, we compared proportions using chi-square tests. A logistic regression model was produced with infection control as outcome variable to identify associated factors. Results: A total of 421 HCWs were interviewed, Majority (77.9%) correctly describe universal precaution and infection control with 19.2, 19.2, and 28.0%, respectively unable to recognize vaccination, postexposure prophylaxis, and surveillance for emerging diseases as standard precaution for infection control. About 70.1% usually wear gloves before handling patients or patients’ care products, 12.6% reported wash their hand before wearing the gloves, 10.7% washed hands after removal of gloves, and 72.4% changed gloves after each patient. Only 3.3% had a sharp disposal system in their various workplaces. Majority (98.6%) of the respondents reported that the major reason for noncompliance to universal precautions is the nonavailability of the equipments. There was a statistically significant difference in the practice of standard precaution among those that were exposed to blood products and body fluid compared to those that had not been exposed in the last 6 months (χ2 = 3.96, P = 0.03), public healthcare providers when compared to private health workers (χ2 = 22.32, P = 0.001), among those working in secondary and tertiary facilities compared to primary healthcare centers (χ2 = 14.64, P = 0.001) and urban areas when compared to rural areas (χ2 = 4.06, P = 0.02). The only predictor of practice of standard precaution was exposure to blood and body fluid in the last 6 months odds ratio (OR) = 4.56 (confidence interval (CI) = 1.00-21.28). Conclusions: This study implies that inadequate workers’ knowledge and environment related problems, including the lack of protective materials and other equipments and utilities required to ensure safety of HCWs is a crucial issue that need urgent attention. Institution of a surveillance system for hospital acquired infection to improve consistent use of standard precautions among health workers is recommended in Nigeria and other low income countries in Africa.
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Affiliation(s)
- Oe Amoran
- Department of Community Medicine and Primary Care, College of Health Sciences, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | - Oo Onwube
- Department of Community Medicine and Primary Care, College of Health Sciences, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
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Needlestick Injuries, Short Peripheral Catheters, and Health Care Worker Risks. JOURNAL OF INFUSION NURSING 2012; 35:164-78. [DOI: 10.1097/nan.0b013e31824d276d] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Franco E, Bagnato B, Marino MG, Meleleo C, Serino L, Zaratti L. Hepatitis B: Epidemiology and prevention in developing countries. World J Hepatol 2012; 4:74-80. [PMID: 22489259 PMCID: PMC3321493 DOI: 10.4254/wjh.v4.i3.74] [Citation(s) in RCA: 235] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 03/14/2012] [Accepted: 03/17/2012] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B virus (HBV) infection is a serious global public health problem. The infection may be transmitted through sexual intercourse, parenteral contact or from an infected mother to the baby at birth and, if contracted early in life, may lead to chronic liver disease, including cirrhosis and hepatocellular carcinoma. On the basis of the HBV carrier rate, the world can be divided in 3 regions of high, medium and low endemicity. The major concern is about high endemicity countries, where the most common route of infection remains vertical transmission from mother to child. Screening of all pregnant women and passive immunization with human hepatitis B immunoglobulin are not affordable for many developing countries. The infection rate can be reduced by modifying behavior, improving individual education, testing all blood donations, assuring asepsis in clinical practice and screening all pregnant women. However, availability of a safe and efficacious vaccine and adoption of appropriate immunization strategies are the most effective means to prevent HBV infection and its consequences. The unsolved problem for poorest countries, where the number of people currently infected is high, is the cost of the vaccine. A future challenge is to overcome the social and economic hurdles of maintaining and improving a prevention policy worldwide to reduce the global burden of the disease.
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Affiliation(s)
- Elisabetta Franco
- Elisabetta Franco, Laura Zaratti, Department of Public Health, University Tor Vergata, via Montpellier 1, 00133 Rome, Italy
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Lin CC, Yang CY, Shih CT, Chen BH, Huang YL. Waning immunity and booster responses in nursing and medical technology students who had received plasma-derived or recombinant hepatitis B vaccine during infancy. Am J Infect Control 2011; 39:408-414. [PMID: 21255876 DOI: 10.1016/j.ajic.2010.07.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 07/09/2010] [Accepted: 07/09/2010] [Indexed: 12/12/2022]
Abstract
BACKGROUND The national hepatitis B virus (HBV) vaccination program was launched in Taiwan in 1984. After November 1992, a recombinant HBV vaccine replaced the plasma-derived HBV vaccine. METHODS A total of 1,812 nursing and medical technology freshman students was tested to evaluate their waning immunity toward hepatitis B. In the 2007 (2008) academic year, 438 (382) students testing nonprotective antibodies received 3 (1) booster doses of HBV vaccine according to suggestions from Taiwan's Center for Disease Control (CDC). RESULTS The seroprevalences of hepatitis B surface antigen (+) were 0.8% and 0.7% in the plasma-derived and recombinant group, respectively; for antibody to hepatitis B surface antigen (anti-HBs) (+), they were 43.2% and 33.3% (P < .001), respectively. In the 2007 freshman group, 99.1% of the students previously vaccinated with plasma-derived HBV vaccine exhibited anti-HBs seroconversion. In the 2008 freshman group, the booster dose induced anti-HBs seroconversions of 92.1% and 95.9% in the students who had received the plasma-derived and recombinant HBV vaccine, respectively (P = .370). CONCLUSION Most students exhibited signs of immune memory after receiving the booster, regardless of having received plasma-derived or recombinant HBV. Only a small number of vaccinees lost their immune memory after 16 years, suggesting that some students might benefit from boosting before proceeding to clinical practice.
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Ko NY, Yeh SH, Tsay SL, Ma HJ, Chen CH, Pan SM, Feng MC, Chiang MC, Lee YW, Chang LH, Jang JF. Intention to comply with post-exposure management among nurses exposed to blood and body fluids in Taiwan: application of the theory of planned behaviour. J Hosp Infect 2011; 77:321-6. [DOI: 10.1016/j.jhin.2010.09.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Accepted: 09/17/2010] [Indexed: 11/30/2022]
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Guest M, Kable A, McLeod M. A survey of sharps including needlestick injuries in nurses in New South Wales, Australia. ACTA ACUST UNITED AC 2010. [DOI: 10.1071/hi10019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Smith DR, Muto T, Sairenchi T, Ishikawa Y, Sayama S, Yoshida A, Townley-Jones M. Hospital safety climate, psychosocial risk factors and needlestick injuries in Japan. INDUSTRIAL HEALTH 2010; 48:85-95. [PMID: 20160412 DOI: 10.2486/indhealth.48.85] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
To investigate the interactions between safety climate, psychosocial issues and Needlestick and Sharps Injuries (NSI), a cross-sectional study was undertaken among nurses at a university teaching hospital in Japan (89% response rate). NSI were correlated with various aspects of hospital safety climate including supporting one another at work, the protection of staff against blood-borne diseases being a high management priority, managers doing their part to protect staff from blood-borne disease, having unsafe work practices corrected by supervisors, having the opportunity to use safety equipment to protect against blood-borne disease exposures, having an uncluttered work area, and having minimal conflict within their department. In conclusion, this study has demonstrated the importance of hospital safety climate in Japanese health care practice, particularly its relationship with NSI. Although the provision of safer devices remains critical in preventing injuries, ensuring a positive safety climate will also be essential in meeting these important challenges for nurses' occupational health.
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Affiliation(s)
- Derek R Smith
- WorkCover New South Wales Research Centre of Excellence, School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah 2258, Australia.
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Knowledge, attitudes and practices towards blood-borne pathogens in healthcare workers in Banja Luka, Bosnia and Herzegovina. Open Med (Wars) 2009. [DOI: 10.2478/s11536-009-0087-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AbstractExposure to blood borne pathogens poses a serious risk to healthcare workers (HCWs). This study was undertaken to investigate knowledge, attitudes and practices among HCWs towards blood borne pathogens. We carried out a cross sectional KAP (Knowledge, Attitudes and Practice) study, using self-administered questionnaire. The study population consisted of 127(23.6%) physicians, and 410 (76.4%) nurses and laboratory technicians. Factor analysis and conditional multiple logistic regression were used in statistical analysis. We found that the knowledge of the epidemiological characteristics of blood-borne infection, the risk of acquisition and available preventative measures among HCWs is insufficient. Doctors were more knowledgeable about the transmissibility of blood borne pathogens regarding sexual transmission after percutaneous exposure (odds ratio) OR=2.71; 95% (confidence interval) CI=1.51–4.84, OR=2.45; 95% CI=1.21–4.96), respectively. Nurses reported professional exposure to patient’s blood more often than doctors (OR=0.90; 95% CI=0.84–0.96). Negative attitudes towards HIV positive patients were also noted. Less than half of HCWs used appropriate barriers (gloves, mask, and glasses) to protect them regularly. The compulsory preventive measures implied by the results of this study are continuous education, immunization against Hepatitis B, implementing Standard Precautions, as well as the development of written guidelines on the prevention of blood-borne infections.
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Organizational climate and its relationship with needlestick and sharps injuries among Japanese nurses. Am J Infect Control 2009; 37:545-50. [PMID: 19272674 DOI: 10.1016/j.ajic.2008.11.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2008] [Revised: 11/04/2008] [Accepted: 11/05/2008] [Indexed: 12/12/2022]
Abstract
BACKGROUND Although certain aspects of organizational climate have been shown to influence needlestick and sharps injuries (NSI) among nurses, this issue has not been adequately investigated in Japan. METHODS Our study involved a modified version of the Hospital Safety Climate Scale, which was distributed to a large cross section of nurses in a Japanese teaching hospital. RESULTS Various aspects of safety climate were associated with a reduced NSI risk, such as being involved in health and safety matters (odds ratio [OR], 0.13; 95% confidence interval [CI]: 0.02-0.65) and being properly trained in risk control procedures (OR, 0.32; 95% CI: 0.12-0.78). Nurses working in departments in which health and safety information was readily available were more likely to report any NSI they sustained (OR, 4.91; 95% CI: 1.30-18.51), whereas nurses working in departments with minimal conflict were less likely to underreport their NSI (OR, 0.45; 95% CI: 0.22-0.87). CONCLUSION Overall, this study suggests that hospital safety climate has an important influence on NSI injury rates and reporting behavior among Japanese nurses. Given the multifaceted nature of identified risk, a comprehensive approach to infection control is clearly required and one that encompasses preventive strategies in both the cultural and physical domains.
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Ho HH, Tsai TY, Lin CL, Wu SY, Li CY. Prevalence and Associated Factors for Metabolic Syndrome in Taiwanese Hospital Employees. Asia Pac J Public Health 2009; 23:307-14. [DOI: 10.1177/1010539509340911] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Metabolic syndrome (MS) is most important because of its association with subsequent development of cardiovascular diseases. However, few studies about the prevalence of MS among hospital employees had been published.The aims of our study were to examine the prevalence of MS and associated factors. The up-to-date health examination data of 1,400 hospital employees of a medical center in North Taiwan were included, and MS was defined according to the criteria that were promulgated by the National Department of Health. The overall prevalence of MS was 10.3% (21.8% males, 7.0% females). Associated factors included male gender, aging, low education, administrative employees, abnormal hemoglobin concentration, and abnormal liver function indexes. According to our study, the prevalence of MS in hospital employees was lower than the general population, and the findings could be a reference to make more efficient health-promotion programs to lower the prevalence of MS in hospital employees.
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Affiliation(s)
- Hsueh-Hua Ho
- Departments of Nursing (HHH, TYT), Management (SYW), and Internal Medicine (CLL), Cathay General Hospital; and Department of Health Care Management, National Taipei College of Nursing (CYL), Taipei, Taiwan
| | - Tzung-Yi Tsai
- Departments of Nursing (HHH, TYT), Management (SYW), and Internal Medicine (CLL), Cathay General Hospital; and Department of Health Care Management, National Taipei College of Nursing (CYL), Taipei, Taiwan
| | - Ching-Ling Lin
- Departments of Nursing (HHH, TYT), Management (SYW), and Internal Medicine (CLL), Cathay General Hospital; and Department of Health Care Management, National Taipei College of Nursing (CYL), Taipei, Taiwan,
| | - Shu-Yuan Wu
- Departments of Nursing (HHH, TYT), Management (SYW), and Internal Medicine (CLL), Cathay General Hospital; and Department of Health Care Management, National Taipei College of Nursing (CYL), Taipei, Taiwan
| | - Chung-Yi Li
- Departments of Nursing (HHH, TYT), Management (SYW), and Internal Medicine (CLL), Cathay General Hospital; and Department of Health Care Management, National Taipei College of Nursing (CYL), Taipei, Taiwan
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Zafar A, Habib F, Hadwani R, Ejaz M, Khowaja K, Khowaja R, Irfan S. Impact of infection control activities on the rate of needle stick injuries at a tertiary care hospital of Pakistan over a period of six years: an observational study. BMC Infect Dis 2009; 9:78. [PMID: 19480683 PMCID: PMC2692861 DOI: 10.1186/1471-2334-9-78] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Accepted: 05/29/2009] [Indexed: 01/25/2023] Open
Abstract
Background Accidental exposure to blood and body fluids is frequent among health care workers. They are at high risk of nosocomial transmission of blood borne pathogens due to injuries caused by used sharps. We are reporting impact of surveillance and educational program on the rate of needle stick injuries among health care workers at a tertiary care hospital in Pakistan. Methods At Aga Khan University Hospital sharp injuries are reported to infection control office. To reduce these incidents a quality improvement project was inducted in the year 2005. Health care workers were educated; surveillance data from 2002 to 2007 was analyzed and compared with various risk factors. Results During study period 1382 incidents were reported. Junior doctors sustained highest number of injuries (n = 394; 28.5%) followed by registered nurses (n = 283; 20.4%). Highest number of incidents was reported during blood collection (19%). An increasing trend was observed in the pre intervention years (2002–04). However noticeable fall was noted in the post intervention period that is in year 2006 and 2007. Major decline was noted among nurses (from 13 to 5 NSI/100 FTE/year). By relating and comparing the rates with various activities directly linked with the use of syringes a significant reduction in incidents were found including; hospital admissions (p-value 0.01), surgeries and procedures performed (p = 0.01), specimens collected in the laboratory (p = 0.001) and patients visits in clinics (p = 0.01). Conclusion We report significant reduction in needle stick injuries especially during post intervention study period. This is being achieved by constant emphasis on improving awareness by regular educational sessions, implemented as a quality improvement project.
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Affiliation(s)
- Afia Zafar
- Department of Pathology and Microbiology, Aga Khan University Hospital, Karachi, Pakistan.
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Occupational Exposure to Sharp Injuries Among Jordanian Health Care Workers. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2009. [DOI: 10.1097/ipc.0b013e31819b8d10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Shiao JS, McLaws M, Lin M, Jagger J, Chen C. Chinese EPINet and Recall Rates for Percutaneous Injuries: An Epidemic Proportion of Underreporting in the Taiwan Healthcare System. J Occup Health 2009; 51:132-6. [DOI: 10.1539/joh.l8111] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Judith Shu‐Chu Shiao
- Department of NursingNational Taiwan University, College of Medicine and NTU HospitalTaiwan
| | - Mary‐Louise McLaws
- NSW Hospital Infection, Epidemiology & Surveillance Unit, School of Health Services Management, The University of New South WalesAustralia
| | - Ming‐Hsiu Lin
- Institute of Occupational Safety and Health, Council of Labor Affairs, Executive YuanTaiwan
| | - Janine Jagger
- Department of Internal MedicineUniversity of Virginia Health SystemUSA
| | - Chiou‐Jong Chen
- Institute of Occupational Safety and Health, Council of Labor Affairs, Executive YuanTaiwan
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Zhang M, Wang H, Miao J, Du X, Li T, Wu Z. Occupational exposure to blood and body fluids among health care workers in a general hospital, China. Am J Ind Med 2009; 52:89-98. [PMID: 19016263 DOI: 10.1002/ajim.20645] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To understand current status of occupational exposure to blood and body fluids (BBF), and awareness of knowledge about occupational bloodborne pathogen exposures and universal precaution among hospital-based health care workers (HCWs). METHODS A cross-sectional study was conducted during April to May 2004 to study incidence of occupational exposure to BBF among 1,144 hospital-based HCWs. RESULTS The total incidence and the average number of episodes exposure to BBF was 66.3/100 HCWs per year and 7.5 per person per year in the past year, respectively. The incidence (per 100/HCWs per year) and the average number of episodes (per HCW per year) of percutaneous injury (PCI), mucous-membrane exposure (MME), and exposure to BBF by damaged skin was 50.3 and 1.8; 34.4 and 1.7; and 37.9 and 4.0, respectively. The leading incidence and the average number of episodes of PCI occurred in delivery room (82.6 and 1.8). The highest percentage of PCI's that occurred during the previous 2 weeks occurred during a surgical operation (22.8%). Of all sharp instruments, the suture needle contributed the highest percentage of PCI's (24.7%) among HCWs in the last 2 weeks. Over two-thirds (68.3%) of respondents were immunized with Hepatitis B vaccine; less than one-half (47%) of HCWs wore gloves while doing procedures on patients. The respondents demonstrated a lack of knowledge regarding transmission of bloodborne diseases and universal precautions. CONCLUSIONS Risk for potential exposure to BBF appears high in HCWs, and almost all of episodes are not reported. It is urgent to establish the Guideline for Prevention and Control of Occupational Exposure to Bloodborne Pathogens among HCWs. Am. J. Ind. Med. 52:89-98, 2009. (c) 2008 Wiley-Liss, Inc.
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Affiliation(s)
- Min Zhang
- National Institute for Occupational Health and Poison Control, China CDC, Beijing, China
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Huang IC, Yang CH, Sung FC, Chen HF, Li CY. Incidence of ambulatory care visits among female nursing staff in Taiwan: a claim data-based retrospective cohort analysis. J Clin Nurs 2008; 18:1207-16. [PMID: 19077026 DOI: 10.1111/j.1365-2702.2008.02461.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To investigate the incidence of ambulatory care visits among female nursing staff in Taiwan. BACKGROUND Literature frequently indicates increased risks of needlestick injury and musculoskeletal disorders among practicing nurses. With increased workload in the healthcare system, nursing staff could also be vulnerable to other diseases. DESIGN A retrospective cohort study design including 27,624 female nursing staff with a contract with Taiwan's National Health Insurance (NHI) programme between 2001-2004. METHODS Information on ambulatory care visits was retrieved from the NHI claim data. Comparison groups included other female medical personnel and active non-medical working women. Incidence rates of ambulatory care visits were calculated using person-year approach. Rate ratio adjusted for potential confounders was estimated from the Poisson regression model. RESULTS The nurse cohort developed a total of 781,352 ambulatory care visits, representing an incidence rate of 85,285/10(4) person-years. Compared with the other female medical personnel, female nurses had significantly elevated incidence of genitourinary [adjusted rate ratio (ARR) = 1.20], circulatory (ARR = 1.14), mental (ARR = 1.12), infectious/parasitic diseases (ARR = 1.11) and pregnancy/birth complications (ARR = 1.07). Significantly increased incidence sustained for both infectious/parasitic diseases and pregnancy/birth complications as the nurse cohort was compared with the active non-medical working women. The nurses, on the contrary, had significantly lower ARRs than the comparison groups of neoplasm, injury, metabolic, respiratory, digestive and musculoskeletal diseases. CONCLUSIONS Female nurses had increased incidences of certain types of systemic illness when compared with other medical personnel and with women working outside of the health industry. Whether the findings found in this study were region specific or could be applicable to other nations, requires further investigations. RELEVANCE TO CLINICAL PRACTICE Policy makers and hospital administrators must not overlook nurses' potentially unseen health problems. A mandatory periodical physical examination for nursing staff must be considered.
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Affiliation(s)
- I-Chin Huang
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, Hsinchuanag, Taipei, Taiwan
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Sukriti, Pati NT, Sethi A, Agrawal K, Agrawal K, Kumar GT, Kumar M, Kaanan AT, Sarin SK. Low levels of awareness, vaccine coverage, and the need for boosters among health care workers in tertiary care hospitals in India. J Gastroenterol Hepatol 2008; 23:1710-5. [PMID: 18761556 DOI: 10.1111/j.1440-1746.2008.05483.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND AIM The risk of acquiring hepatitis B virus (HBV) infection through exposure to blood or its products is highest amongst health care workers (HCWs). Despite potential risks, a proportion of HCWs never get vaccinated. India is second to China in the numbers of people with chronic HBV. This study aimed to investigate the vaccination practices and the prevalence of HBV infection in HCWs in India. METHODS A total of 2162 HCWs were screened for the presence of serological markers of HBV and hepatitis C virus (HCV). Occult HBV infection was tested by detection of HBV-DNA for surface and core regions by nested polymerase chain reaction in HBsAg-negative and IgG anti-hepatitis core antigen-positive subjects. RESULTS Only 1198 (55.4%) of the 2162 HCWs screened had been vaccinated; and 964 (44.6%) were not vaccination-status conscious; of these HCWs, 600 (27.7%) had never been vaccinated and 364 (16.4%) were unaware of their vaccination status. Protective (> 10 IU/mL) anti-hepatitis B surface (anti-HBs) antigen titers were seen in only 61.7%. The anti-HBs titers were found to be lower with the passage of time; the median anti-HBs titers in subjects who were vaccinated > 10 years ago were significantly lower than those who had been vaccinated < 5 years ago (P < 0.001). One percent of HCWs were HBsAg-positive, and 24.7% of 700 HCWs screened had past exposure (IgG-anti-HBc-positive). Occult HBV was detected in 5% of 120 positive subjects with past exposure; all had anti-HBs titers > 10 IU/mL. CONCLUSIONS Even today, 28% HCWs in India are unvaccinated and 17% are unaware of their vaccination status. This data suggests that use of hepatitis B immune globulin be mandatory in needle-pricked HCWs in India, and that implementation of awareness strategies is urgent. Since the anti-HBs titers decline in a fair proportion, there is justification for giving a booster dose of vaccine 10 years after primary vaccination to HCWs in India.
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Affiliation(s)
- Sukriti
- Department of Gastroenterology, G.B. Pant hospital, New Dehli, India
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Lopes ACS, Oliveira AC, Silva JT, Paiva MHRS. Adesão às precauções padrão pela equipe do atendimento pré-hospitalar móvel de Belo Horizonte, Minas Gerais, Brasil. CAD SAUDE PUBLICA 2008; 24:1387-96. [DOI: 10.1590/s0102-311x2008000600019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2007] [Accepted: 11/08/2007] [Indexed: 11/22/2022] Open
Abstract
Estudo transversal com profissionais do Serviço de Atendimento Pré-hospitalar de Belo Horizonte, Minas Gerais, Brasil, com o objetivo de avaliar a adesão às precauções padrão. Instrumento constou de questões sobre conhecimento, atitude e fatores facilitadores à adesão das precauções. Para verificar a adesão considerou-se percentual de adequação: > 75% de respostas corretas. Condutores apresentaram menor e médicos maior grau de conhecimento. No relato das atitudes, profissionais não alcançaram adequação para uso de máscara facial, óculos e equipamento proteção individual (EPI), e, condutores relataram atitude inadequada para todos itens. Na análise univariada, categoria profissional, sexo e unidade de lotação foram associados à adoção das precauções. Já na multivariada, apenas categoria profissional (condutor e técnico/auxiliar enfermagem). Fatores facilitadores mais citados para melhorar adesão foram: treinamentos sobre infecções, riscos ocupacionais e uso de EPI; reuniões periódicas de equipe; e criação de central para limpeza, desinfecção e esterilização de material. Profissionais do Serviço de Atendimento Pré-hospitalar demonstraram atitudes compatíveis com conhecimento. No entanto, a profissão interferiu no conhecimento das medidas de precaução e no relato de atitudes adequadas.
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Shiao JSC, Lin MS, Shih TS, Jagger J, Chen CJ. National incidence of percutaneous injury in Taiwan healthcare workers. Res Nurs Health 2008; 31:172-9. [PMID: 18196578 DOI: 10.1002/nur.20240] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We established a standardized surveillance system using the Chinese Exposure Prevention Information Network to estimate the frequency of percutaneous injuries (PCIs) in Taiwanese healthcare workers (HCWs). Fourteen hospitals employing 8,132 HCWs participated and a total of 583 PCIs were reported. The annual number was estimated to be 8,058 PCIs per hospital size, 8,100 per HCWs, and 8,286 per inpatient-day; indicating similar estimates using different denominators. The estimated annual frequency of pathogen-specific PCIs was 1,168 for hepatitis B, 1,263 for hepatitis C, and 59 for HIV. This study documents the annual incidence of PCI among HCWs showing important potential exposure to viral hepatitis and HIV in Taiwan.
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Affiliation(s)
- Judith S C Shiao
- Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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Lin YP, Hong O, Yeh MC. Occupational Health Nursing Practice, Education, and Research in Taiwan. ACTA ACUST UNITED AC 2008; 56:151-8. [DOI: 10.3928/08910162-20080401-06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This article describes occupational health nursing practice, education, research, and future perspectives in Taiwan. It also provides a brief overview of major occupational health and safety problems, laws and regulations, and organizations in Taiwan.
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Sharps Injury and Body Fluid Exposure Among Health Care Workers in an Australian Tertiary Hospital. Asia Pac J Public Health 2008; 20:139-47. [DOI: 10.1177/1010539507312235] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To examine sharps injury and body fluid exposure among health care workers, a descriptive epidemiological study was conducted in a 1000-bed tertiary hospital between 2000 and 2003 using surveillance data of all reported sharps injuries and body fluid exposures. A total of 640 sharps injuries and body fluid exposures were reported from hospital and nonhospital staff, although no seroconversions to HIV, hepatitis B virus, or hepatitis C virus were observed during the study period. Nurses reported 47% of sharps injuries and 68% of body fluid exposures, medical staff reported 38% and 16%, and other nonmedical staff notified 5% and 4%, respectively, while nonhospital staff reported the rest. Hollow-bore needles accounted for 56% of sharps injuries, while 11% of the incidents were sustained during recapping and inappropriate disposal. Further research into Australian work practices, disposal systems, education strategies, and the use of safety sharps should be emphasized to implement strategies to reduce work-related injuries among health care workers.
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Singru SA, Banerjee A. Occupational exposure to blood and body fluids among health care workers in a teaching hospital in mumbai, India. Indian J Community Med 2008; 33:26-30. [PMID: 19966992 PMCID: PMC2782223 DOI: 10.4103/0970-0218.39239] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2007] [Accepted: 12/01/2007] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Exposure to blood and body fluids is one of the hidden hazards faced by health care workers (HCWs). The objective of the present study was to estimate the incidence of such exposure in a teaching hospital. MATERIALS AND METHODS A cross-sectional study among a random sample of residents, interns, nurses and technicians (n = 830) was carried out in a teaching hospital to estimate the incidence of exposure to blood and body fluids in the preceding 12-month period. Self-reported occurrence and the circumstances of the same were recorded by face-to-face interviews using a semi-structured questionnaire. RESULTS The response rate to the study was 89.76%. Occupational exposure to blood and body fluids in the preceding 12 months was reported by 32.75% of the respondents. The self-reported incidence was the highest among the nurses. Needle-stick injury was the most common mode of such exposures (92.21% of total exposures). Index finger and thumb were the commonest sites of exposure. Only 50% of the affected individuals reported the occurrence to concerned hospital authorities. Less than a quarter of the exposed persons underwent post-exposure prophylaxis (PEP) against HIV, although the same was indicated in about 50% of the affected HCWs based on the HIV status of the source patient. CONCLUSIONS Occupational exposure to blood and body fluids was a common occurrence in the study sample. There was gross under-reporting of such incidents leading to a lack of proper PEP against HIV in 50% of those in whom the same appeared to be indicated.
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Affiliation(s)
- Samir A Singru
- Department of Community Medicine, Dr. D.Y. Patil Medical College, Pune - 411 018, Maharashtra, India
| | - Amitav Banerjee
- Department of Community Medicine, Dr. D.Y. Patil Medical College, Pune - 411 018, Maharashtra, India
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Low seroprevalence of hepatitis B surface antibody among nursing students in Taiwan: An implication for boosting. Vaccine 2007; 25:8508-11. [DOI: 10.1016/j.vaccine.2007.10.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Revised: 10/01/2007] [Accepted: 10/07/2007] [Indexed: 11/23/2022]
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Askarian M, Shaghaghian S, McLaws ML. Needlestick injuries among nurses of Fars province, Iran. Ann Epidemiol 2007; 17:988-92. [PMID: 17923420 DOI: 10.1016/j.annepidem.2007.07.106] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2007] [Revised: 07/17/2007] [Accepted: 07/21/2007] [Indexed: 11/16/2022]
Abstract
PURPOSE A prevalence survey was performed to estimate the magnitude and predictors for needlestick injury (NSI) in nurses of Fars province hospitals. METHODS Questionnaires were distributed in 52 hospitals to a stratified random sample of 2,118 (46.3%) nurses between April and September 2005 to collect self-reported NSI in the past 12- months. RESULTS Of the 1,555 nurses who returned a completed questionnaire, 49.6% (95% confidence interval [95 CI] 47.1%-52.1%) recalled at least one sharps injury, of which 52.6% were classified as NSI. Just over one fourth (26.3%; 95 CI 24.1%-28.6%, 409/1,555) of respondents sustained at least one NSI, 75.6% (95 CI 71.1%-79.6%) recalled having sustained between 1 and 4 injuries in the past 12-months, of which 72.2% involved a hollow-bore needle and 95.1% of injuries involved fingers. Predictors of NSI included being a registered nurse (odds ratio [OR] 1.6, 95% CI 1.1-2.3) or midwife (OR 2.4, 95% CI 1.4-3.9) compared with nurse managers, being employed in a hospital located in other cities smaller than Shiraz (OR 1.4, 95% CI 1.1-1.8). Nurses who reported a previous contaminated NSI were less likely to sustain a further injury (OR 0.3, 95% CI 0.2-0.4). CONCLUSION The prevalence of NSI in Iranian nurses is high, with the majority of injured staff having sustained up to 4 NSIs in a 12-month period. Nearly all NSIs were high-risk injuries involving a hollow-bore needle. Providing nursing staff with safety-engineered devices, including retractable syringes when hollow-bore needles are to be used, will be an important step toward reducing our NSI epidemic.
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Affiliation(s)
- Mehrdad Askarian
- Department of Community Medicine, Shiraz University of Medical Sciences, The University of New South Wales, Sydney, Australia.
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Kubitschke A, Bader C, Tillmann HL, Manns MP, Kuhn S, Wedemeyer H. Verletzungen mit Hepatitis-C-Virus-kontaminierten Nadeln. Internist (Berl) 2007; 48:1165-72. [PMID: 17684714 DOI: 10.1007/s00108-007-1912-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The risk of infection after injury with a needle contaminated with hepatitis C virus (HCV) is thought to be about 3%, but this assumption is mainly based on studies published in the 1990's, which were limited by small sample sizes and insensitive HCV-RNA assays. We therefore investigated needle injuries at the Hannover Medical School over a period of 6 years and performed a systematic review of the literature identifying 22 studies with a total of 6,956 injuries with HCV contaminated needles. Between 2000 and 2005, 1,431 occupational injuries were reported at our institution and two-thirds were needle injuries. Index patients were known to be HCV infected in 166 cases but there were no cases of HCV seroconversion during follow-up. Analysis of published data showed seroconversion rates of 0-10.3% with a mean of 0.75% (52/6,956). The risk of acute HCV infection was lower in Europe with 0.42% compared to Eastern Asia with 1.5% of cases where an HCV viremia was reported during follow-up. In summary, the risk of acquiring an HCV infection after a needlestick injury is lower than frequently reported. Worldwide differences in HCV seroconversion rates suggest that genetic factors might provide some level of natural resistance against HCV. Future studies should address not only the frequency of acute hepatitis but also factors associated with a higher risk of becoming HCV infected.
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Affiliation(s)
- A Kubitschke
- Abteilung für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str 1, 30625, Hannover, Germany
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Abstract
Although needlestick and sharps injuries (NSI) are known to affect professional nurses at high rates, most studies depend on officially reported data and few have been undertaken in Korea. Thus, we surveyed a large cross-section of nurses from a hospital in Gangneung (response rate, 97.9%). Four hundred thirty-two incidents of NSI were reported by 263 nurses (79.7%) in the previous 12-month period (average, 1.31 events/nurse/year). Syringe needles were the most common devices, affecting 67.3% and comprising 52% of all NSI events. Sixty percent of all NSI events involved contaminated devices. Opening an ampoule or vial was the most common cause (affecting 35.2% of all nurses and accounting for 15.9% of all NSI events). Logistic regression indicated that nurses working in "other" departments were 5.4 times more likely to suffer any NSI (odds ratio [OR] = 5.4; 95% confidence interval [95% CI] = 2.0-15.2; P < .05) and 4.7 times more likely to incur a syringe-needle injury than nurses in intensive care units or inpatient departments (OR = 4.7; 95% CI = 2.0-11.6; P < .05). Younger-than-average nurses (< 27 years) were 4.5 times more likely to suffer NSI (OR = 4.5; 95% CI = 1.7-12.6; P < .05) and 3.1 times more likely to incur a syringe-needle injury (OR = 3.1; 95% CI = 1.4-7.0; P < .05). Working mixed shifts also increased the risk of any NSI (OR = 4.0; 95% CI = 1.7-10.4; P < .05) or syringe-needle NSI (OR = 4.4; 95% CI = 2.0-10.1; P < .05). Overall, our study suggests that NSI are common among Korean hospital nurses and represent a significant occupational burden for this large Asian demographic. Intervention and preventive strategies to help reduce their NSI exposures are urgently required in this country.
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Kubitschke A, Bahr MJ, Aslan N, Bader C, Tillmann HL, Sarrazin C, Greten T, Wiegand J, Manns MP, Wedemeyer H. Induction of hepatitis C virus (HCV)-specific T cells by needle stick injury in the absence of HCV-viraemia. Eur J Clin Invest 2007; 37:54-64. [PMID: 17181568 DOI: 10.1111/j.1365-2362.2007.01753.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The risk of hepatitis C virus (HCV) infection after occupational exposure is low with seroconversion rates between 0 and 5%. However, factors associated with natural resistance against HCV after needle stick injury are poorly defined. HCV-specific T-cell responses have been described in cross-sectional studies of exposed HCV-seronegative individuals. MATERIALS AND METHODS In this study, we prospectively followed 10 healthcare professionals who experienced an injury with an HCV-contaminated needle. Blood samples were taken on the day or the day after the event and at different time points during follow-up for up to 32 months. HCV-specific T-cell responses were investigated directly ex vivo and in T-cell lines. RESULTS None of the individuals became positive for HCV-RNA in serum tested with the highly sensitive transcription-mediated amplification (TMA)-assay or in peripheral blood mononuclear cells (PBMC). All of them remained anti-HCV negative throughout follow-up. At the time of injury, HCV-specific CD4+ T-cell responses were already detectable in two individuals and became detectable thereafter in three additional persons. Transient HCV-specific CD8+ T-cell responses developed in two HLA-A2 positive patients, which became negative until the most recent follow-up after 5 and 17 months, respectively. CONCLUSION We demonstrate the development of HCV-specific T cells in HCV-exposed individuals after needle stick injury indicating subinfectious exposure to HCV. T-cell immunity against HCV may contribute to the low prevalence of HCV in medical healthcare professionals in Western countries.
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Affiliation(s)
- A Kubitschke
- Department of Gastroenterology, Hannover Medical School, Hannover, Germany
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Pati NT, Hissar S, Agrawal K, Rani R, Sarin SK. Decrease in CD4+ T lymphocyte proliferation responses and enhanced CD150 cell expression in health care workers non-responsive to HBV vaccine. Vaccine 2006; 25:1848-55. [PMID: 17240488 DOI: 10.1016/j.vaccine.2006.10.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2006] [Revised: 10/16/2006] [Accepted: 10/18/2006] [Indexed: 01/19/2023]
Abstract
The non-response to hepatitis B vaccine in health care workers (HCWs) is reported to vary between 5 and 40%. The underlying cellular and molecular events for unresponsiveness to HBV vaccine have not yet been characterized at any great extent. In the current study, we examined the CD150 surface expression levels and its association with polyclonally activated and HBV specific stimulated cellular proliferations in responders and non-responders. CD150 was identified as upregulated expression marker with suppressive regulatory cell function on all activated T cells by gene chip analysis. We found the overall weak cellular proliferation in response to specific and non-specific agents in non-responders. This is significantly associated with enhanced surface expression of CD150 in the non-responders. A strong expression of CD150 with weak cellular proliferation could be used as a predictive marker for non-responsiveness.
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