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Battail T, Fort E, Denis MA, Fassier JB, Bonneterre V, Dutheil F, Fontana L, Paul A, Botokeky E, Massardier-Pilonchéry A. Underreporting of occupational blood and body fluid exposure in French university hospitals in 2017. Work 2022; 73:1393-1403. [DOI: 10.3233/wor-210007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Occupational blood and body fluid exposures (OBBFEs) are one of the biological risks run by health professionals, especially in hospitals. OBJECTIVE: The objectives of this study were to assess the occurrence and reporting of occupational blood and body fluid exposures (OBBFEs) in university hospital medical staff and to investigate factors associated to declared OBBFE and factors associated to reported OBBFE. METHODS: A self-administered questionnaire has been e-mailed to all junior and senior medical staff in four university hospital centers in one administrative region of France in 2017. RESULTS: 292 of the 1,228 respondents declared at least one OBBFE. More than two-thirds (70.2%) were under-reporters and more than half (53.8%) non-reporters. Younger subjects, surgical specialties and other associated work accidents were risk factors for OBBFE. Considering the reporting procedure too complex was a risk factor for underreporting. CONCLUSIONS: Underreporting by hospital medical staff was a persistent phenomenon, with a high rate. The OBBFE reporting procedure needs rethinking.
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Affiliation(s)
- Thibault Battail
- Faculty of Health Charles Mérieux Lyon Sud, University of Lyon, Claude Bernard Lyon 1 University, Oullins, France
| | - Emmanuel Fort
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, UMRESTTE, UMR T, Lyon, France
| | - Marie-Agnès Denis
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, UMRESTTE, UMR T, Lyon, France
- Hospices Civils de Lyon, Department of Occupational Medicine and Occupational Diseases, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Jean-Baptiste Fassier
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, UMRESTTE, UMR T, Lyon, France
- Hospices Civils de Lyon, Department of Occupational Medicine and Occupational Diseases, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Vincent Bonneterre
- “Environment and Health Prediction in Populations” Team, University of Grenoble, Grenoble Alpes University, TIMC-IMAG, UMR, La Tronche, France
- Department of Preventive and Occupational Medicine, University Hospital of Grenoble Alpes (CHU), Grenoble, France
| | - Frédéric Dutheil
- “Physiological and Psychosocial Stress” Team, University of Clermont-Ferrand, Clermont Auvergne University, LAPSCO, UMR, Clermont-Ferrand, France
- Occupational Diseases Center, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France
| | - Luc Fontana
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, Université Jean Monnet, UMRESTTE, UMR T, St Etienne, France
- Department of Preventive and Occupational Medicine, University Hospital of St Etienne (CHU), St Etienne, France
| | - Adèle Paul
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, UMRESTTE, UMR T, Lyon, France
- Hospices Civils de Lyon, Department of Occupational Medicine and Occupational Diseases, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Elsa Botokeky
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, UMRESTTE, UMR T, Lyon, France
- Hospices Civils de Lyon, Department of Occupational Medicine and Occupational Diseases, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Amélie Massardier-Pilonchéry
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, UMRESTTE, UMR T, Lyon, France
- Hospices Civils de Lyon, Department of Occupational Medicine and Occupational Diseases, Centre Hospitalier Lyon Sud, Pierre Bénite, France
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Manheim D, Lewis G. High-risk human-caused pathogen exposure events from 1975-2016. F1000Res 2022; 10:752. [PMID: 35903214 PMCID: PMC9274012 DOI: 10.12688/f1000research.55114.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 11/20/2022] Open
Abstract
Biological agents and infectious pathogens have the potential to cause very significant harm, as the natural occurrence of disease and pandemics makes clear. As a way to better understand the risk of Global Catastrophic Biological Risks due to human activities, rather than natural sources, this paper reports on a dataset of 71 incidents involving either accidental or purposeful exposure to, or infection by, a highly infectious pathogenic agent. There has been significant effort put into both reducing the risk of purposeful spread of biological weapons, and biosafety intended to prevent the exposure to, or release of, dangerous pathogens in the course of research. Despite these efforts, there are incidents of various types that could potentially be controlled or eliminated by different lab and/or bioweapon research choices and safety procedures. The dataset of events presented here was compiled during a project conducted in 2019 to better understand biological risks from anthropic sources. The events which are listed are unrelated to clinical treatment of naturally occurring outbreaks, and are instead entirely the result of human decisions and mistakes. While the events cover a wide range of cases, the criteria used covers a variety of events previously scattered across academic, policy, and other unpublished or not generally available sources.
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Affiliation(s)
| | - Gregory Lewis
- Future of Humanity Institute, University of Oxford, Oxford, UK
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Takahashi S, Arakawa S, Ishikawa K, Kamei J, Kobayashi K, Shigemura K, Takahashi S, Hiyama Y, Hamasuna R, Hayami H, Yazawa S, Yasuda M, Togo Y, Yamamoto S, Wada K, Watanabe T. Guidelines for Infection Control in the Urological Field, including Urinary Tract Management (revised second edition). Int J Urol 2021; 28:1198-1211. [PMID: 34480379 DOI: 10.1111/iju.14684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/17/2021] [Indexed: 01/08/2023]
Abstract
The Committee for the Development of Guidelines for Infection Control in the Urological Field, including Urinary Tract Management of the Japanese Urological Association, together with its systematic review team and external reviewers, have prepared a set of practice guidelines, an abridged version of which is published herein. These guidelines cover the following topics: (i) foundations of infection control, standard precautions, route-specific precautions, and occupational infection control (including vaccines); (ii) the relationship between urologists and infection control; (iii) infection control in urological wards and outpatient clinics; (iv) response to hepatitis B virus reactivation; (v) infection control in urological procedures and examinations; (vi) prevention of infections occurring in conjunction with medical procedures and examinations; (vii) responses to urinary tract tuberculosis and bacillus Calmette-Guérin; (viii) aseptic handling, cleaning, disinfection, and sterilization of urinary tract endoscopes (principles of endoscope manipulation, endoscope lumen cleaning, and disinfection); (ix) infection control in the operating room (principles of hand washing, preoperative rubbing methods, etc.); (x) prevention of needlestick and blood/bodily fluid exposure and response to accidental exposure; (xi) urinary catheter-associated urinary tract infection and purple urinary bag syndrome; and (xii) urinary catheter-associated urinary tract infections in conjunction with home care. In addressing these topics, the relevant medical literature was searched to the extent possible, and content was prepared for the purpose of providing useful information for clinical practice.
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Affiliation(s)
- Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Soichi Arakawa
- Department of Urology, Sanda City Hospital, Sanda, Hyogo, Japan
| | - Kiyohito Ishikawa
- Department of Quality and Safety in Healthcare, Division of Infection Control and Prevention, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Jun Kamei
- Department of Urology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Kanao Kobayashi
- Department of Urology, Japan Organization of Occupational Health and Safety, Chugoku Rosai Hospital, Kure, Hiroshima, Japan
| | | | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Ryoichi Hamasuna
- Department of Urology, Federation of National Public Service and Affiliated Personal Mutual Aid Association, Shin-Kokura Hospital, Kitakyushu, Fukuoka, Japan
| | - Hiroshi Hayami
- Blood Purification Center, Kagoshima University Hospital, Kagoshima, Japan
| | - Satoshi Yazawa
- Yazawa Clinic, Tokyo, Japan.,Keio University School of Medicine, Tokyo, Japan
| | - Mitsuru Yasuda
- Center for Nutrition Support and Infection Control, Gifu University Hospital, Gifu, Japan
| | - Yoshikazu Togo
- Department of Urology, Kyowakai Medical Corporation Kyoritsu Hospital, Kawanishi, Hyogo, Japan
| | - Shingo Yamamoto
- Urology and Kidney Transplant Center, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Koichiro Wada
- Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Toyohiko Watanabe
- Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
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Gomes SCS, Ferreira TF, Caldas ADJM. Temporal trends in occupational accidents involving exposure to biological material in Brazil, 2010 to 2016. Rev Bras Med Trab 2021; 19:43-50. [PMID: 33986779 PMCID: PMC8100764 DOI: 10.47626/1679-4435-2021-565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction: Accidents involving biological material are the main cause of occupational exposure among health care professionals. Objectives: To analyze trends in the number of accidents involving exposure to biological material among health care workers in Brazil, in the period of 2010 to 2016. Methods: This was an ecological study based on secondary data on occupational accidents involving biological material reported to the Information System for Notifiable Diseases (Sistema Nacional de Agravos de Notificação). The data were analyzed using descriptive methods, followed by a calculation of incidence rates per 1,000 workers per year. Lastly, trend analysis was performed using Prais-Winsten regression. Results: A total of 243,621 accidents involving exposure to biological materials were reported among health professionals in the study period. The highest incidence rate (16.74 accidents per 1,000 workers per year) was observed in 2014. Regional analyses showed that Midwestern, South and Southeast Brazil had higher incidence rates than other regions of the country. At the state level, the highest rates were observed in Roraima, Rio Grande do Norte, Alagoas, Goiás, Minas Gerais, São Paulo, Paraná, and Santa Catarina. National incidence rates of occupational accidents with exposure to biological material in health care workers had a stable trend over the study period. Conclusions: In Brazil, health care workers are disproportionately affected by occupational accidents with exposure to biological material. The present findings, together with other indicators, cast doubt on the stability of these figures over time.
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Affiliation(s)
- Sâmea Cristina Santos Gomes
- Programa de Pós-Graduação em Saúde Coletiva, Coordenação do Curso de Medicina, Centro de Ciências Sociais, Saúde e Tecnologia, Universidade Federal do Maranhão (UFMA), Imperatriz, MA, Brazil
| | - Thais Furtado Ferreira
- Programa de Pós-Graduação em Saúde Coletiva, Departamento de Enfermagem, UFMA, Pinheiro, MA, Brazil
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Abuduxike G, Acar Vaizoglu S, Asut O, Cali S. An Assessment of the Knowledge, Attitude, and Practice Toward Standard Precautions Among Health Workers From a Hospital in Northern Cyprus. Saf Health Work 2021; 12:66-73. [PMID: 33732531 PMCID: PMC7940130 DOI: 10.1016/j.shaw.2020.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/09/2020] [Accepted: 09/03/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The objective was to assess the knowledge level, attitude, and practice of health care workers towards standard precautions, and to identify the related factors. Furthermore, it was attempted to identify the proportion of having the experience of needle stick injuries (NSIs) and associated factors among participants. METHODS A cross-sectional study was conducted in a teaching hospital among 233 health workers using a self-administrated questionnaire. The questionnaire included eight knowledge items, seven practice items, and five attitude items. Based on the mean score of each category, responses were grouped into "satisfactory" and "unsatisfactory". Univariate, bivariate, and multivariable logistic regression analyses were done. RESULTS The mean age of the participants 32.95 (SD ± 9.70) and 62.2% of them were women. 57.5% of the staff had a satisfactory level of correct knowledge (>5 correct answers), 37.3% had a satisfactory positive attitude (>3 correct answers), and 30.9% had a satisfactory practice (>3 correct answers) towards standard precautions. The occupation was one of the predictors as doctors were less likely to have satisfactory knowledge and practice compared to nurses (OR = 0.269, 95% CI: 0.10-0.70 and OR = 0.248, 95% CI: 0.08-0.77, respectively). Out of 174 participants, 31.6% of them reported experiencing NSIs and support staff were 71% less likely to experience NSIs compared to nurses & paramedics. CONCLUSION The findings revealed a substandard adherence of standard precautions among participants, which highlighted the necessity of the provision of a periodic, tailored training program based on the occupation and risk exposure.
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Affiliation(s)
- Gulifeiya Abuduxike
- Department of Public Health, Faculty of Medicine, Near East University, Cyprus
| | | | - Ozen Asut
- Department of Public Health, Faculty of Medicine, Near East University, Cyprus
| | - Sanda Cali
- Department of Public Health, Faculty of Medicine, Near East University, Cyprus
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Priddle H, Pickup S, Hayes C. Occupational health issues experienced by UK embryologists: informing improvements in clinical reproductive science practice. HUM FERTIL 2021; 25:608-617. [PMID: 33459106 DOI: 10.1080/14647273.2021.1871782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A consultation exercise was undertaken with UK embryologists to construct knowledge of the occupational health issues they experience in everyday practice. Data were obtained from 223 eligible survey responses. Work-related ill health was self-reported by 58.3% of respondents, 76.2% of whom reported multiple issues. The most frequently disclosed ill-health conditions were musculoskeletal disorders (45.3%) and stress and mental health problems (27.8%). Other issues with an incidence above 3% were ocular and auditory problems and needlestick and liquid nitrogen injuries. Shoulder injury or pain correspondingly increased in incidence with length of time in service. Absence from work and/or light duties were necessitated for 34.5% of those affected. Assessment of the evidence base for these work-related ill-health conditions explored contributory and ameliorating factors, which enabled a series of evidence-based recommendations to be formulated via the adoption of a GRADE-based framework.
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Affiliation(s)
| | - Sarah Pickup
- School of Psychology, University of Sunderland, Sunderland, UK
| | - Catherine Hayes
- School of Nursing and Health Sciences, University of Sunderland, Sunderland, UK.,Visiting Professor, University of Cumbria, Carlisle, UK
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Al-Abhar N, Moghram GS, Al-Gunaid EA, Al Serouri A, Khader Y. Occupational Exposure to Needle Stick Injuries and Hepatitis B Vaccination Coverage Among Clinical Laboratory Staff in Sana'a, Yemen: Cross-Sectional Study. JMIR Public Health Surveill 2020; 6:e15812. [PMID: 32229462 PMCID: PMC7157492 DOI: 10.2196/15812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 01/26/2020] [Accepted: 02/12/2020] [Indexed: 11/24/2022] Open
Abstract
Background Laboratory staff handling blood or biological samples are at risk for accidental injury or exposure to blood-borne pathogens. Hepatitis B virus (HBV) vaccinations for laboratory staff can minimize these risks. Objective The aims of this study were to determine the prevalence of occupational exposure to needle stick injuries (NSIs) and assess HBV vaccination coverage among clinical laboratory staff in Sana’a, Yemen. Methods A cross-sectional survey was conducted among clinical laboratory staff who were involved in handling and processing laboratory samples at the main public and private clinical laboratories in Sana’a. Data collection was done using a semistructured questionnaire. The questionnaire was divided into 3 parts. Part 1 included information on sociodemographic characteristics of participants. Part 2 included information on the availability of the personal protective equipment in the laboratories, such as lab coats and gloves. Part 3 included questions about the history of injury during work in the laboratory and the vaccination status for HBV. Results A total of 219/362 (60%) participants had been accidentally injured while working in the laboratory. Of those, 14.6% (32/219) had been injured during the last 3 months preceding the data collection. Receiving the biosafety manual was significantly associated with lower risk of injury. Out of those who were injured, 54.8% (120/219) had received first aid. About three-quarters of respondents reported that they had been vaccinated against HBV. The vaccination against HBV was significantly higher among laboratory staff who were working at private laboratories (P=.01), who had postgraduate degrees (P=.005), and who received the biosafety manual (P=.03). Conclusions Occupational exposure to NSI is still a major problem among laboratory staff in public and private laboratories in Sana’a, Yemen. The high incidence of injuries among laboratory staff and the low rate of receiving first aid in laboratories combined with low vaccination coverage indicates that all laboratory staff are at risk of exposure to HBV. Therefore, strengthening supervision, legalizing HBV vaccinations for all laboratory staff, and optimizing laboratory practices regarding the management of sharps can minimize risks and prerequisites in Yemen.
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Affiliation(s)
- Nabil Al-Abhar
- Field Epidemiology Training Program, Sana'a, Yemen.,National Center of Public Health Laboratories, Sana'a, Yemen
| | | | | | | | - Yousef Khader
- Jordan Field Epidemiology Training Program, Jordan Ministry of Health, Amman, Jordan
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8
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Abstract
Background Under Canada's Human Pathogens and Toxins Act and Human Pathogens and Toxins Regulations, the Public Health Agency of Canada (PHAC) is mandated with monitoring laboratory incident notifications through the Laboratory Incident Notification Canada (LINC) surveillance system. The year 2017 marks the second complete year of data. Objective To describe the laboratory exposure and laboratory-acquired infection incidents that occurred in Canada in 2017 by sector, human pathogens and toxins involved, number of affected persons, incident type and root causes. Methods The incidents included in the analysis occurred between January 1 and December 31, 2017. They were reported by laboratories with active licences to PHAC through the LINC surveillance system. Microsoft Excel 2010 was used for basic descriptive statistics. Results A total of 44 exposure and laboratory-acquired infection incidents were reported to the LINC in 2017. Compared by sector and their respective shares of licences, the number of incidents was highest in the academic and hospital sectors compared with government laboratories and private industry. Altogether 118 people were exposed for an average of 2.7 people per incident (range of 1-29). There were no reports of secondary exposure. Six exposure incidents (14%) led to "suspected" (n=5) or confirmed (n=1) cases of laboratory-acquired infection. Although overall, risk group (RG)2 human pathogens and toxins were involved in the majority of incidents (n=23; 52%), Francisella tularensis (n=4; 9%) and Coccidioides immitis (n=3; 7%) were the most frequently involved in reported exposure incidents. These two pathogens are both RG3 and security-sensitive biological agents (SSBAs). An average of 2.3 root causes were identified per incident (n=101). Problems with standard operating procedures (SOPs) and human error were the two most common causes. Conclusion The incidence of laboratory exposure incidents was relatively low in 2017. The most common route of exposure was through inhalation and the most common root causes were problems with SOPs and human error. Since this is a new surveillance system, baseline estimates are still being established.
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Burmen BK, Mogunde J, Olilo P. Human Immunodeficiency Virus and Hepatitis B Virus Infection Prevention Following Occupational Exposure among Staff at a Regional Referral Hospital in Western Kenya. Int J Prev Med 2018; 9:43. [PMID: 29899881 PMCID: PMC5981229 DOI: 10.4103/ijpvm.ijpvm_217_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/30/2017] [Indexed: 11/16/2022] Open
Abstract
Background: Postexposure prophylaxis (PEP) with antiretroviral therapy (ART) and vaccination against hepatitis B virus (HBV) aides in preventing human immunodeficiency virus (HIV) infection and HBV, respectively, from accidental or occupational exposure. We assessed compliance to guidelines for HIV and HBV prevention after occupational exposure among hospital staff at a referral Kenyan hospital. Methods: We reviewed PEP registers for hospital staff reporting an occupational injury at a referral hospital in Western Kenya between January 2011 and December 2012. Proportions were used to summarize number of participants receiving the recommended services, Kaplan–Meier curves were used to describe time to ART initiation, and Chi-square statistics was used to describe the association between participant characteristics and PEP completion rates. P < 0.05 was considered statistically significant. Results: Majority of documented hospital staff (n = 52) were health workers (63%) and students (27%) and had high HIV risk exposures (97%). All had timely PEP initiation with 50% completing PEP. Completion rates did not vary by gender (P = 0.78), exposure type (P = 1.0), or department of exposure (P = 0.75). Retesting for HIV and negativity rates at months 1.5, 3, and 6 were 96%, 25%, and 17% and 100%, 100%, and 100%, respectively. At the time of exposure, 17% (9) of staff were HBV vaccinated and HBV status of sources was unknown; no intervention was provided for HBV prevention. Conclusions: Low rates of completion and follow-up negate intended benefits of PEP. Efforts should be directed to enforce universal precaution practices and completion of PEP. Low rates of HBV testing and vaccination illustrate the need for support for the implementation of HBV prevention guidelines.
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Affiliation(s)
- Barbara Kabai Burmen
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Joseph Mogunde
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Pamela Olilo
- Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, Kenya
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10
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Brack AF. Maintaining a Culture of Patient and Staff Member Safety. AORN J 2018; 107:762-764. [DOI: 10.1002/aorn.12166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Khabour OF, Al Ali KH, Mahallawi WH. Occupational infection and needle stick injury among clinical laboratory workers in Al-Madinah city, Saudi Arabia. J Occup Med Toxicol 2018; 13:15. [PMID: 29942343 PMCID: PMC5963129 DOI: 10.1186/s12995-018-0198-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/13/2018] [Indexed: 12/27/2022] Open
Abstract
Background Clinical laboratory workers face biohazard such as needlestick injury and occupational infection on a daily basis. In this study, we examined self-reported frequency of occupational infection and needlestick injury among the clinical laboratory workers in Al- Madinah, Saudi Arabia. Methods A total of 234 clinical laboratory workers were recruited from private and government health sectors to answer a self-administered questionnaire that was prepared to achieve the aims of the study. Results The results showed that approximately 33% of the sample had an experienced occupational infection while 24% had experienced a needlestick injury. Approximately, 49% reported that they always recap needle after use, whereas 15% reported doing that most of the times. Occupational infection, needlestick injury and recapping needles after use were associated with lack of training on biosafety (P < 0.05). Conclusion The frequency of occupational infection and needlestick injury among clinical laboratory workers in Al-Madinah is high. Interventions related to biosafety and infection control and the use of needlestick prevention devices might be useful in lowering such frequency.
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Affiliation(s)
- Omar F Khabour
- 1Department of Clinical Laboratory Sciences, Taibah University, Al-Madinah, 41477 Saudi Arabia.,2Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalil H Al Ali
- 1Department of Clinical Laboratory Sciences, Taibah University, Al-Madinah, 41477 Saudi Arabia
| | - Waleed H Mahallawi
- 1Department of Clinical Laboratory Sciences, Taibah University, Al-Madinah, 41477 Saudi Arabia
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Zemlin AE. Errors in the Extra-Analytical Phases of Clinical Chemistry Laboratory Testing. Indian J Clin Biochem 2018; 33:154-162. [PMID: 29651205 PMCID: PMC5891449 DOI: 10.1007/s12291-017-0657-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 04/28/2017] [Indexed: 01/06/2023]
Abstract
The total testing process consists of various phases from the pre-preanalytical to the post-postanalytical phase, the so-called brain-to-brain loop. With improvements in analytical techniques and efficient quality control programmes, most laboratory errors now occur in the extra-analytical phases. There has been recent interest in these errors with numerous publications highlighting their effect on service delivery, patient care and cost. This interest has led to the formation of various working groups whose mission is to develop standardized quality indicators which can be used to measure the performance of service of these phases. This will eventually lead to the development of external quality assessment schemes to monitor these phases in agreement with ISO15189:2012 recommendations. This review focuses on potential errors in the extra-analytical phases of clinical chemistry laboratory testing, some of the studies performed to assess the severity and impact of these errors and processes that are in place to address these errors. The aim of this review is to highlight the importance of these errors for the requesting clinician.
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Affiliation(s)
- Annalise E. Zemlin
- Division of Chemical Pathology, National Health Laboratory Service (NHLS) and University of Stellenbosch, Tygerberg Hospital, Cape Town, 7505 South Africa
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13
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Tamayo I, Gamazo C, de Souza Rebouças J, Irache JM. Topical immunization using a nanoemulsion containing bacterial membrane antigens. J Drug Deliv Sci Technol 2017. [DOI: 10.1016/j.jddst.2017.02.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Surveillance of laboratory exposures to human pathogens and toxins: Canada 2016. ACTA ACUST UNITED AC 2017; 43:228-235. [PMID: 29770052 DOI: 10.14745/ccdr.v43i11a04] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background Canada recently enacted legislation to authorize the collection of data on laboratory incidents involving a biological agent. This is done by the Public Health Agency of Canada (PHAC) as part of a comprehensive national program that protects Canadians from the health and safety risks posed by human and terrestrial animal pathogens and toxins. Objective To describe the first year of data on laboratory exposure incidents and/or laboratory-acquired infections in Canada since the Human Pathogens and Toxins Regulations came into effect. Methods Incidents that occurred between January 1 and December 31, 2016 were self-reported by federally-regulated parties across Canada using a standardized form from the Laboratory Incident Notification Canada (LINC) surveillance system. Exposure incidents were described by sector, frequency of occurrence, timeliness of reporting, number of affected persons, human pathogens and toxins involved, causes and corrective actions taken. Microsoft Excel 2010 was used for basic descriptive analyses. Results In 2016, 46 exposure incidents were reported by holders of 835 active licences in Canada representing 1,352 physical areas approved for work involving a biological agent, for an overall incidence of 3.4%. The number of incidents was highest in the academic (n=16; 34.8%) and hospital (n=12; 26.1%) sectors, while the number of reported incidents was relatively low in the private industry sector. An average of four to five incidents occurred each month; the month of September presented as an outlier with 10 incidents.: A total of 100 people were exposed, with no reports of secondary exposure. Four incidents led to suspected (n=3) or confirmed (n=1) cases of laboratory-acquired infection. Most incidents involved pathogens classified at a risk group 2 level that were manipulated in a containment level 2 laboratory (91.3%). Over 22 different species of human pathogens and toxins were implicated, with bacteria the most frequent (34.8%), followed by viruses (26.1%). Eleven (23.9%) incidents involved a security sensitive biologic agent. Procedure breaches (n=15) and sharps-related incidents (n=14) were the most common antecedents to an exposure. In 10 (21.7%) cases, inadvertent possession (i.e., isolation of an unexpected biological agent during routine work) played a role. Possible improvements to standard operating procedures were cited in 71.7% of incidents. Improvements were also indicated for communication (26.1%) and management (23.9%). Conclusions The Laboratory Incident Notification Canada is one of the first surveillance systems in the world to gather comprehensive data on laboratory incidents involving human pathogens and toxins. Exposure incidents reported in the first year were relatively rare, occurring in less than 4% of containment zones within laboratory settings.
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El-Sokkary RH, Tash RME, Meawed TE, El Seifi OS, Mortada EM. Detection of hepatitis C virus (HCV) among health care providers in an Egyptian university hospital: different diagnostic modalities. Infect Drug Resist 2017; 10:357-364. [PMID: 29270026 PMCID: PMC5655154 DOI: 10.2147/idr.s145844] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Hepatitis C virus (HCV) infection has received much attention and is placed at the core of the infection control agenda. It is considered as a major public health problem in Egypt, where the highest prevalence of HCV exists. The great risk of exposure to infection of health care providers (HCPs) has highlighted the urgent need for implementing an infection control program. Objective The purpose of this study was to detect the prevalence of HCV infection among HCPs in Zagazig University Hospitals and to assess the performance of different diagnostic modalities. Methodology Blood, polymerase chain reaction (PCR), enzyme-linked immunosorbent assay (ELISA), and saliva tests were performed in enrolled HCPs. Results This study compared HCV diagnosis Hepanostika HCV Ultra ELISA as a screening test and PCR as gold standard test, which resulted in 40.6% positive results by ELISA compared to 34.8% by PCR (p<0.0001), while OraQuick HCV rapid antibody compared to PCR shows that 37.7% of the participants were positive by OraQuick HCV rapid antibody test. Application of standard precautions while dealing with blood has negative significant correlation with HCV infection (rs=−0.265, p=0.03). Conclusion HCPs at Zagazig University Hospitals are at high risk for HCV infection. Lack of compliance and awareness of prevention and control of the infection are associated cofactors. Serum HCV-Ab detection by Hepanostika HCV Ultra ELISA and OraQuick HCV rapid antibody test are sensitive and specific serologic assays for diagnosis with correspondent results to that obtained by quantitative real-time PCR.
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Affiliation(s)
| | | | | | - Omnia S El Seifi
- Community, Environmental and Occupational Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Eman M Mortada
- Community, Environmental and Occupational Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Garozzo A, Falzone L, Rapisarda V, Marconi A, Cinà D, Fenga C, Spandidos DA, Libra M. The risk of HCV infection among health-care workers and its association with extrahepatic manifestations (Review). Mol Med Rep 2017; 15:3336-3339. [PMID: 28339065 PMCID: PMC5428681 DOI: 10.3892/mmr.2017.6378] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 02/21/2017] [Indexed: 01/20/2023] Open
Abstract
Health care workers (HCWs) are frequently exposed to different biological agents during their activities and are frequently monitored. Among these infectious agents, human hepatitis C (HCV) can infect HCWs. In this review article, the risk of HCV infection among HCWs is discussed along with extrahepatic HCV-related malignancies, such as non‑Hodgkin lymphoma. Accidental contamination, represented by percutaneous and mucocutaneous infections is the main risk factor for such infection. The compliance of the protection procedures, included in the current regulation for HCWs, is the most important issue to reduce the risk of pathogen infections that in turn may produce reduction of infection‑associated malignancies.
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Affiliation(s)
- Adriana Garozzo
- Section of Microbiology, Department of Biomedical and Biotechnological Sciences, University of Catania, I‑95124 Catania, Italy
| | - Luca Falzone
- Section of General, Clinical and Oncological Pathology, Department of Biomedical and Biotechnological Sciences, University of Catania, I‑95123 Catania, Italy
| | - Venerando Rapisarda
- Section of Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, I‑9124 Catania, Italy
| | - Andrea Marconi
- Section of Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, I‑9124 Catania, Italy
| | - Diana Cinà
- Department of Clinical Pathology, Garibaldi Hospital, I‑9124 Catania, Italy
| | - Concettina Fenga
- Section of Occupational Medicine, Department of the Environment, Safety, Territory, Food and Health Sciences, University of Messina, I‑98125 Messina, Italy
| | - Demetrios A Spandidos
- Department of Virology, Faculty of Medicine, University of Crete, Heraklion 71003, Crete, Greece
| | - Massimo Libra
- Section of General, Clinical and Oncological Pathology, Department of Biomedical and Biotechnological Sciences, University of Catania, I‑95123 Catania, Italy
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Nikolac N, Krleza JL, Simundic AM. Preanalytical external quality assessment of the Croatian Society of Medical Biochemistry and Laboratory Medicine and CROQALM: finding undetected weak spots. Biochem Med (Zagreb) 2017; 27:131-143. [PMID: 28392736 PMCID: PMC5382847 DOI: 10.11613/bm.2017.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 01/14/2017] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION The aim of this paper is to present results of first two years of preanalytical external quality assessment (EQA) in Croatia. MATERIALS AND METHODS This paper summarizes results from 6 rounds of preanalytical EQA during 2014-2016 in 161-175 Croatian laboratories (number ranged between cycles). EQA was designed as an online survey of the compliance with National recommendations for phlebotomy (NRP). Forty-seven questions in 5 categories are analyzed (materials and equipment, patient identification, patient preparation, sampling and storage). Additionally, preanalytical cases are presented. Overall performance scores (Question score (Qscore) for compliance with NRP and Case score (Cscore) for preanalytical cases) are calculated for each question/case as a proportion of laboratories with satisfactory procedure (x 100). Qscores and Cscores ≥ 70 were classified as acceptable (maximal score = 100). RESULTS In investigation of compliance with NRP, acceptable Qscores were obtained for 34/47 questions. The lowest scores were observed for the availability of sterile disposable tourniquets (Qscore = 15) and safe-sharp needles (Qscore = 34), obtaining patients address as an identifier (Qscore = 21), using glycolysis inhibitor tubes for glucose concentration measurement (Qscore = 21) and verification of manufacturers declarations on temperature and time of storage (Qscore = 31). There was no statistically significant difference in overall Qscore according to different categories of phlebotomy procedures (P = 0.284). The results of preanalytical cases showed acceptable Cscore values for all cases (89-96). CONCLUSION First two years of preanalytical EQA showed good compliance with the NRP and excellent expertise in resolving complex preanalytical issues. Major critical spots are lack of availability of safe-sharp needles, disposable tourniquets and glucose inhibitor tubes.
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Affiliation(s)
- Nora Nikolac
- University Department of Chemistry, Medical School University Hospital Sestre Milosrdnice, Zagreb, Croatia; Working group for preanalytical phase, Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
| | - Jasna Lenicek Krleza
- Department of laboratory diagnostics, Children's hospital Zagreb, Croatia; CROQALM, Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
| | - Ana-Maria Simundic
- Working group for preanalytical phase, Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia; Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia
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18
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Hong KH. Viral Infections in Workers in Hospital and Research Laboratory Settings. ANNALS OF CLINICAL MICROBIOLOGY 2017. [DOI: 10.5145/acm.2017.20.2.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Ki Ho Hong
- Department of Laboratory Medicine, Seoul Medical Center, Seoul, Korea
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19
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Shindano TA, Bahizire E, Fiasse R, Horsmans Y. Knowledge, Attitudes, and Practices of Health-Care Workers About Viral Hepatitis B and C in South Kivu. Am J Trop Med Hyg 2016; 96:400-404. [PMID: 27920392 DOI: 10.4269/ajtmh.16-0287] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 10/16/2016] [Indexed: 01/27/2023] Open
Abstract
Health-care workers (HCWs) are at risk of infections associated with accidental exposure to blood, including viral hepatitis B (HBV) and C (HCV). A survey using a questionnaire was conducted on 250 HCW in Bukavu, an eastern town of the Democratic Republic of Congo, to analyze their attitude and knowledge about these two viruses. A response rate of 86.8% (217/250) was obtained. The mean age of the respondents was 39.6 ± 9.8 years, in majority from paramedical staff (66.4%) and with more than 5 years of professional experience (60.8%). The mean proportion of adequate answers on HBV and HCV was 33.2% (±11%) and 30.6% (±7%), respectively. Ninety-three HCW (42.8%) reported recent experience of blood exposure accident, more frequently among the paramedical staff (50%) than physicians (28.8%; P = 0.002). This was mainly related to inadequate protection resources (76.9%). Among all participants, only 24.4% had a history of at least one injection of HBV vaccine; this was more frequently found among physicians than among paramedical staff (49.3% versus 11.8%; P < 0.001). Moreover, only 3.8% of vaccinated HCW received the complete vaccination schedule of three vaccine doses. The efficiency of this vaccine is not well recognized by HCW, and the majority of them seemed to be more worried about the risk of infection by human immunodeficiency virus than by viral hepatitis. Our study reveals that the level of knowledge about HBV and HCV is rather low among HCW in Bukavu.
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Affiliation(s)
- Tony Akilimali Shindano
- Department of Internal Medicine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo.,Department of Hepatogastroenterology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCL), Brussels, Belgium
| | - Esto Bahizire
- Centre de Recherche en Sciences Naturelles de Lwiro, Bukavu, Democratic Republic of Congo.,Department of Microbiology, University of Nairobi, Kenya
| | - René Fiasse
- Department of Hepatogastroenterology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCL), Brussels, Belgium
| | - Yves Horsmans
- Department of Hepatogastroenterology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCL), Brussels, Belgium.
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20
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Dulon M, Lisiak B, Wendeler D, Nienhaus A. Causes of needlestick injuries in three healthcare settings: analysis of accident notifications registered six months after the implementation of EU Directive 2010/32/EU in Germany. J Hosp Infect 2016; 95:306-311. [PMID: 28034473 DOI: 10.1016/j.jhin.2016.11.015] [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: 10/10/2016] [Accepted: 11/24/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Needlestick injuries (NSIs) are the most common cause of sharps injuries and pose a serious risk to healthcare workers (HCWs). In 2014, 'Technical rule for biological agents in healthcare and welfare facilities' (TRBA 250) was modified in Germany in order to promote the prevention of sharps injuries. AIMS To examine the epidemiology of NSIs among HCWs in hospitals, doctor's offices and in- and outpatient care; to collect information on the causes of the accidents when safety-engineered devices (SEDs) are used; and to compare the results with the main principles of TRBA 250. METHODS The survey was based on HCWs' compensation claims for NSIs, as notified within a four-week period in November 2014. Detailed information on the NSI was collected by telephone interview. FINDINGS In total, 533 HCWs participated. Subcutaneous needles were most often involved in NSIs, regardless of the healthcare setting (39% of all NSIs). Insulin pens were involved in 48% of NSIs in in- and outpatient care. Disposal of sharps devices accounted for 38% of the injuries. SEDs were used in 20% of NSIs. Lack of activation was the most important cause of failure when SEDs were used. CONCLUSION Despite the binding recommendations of TRBA 250, more efforts are needed to increase the experience of HCWs in terms of working with SEDs. All professional groups must be encouraged to be more aware of the risks associated with sharps disposal. Safe handling practices for disposal of insulin pens are needed in in- and outpatient care settings.
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Affiliation(s)
- M Dulon
- Department of Occupational Medicine, Public Health and Hazardous Substances, Statutory Accident Insurance and Prevention in the Health and Welfare Services, Hamburg, Germany.
| | - B Lisiak
- Department of Occupational Medicine, Public Health and Hazardous Substances, Statutory Accident Insurance and Prevention in the Health and Welfare Services, Hamburg, Germany
| | - D Wendeler
- Department of Occupational Medicine, Public Health and Hazardous Substances, Statutory Accident Insurance and Prevention in the Health and Welfare Services, Hamburg, Germany
| | - A Nienhaus
- Department of Occupational Medicine, Public Health and Hazardous Substances, Statutory Accident Insurance and Prevention in the Health and Welfare Services, Hamburg, Germany; Institute for Health Services Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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21
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Kizny Gordon A, McIver C, Kim M, Murrell DF, Taylor P. Clinical application of a molecular assay for the detection of dermatophytosis and a novel non-invasive sampling technique. Pathology 2016; 48:720-726. [PMID: 27780596 DOI: 10.1016/j.pathol.2016.08.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 08/23/2016] [Accepted: 08/28/2016] [Indexed: 11/30/2022]
Abstract
The dermatophytoses are the most common superficial fungal infections worldwide. Clinical diagnosis is not reliable as there are many differentials, and laboratory diagnosis is required to gain access to treatment in more severe disease. Traditional diagnostic methods are limited by suboptimal sensitivity, specificity and prolonged turnaround times. Molecular methods are being used increasingly in the diagnostic algorithm in the clinical microbiology laboratory. The aim of this study was to evaluate a real-time polymerase chain reaction (RT-PCR) targeting the chitin synthase 1 gene (CHS1) of dermatophytes for analytical specificity, and to assess its clinical application by comparing it to the current methods of microscopy and culture. We also assessed a novel non-invasive sample collection technique involving adhesive tape impressions of suspected lesions. The PCR was highly specific, being able to discern between cultures of dermatophytes and other microorganisms. It also proved to be more sensitive than traditional methods at detecting dermatophytes in clinical samples. Similar sensitivities were seen on the samples assessed by the adhesive tape technique. An internal control system allowed for the detection of inhibition in certain culture and clinical specimens. This rapid and cost-effective technique could be incorporated into the initial diagnostic algorithm for dermatophytosis in Australian laboratories.
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Affiliation(s)
- Alice Kizny Gordon
- Department of Microbiology, South Eastern Area Laboratory Services, St George Hospital, Sydney, Australia.
| | - Christopher McIver
- Department of Microbiology, South Eastern Area Laboratory Services, St George Hospital, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Minhee Kim
- Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Dermatology, St George Hospital, Sydney, NSW, Australia
| | - Dedee F Murrell
- Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Dermatology, St George Hospital, Sydney, NSW, Australia
| | - Peter Taylor
- Department of Microbiology, South Eastern Area Laboratory Services, St George Hospital, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
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22
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Mannocci A, De Carli G, Di Bari V, Saulle R, Unim B, Nicolotti N, Carbonari L, Puro V, La Torre G. How Much do Needlestick Injuries Cost? A Systematic Review of the Economic Evaluations of Needlestick and Sharps Injuries Among Healthcare Personnel. Infect Control Hosp Epidemiol 2016; 37:635-46. [PMID: 27022671 PMCID: PMC4890345 DOI: 10.1017/ice.2016.48] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 02/10/2016] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To provide an overview of the economic aspects of needlestick and sharps injury (NSI) management among healthcare personnel (HCP) within a Health Technology Assessment project to evaluate the impact of safety-engineered devices on health care METHODS A systematic review of economic analyses related to NSIs was performed in accordance with the PRISMA statement and by searching PubMed and Scopus databases (January 1997-February 2015). Mean costs were stratified by study approach (modeling or data driven) and type of cost (direct or indirect). Costs were evaluated using the CDC operative definition and converted to 2015 International US dollars (Int$). RESULTS A total of 14 studies were retrieved: 8 data-driven studies and 6 modeling studies. Among them, 11 studies provided direct and indirect costs and 3 studies provided only direct costs. The median of the means for aggregate (direct + indirect) costs was Int$747 (range, Int$199-Int$1,691). The medians of the means for disaggregated costs were Int$425 (range, Int$48-Int$1,516) for direct costs (9 studies) and Int$322 (range, Int$152-Int$413) for indirect costs (6 studies). When compared with data-driven studies, modeling studies had higher disaggregated and aggregated costs, but data-driven studies showed greater variability. Indirect costs were consistent between studies, mostly referring to lost productivity, while direct costs varied widely within and between studies according to source infectivity, HCP susceptibility, and post-exposure diagnostic and prophylactic protocols. Costs of treating infections were not included, and intangible costs could equal those associated with NSI medical evaluations. CONCLUSIONS NSIs generate significant direct, indirect, potential, and intangible costs, possibly increasing over time. Economic efforts directed at preventing occupational exposures and infections, including provision of safety-engineered devices, may be offset by the savings from a lower incidence of NSIs. Infect Control Hosp Epidemiol 2016;37:635-646.
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Affiliation(s)
- Alice Mannocci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Gabriella De Carli
- Department of Epidemiology, Pre-Clinical Research and Advanced Diagnostics, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
| | - Virginia Di Bari
- Department of Epidemiology, Pre-Clinical Research and Advanced Diagnostics, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
| | - Rosella Saulle
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Brigid Unim
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Nicola Nicolotti
- Department of Epidemiology, Pre-Clinical Research and Advanced Diagnostics, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
| | - Lorenzo Carbonari
- Department of Economics and Finance & CEIS, University of Rome “Tor Vergata”Italy
| | - Vincenzo Puro
- Department of Epidemiology, Pre-Clinical Research and Advanced Diagnostics, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
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23
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Cornes MP, Church S, van Dongen-Lases E, Grankvist K, Guimarães JT, Ibarz M, Kovalevskaya S, Kristensen GB, Lippi G, Nybo M, Sprongl L, Sumarac Z, Simundic AM. The role of European Federation of Clinical Chemistry and Laboratory Medicine Working Group for Preanalytical Phase in standardization and harmonization of the preanalytical phase in Europe. Ann Clin Biochem 2016; 53:539-47. [PMID: 27141012 DOI: 10.1177/0004563216643969] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2016] [Indexed: 11/16/2022]
Abstract
Patient safety is a leading challenge in healthcare and from the laboratory perspective it is now well established that preanalytical errors are the major contributor to the overall rate of diagnostic and therapeutic errors. To address this, the European Federation of Clinical Chemistry and Laboratory Medicine Working Group for Preanalytical Phase (EFLM WG-PRE) was established to lead in standardization and harmonization of preanalytical policies and practices at a European level. One of the key activities of the WG-PRE is the organization of the biennial EFLM-BD conference on the preanalytical phase to provide a forum for National Societies (NS) to discuss their issues. Since 2012, a year after the first Preanalytical phase conference, there has been a rapid growth in the number of NS with a working group engaged in preanalytical phase activities and there are now at least 19 countries that have one. As a result of discussions with NS at the third conference held in March 2015 five key areas were identified as requiring harmonisation. These were test ordering, sample transport and storage, patient preparation, sampling procedures and management of unsuitable specimens. The article below summarises the work that has and will be done in these areas. The goal of this initiative is to ensure the EFLM WG-PRE produces work that meets the needs of the European laboratory medicine community. Progress made in the identified areas will be updated at the next preanalytical phase conference and show that we have produced guidance that has enhanced standardisation in the preanalytical phase and improved patient safety throughout Europe.
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Affiliation(s)
- Michael P Cornes
- Departments of Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands, UK
| | | | | | - Kjell Grankvist
- The Department of Medical Biosciences, Clinical Chemistry, Umea University, Umea, Sweden
| | - João T Guimarães
- Department of Clinical Pathology, São João Hospital Center, Department of Biochemistry, Faculty of Medicine, and EPI Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Mercedes Ibarz
- Laboratori Clínic Hospital Arnau de Vilanova, Lleida, Spain
| | - Svetlana Kovalevskaya
- Clinical Laboratory Diagnostic Department with Course of Molecular Medicine, First Saint Petersburg Pavlov State Medical University, St-Petersburg, Russia
| | | | - Giuseppe Lippi
- Section of Clinical Chemistry, University of Verona, Verona, Italy
| | - Mads Nybo
- Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Ludek Sprongl
- Central Laboratory, Hospital Sumperk, Sumperk, Czech Republic
| | - Zorica Sumarac
- Center for Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia
| | - Ana-Maria Simundic
- Department of Medical Laboratory Diagnostics, Clinical Hospital Sveti Duh, Zagreb, Croatia
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24
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Sossai D, Di Guardo M, Foscoli R, Pezzi R, Polimeni A, Ruzza L, Miele M, Ottaggio L, Fontana V, Copello F, Dellacà P, Doria M, Onesti A, Montecucco G, Risso F, Nelli M, Benvenuti I, Santacroce M, Giribaldi L, Picelli G, Simonini S, Venturini P. Efficacy of safety catheter devices in the prevention of occupational needlestick injuries: applied research in the Liguria Region (Italy). JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2016; 57:E110-4. [PMID: 27582628 PMCID: PMC4996039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 02/28/2016] [Indexed: 11/10/2022]
Abstract
Healthcare workers who use or may be exposed to needles are at risk of needlestick injuries, which can lead to serious infections by bloodborne pathogens. These injuries can be avoided by eliminating the unnecessary use of needles and using safety devices. The present study was aimed at evaluating the impact of a safety-engineered device, with passive fully automatic needlestick protection, on the rate of needlestick injuries among healthcare workers. The setting of the study was a network of five public healthcare institutions situated in a Northern Italian Region. Data on the type of device, the number of employees and the number of catheter devices used per year were collected through regular meetings with healthcare workers over a period of five years. The most notable result of this study was the huge risk reduction associated with safety devices. Indeed, the risk of needlestick injuries due to conventional devices was found to be 25-fold higher than that observed for safety devices. However, it is noteworthy that a considerable part of this excess can be explained by the different background number of devices used. Moreover, descriptive analysis suggested that individuals with a poor/moderate training level had a lower risk than those with good/high training, though the difference was not statistically significant. In conclusion, there is convincing evidence of a causal connection between the introduction of safety devices and the reduction in needlestick injuries. This consideration should prompt the introduction of safety devices into daily clinical practice.
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Affiliation(s)
- D. Sossai
- Prevention and Protection Unit, IRCCS AOU San Martino, IST Genoa, Italy
| | - M. Di Guardo
- Prevention and Protection Unit, IRCCS AOU San Martino, IST Genoa, Italy
| | - R. Foscoli
- Prevention and Protection Unit, IRCCS AOU San Martino, IST Genoa, Italy
| | - R. Pezzi
- Epidemiology, Biostatistics and Clinical Trials Unit, IRCCS AOU San Martino, IST Genoa, Italy
| | - A. Polimeni
- Prevention and Protection Unit, IRCCS AOU San Martino, IST Genoa, Italy
| | - L. Ruzza
- Prevention and Protection Unit, IRCCS AOU San Martino, IST Genoa, Italy
| | - M. Miele
- Mutagenesis Unit, IRCCS AOU San Martino, IST Genoa, Italy
| | - L. Ottaggio
- Mutagenesis Unit, IRCCS AOU San Martino, IST Genoa, Italy
| | - V. Fontana
- Epidemiology, Biostatistics and Clinical Trials Unit, IRCCS AOU San Martino, IST Genoa, Italy
| | - F. Copello
- Occupational Needlestick Injuries Study Group
| | - P. Dellacà
- Occupational Needlestick Injuries Study Group
| | - M. Doria
- Occupational Needlestick Injuries Study Group
| | - A. Onesti
- Occupational Needlestick Injuries Study Group
| | | | - F. Risso
- Occupational Needlestick Injuries Study Group
| | - M. Nelli
- Occupational Needlestick Injuries Study Group
| | | | | | | | - G. Picelli
- Occupational Needlestick Injuries Study Group
| | - S. Simonini
- Occupational Needlestick Injuries Study Group
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25
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Accidental Needlestick Exposures linked to the Administration of Local Anesthesia by Healthcare Workers. Infect Control Hosp Epidemiol 2015; 36:1487-8. [PMID: 26449423 DOI: 10.1017/ice.2015.229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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26
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Rajkumari N, Mathur P, Gunjiyal J, Misra MC. Effectiveness of Intensive Interactive Classes and Hands on Practice to Increase Awareness about Sharps Injuries and Splashes among Health Care Workers. J Clin Diagn Res 2015; 9:DC17-21. [PMID: 26393129 DOI: 10.7860/jcdr/2015/12833.6219] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 06/18/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Occupational exposure to sharps and splashes pose a major hazard among health care workers (HCWs); so knowledge and awareness regarding sharps/splashes by blood and potentially infectious body fluids (BBF) is a must. Hence, the study was done to assess the extent of knowledge of the staff and using awareness classes and hands on practice as a model to increase awareness as well as prevention. MATERIALS AND METHODS This prospective interventional cohort study, using before - after trial, was conducted in a Level I trauma care centre. All cadres of HCWs were enrolled randomly into 5 different groups of 15 each. This study was conducted in 2 phases - interactive classes and hands on practice (Phase I) and questionnaire assessment and work area observation (phase II). This was repeated twice and the final outcome was analysed. A systematic level of grading was used to assess the improvement. RESULTS It was observed that Group 1 (doctors) and group 2 (nurses) had the maximum knowledge about such exposures and its prevention compared to the other groups (groups 3, 4 and 5) during the initial assessment (Phase I). The remaining groups showed a major improvement after the 2(nd) assessment, though their knowledge was poor in the beginning. Groups 1and 2 showed 32% and remaining groups showed a 25% improvement in voluntary reporting after the second assessment (Phase II). CONCLUSION Awareness classes and hands on practice are indeed useful in generating knowledge about sharps/ splashes. Certain incentives given at right time can improve it further.
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Affiliation(s)
- Nonika Rajkumari
- Assistant Professor, Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research , Puducherry, India
| | - Purva Mathur
- Additional Professor, Department of Laboratory Medicine (Microbiology Division), Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences , New Delhi, India
| | - Jacinta Gunjiyal
- Nursing-in-Charge, Hospital Infection Control, Hospital Infection Control Unit, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences , New Delhi, India
| | - Mahesh Chandra Misra
- Professor, Department of Surgical Disciplines, All India Institute of Medical Sciences , New Delhi, India
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van de Wijdeven GG, Hirschberg HJ, Weyers W, Schalla W. Phase 1 clinical study with Bioneedles, a delivery platform for biopharmaceuticals. Eur J Pharm Biopharm 2015; 89:126-33. [DOI: 10.1016/j.ejpb.2014.11.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 11/25/2014] [Accepted: 11/26/2014] [Indexed: 10/24/2022]
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