Bloodborne viruses in forensic medical practice in South Africa

Health care workers are at risk of exposure to bloodborne viruses including human immunodeficiency virus types 1 and 2 (HIV-1 and -2), hepatitis B vir us (HBV) and hepatitis C virus (HCV). However, limited data is available re garding these risks to forensic medical personnel who are exposed daily to large numbers of severely traumatized bodies in South Africa, a country tha t has an existing and growing HIV epidemic and a high HBV seroprevalence. B ecause no specific prescriptions ensuring occupational safety in this regar d exist for forensic medical personnel in South Africa, the prevalence of b loodborne viruses within this setting must be determined. Blood was taken r andomly from 263 bodies examined at the Medicolegal Laboratory in Pretoria. Serologic tests to detect antibodies to I-W, HCV, and human T-cell lymphot ropic virus types I and Il (HTLV-I and -II) and to detect the presence of H BV surface antigen (HBsAg) were performed and positive results confirmed us ing conventional serologic assays. Serologic tests detected at least one of the four bloodborne viruses in 21% of cases. The overall seroprevalence fo r PIN-IR was 11%, rising to 19% in the sexually active reproductive age gro up (15-49 years). The HBsAg prevalence overall was 8%, rising to 9% in sexu ally active reproductive individuals. There was a low overall HCV seropreva lence of 1% and an even lower HTLV-VII seroprevalence of 0.01%. Forensic me dical personnel in South Africa are therefore at risk of exposure to bloodb orne viral pathogens in, on average, 1 of 5 bodies autopsied. This risk is compounded by the high daily workload, traumatized state of many of the bod ies, and adverse working conditions. It is imperative that occupational hea lth safety guidelines be created for the forensic medicine discipline and c rime scene attendants in South Africa.