Risk and management of blood-borne infections in health care workers

Exposure to blood-borne pathogens poses a serious risk to health care worke rs (HCWs). We review the risk and management of human immunodeficiency viru s (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in HCWs and also discuss current methods for preventing exposures and recomme ndations for postexposure prophylaxis. In the health care setting blood-bor ne pathogen transmission occurs predominantly by percutaneous or mucosal ex posure of workers to the blood or body fluids of infected patients. Prospec tive studies of HCWs have estimated that the average risk for HIV transmiss ion after a percutaneous exposure is approximately 03%, the risk of HBV tra nsmission is 6 to 30%, and the risk of HCV transmission is approximately 1. 8%. To minimize the risk of blood-borne pathogen transmission from HCWs to patients, all HCWs should adhere to standard precautions, including the app ropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments. Employers should have in p lace a system that includes written protocols for prompt reporting, evaluat ion, counseling, treatment, and follow-up of occupational exposures that ma y place a worker at risk of blood-borne pathogen infection. A sustained com mitment to the occupational health of all HCWs will ensure maximum protecti on for HCWs and patients and the availability of optimal medical care for a ll who need it.