PREVENTION OF OCCUPATIONAL TRANSMISSION OF HUMAN-IMMUNODEFICIENCY-VIRUS AND HEPATITIS-B VIRUS AMONG ANESTHESIOLOGISTS - A SURVEY OF ANESTHESIOLOGY PRACTICE

In light of the increasing prevalence of the human immunodeficiency vi rus (HN) and hepatitis B virus (HBV), anesthesiologists are now likely to see more patients who are at high risk for these viruses. Therefor e, it is important that they adopt infection control policies aimed at preventing occupational transmission of these and other pathogens dur ing their clinical practice. This study was designed, using a question naire format, to evaluate anesthesiologist compliance with Centers for Disease Control (CDC) guidelines for the prevention of occupational t ransmission of HIV and HBV. A total of 1149 questionnaires were mailed to anesthesiologists randomly selected from the members' directory of the American Society of Anesthesiologists (ASA). Of these, 493 (44%) were completed and returned. Eighty-eight percent of respondents repor ted that they always complied with CDC guidelines when presented with an HIV-infected patient, but only 24.7% adhered to the guidelines when the patient was considered low risk (P<0.01). This trend was also ref lected in the use of gloves and other protective wear in the periopera tive period. Although 70% of respondents indicated that they recapped needles on a regular basis, this practice was not associated with an i ncreased incidence of needlestick injuries. However, anesthesiologists who reported recapping needles using the one-handed technique were le ss likely to sustain a needlestick injury than those who recapped usin g the two-handed technique. Thirty-one percent and 72% of respondents respectively reported a clean or contaminated needlestick within the p receeding 12 mo. Only 45.4% of those receiving a contaminated needlest ick sought treatment. This study suggests that, although most anesthes iologists use appropriate precautions for the prevention of occupation al transmission of HN and HBV, they do not fully embrace the concept o f universal precautions. Greater education and the development of impr oved engineering controls for the prevention of transmission of these pathogens seems, therefore, imperative.