Occupational exposure of interns to blood in an area of high HIV seroprevalence

Objective. To determine the epidemiology of work-related exposure to blood among interns. Design. Interns were invited to complete anonymously a questionnaire concer ning their past percutaneous and mucocutaneous exposures to blood. Setting. Chris Hani Baragwanath Hospital, Soweto, and Johannesburg Hospital , Gauteng, where HN infection is common among patients. Results. Ninety-eight interns (96%) were surveyed. Sixty-nine per cent of i nterns reported one or more percutaneous exposures to blood during the inte rn year, and 33% of interns recalled accidental percutaneous exposure to HI V-infected;blood. Forty-five per cent recalled a mucocutaneous exposure to HIV-positive blood. Only 28 (64%) of 44 percutaneous injuries from HIV-infe cted patients were reported. During their student clinical training, 56% of interns had suffered a penetrating injury, and 18% recollected needlestick injuries involving HIV-infected patients. The most common mechanisms of in jury included unexpected patient movement (23%), needle recapping (17%), an d withdrawal of the needle (17%). Half of the injuries occurred during the first 4 months of internship. Only 22% of intern percutaneous exposures cou ld have been avoided by following universal precautions. Conclusions. Intern and medical student exposure to blood is extremely comm on, but is markedly underreported. Strict compliance with universal precaut ions will not prevent the majority of exposures. Priorities should be the i ntroduction of safer techniques and equipment, skills training and methods of reporting blood exposures.