Trends in bloodborne pathogen exposure and follow-up at an urban teaching hospital: 1987 to 1997

Health care workers (HCWs) risk occupational exposure to blood-borne pathog ens. Effective postexposure treatment and testing depend on compliance with follow-up, but compliance rates are poorly understood. We examined trends in exposure and follow-up at a large teaching hospital after interventions to improve compliance. We reviewed exposures from October 1987 to September 1988 (group 1) and July 1996 to June 1997 (group 2). Data were analyzed fo r HCW demographics, source patient characteristics, and follow-up outcomes. We found that group 2 source patient serologic data were obtained more oft en. Group 1 source patients were more likely to be positive for the human i mmunodeficiency virus (HIV). Group 2 HCWs were more likely to be immune to hepatitis B virus, to agree to HIV testing, and to comply with follow-up. F ollow-up rates remained suboptimal, even after high-risk exposures. Non-lic ensed HCWs were less likely to accept postexposure testing than physicians or nurses in group 2. General and targeted interventions to improve complia nce and follow-up are still needed.