Risk of exposure to bloodborne infection for Italian healthcare workers, by job category and work area

OBJECTIVE: To analyze the rate of occupational exposure to blood and body f luids from ail sources and specifically from human immunodeficiency virus ( HIV)-infected sources among hospital workers, by job category and work area . DESIGN: Multicenter prospective study. Occupational exposure data (numerato r) and full-time equivalents ([FTEs] denominator) were collected over a 5-y ear period (1994-1998) and analyzed. SETTING: 18 Italian urban acute-care hospitals with infectious disease unit s. RESULTS: A total of 10,988 percutaneous and 3,361 mucocutaneous exposures w ere reported. The highest rate of percutaneous exposure per 100 FTEs was ob served among general surgery (11%) and general medicine (10.6%) nurses, the lowest among infectious diseases (1.1%) and laboratory (1%) physicians. Th e highest rates of mucocutaneous exposure were observed among midwives (5.3 %) and dialysis nurses (4.7%), the lowest among pathologists (0%). Inadequa te sharps disposal and the prevalence of sharps in the working unit influen ce the risk to housekeepers. The highest combined HIV exposure rates were o bserved among nurses (7.8%) and physicians (1.9%) working in infectious dis ease units. The highest rates of high-risk percutaneous exposures per 100 F TE were again observed in nurses regardless of work area, but this risk was higher in medical areas than in surgery (odds ratio, 2.1; 95% confidence i nterval, 1.9-2.5; P < .0001). CONCLUSION: Exposure risk is related to job tasks, as well as to the type a nd complexity of care provided in different areas, whereas HIV exposure ris k mainly relates to the prevalence of HIV-infected patients in a specific a rea. The number of accident-prone procedures, especially those involving th e use of hollow-bore needles, performed by job category influence the rate of exposure with high risk of infection. Job- and area-specific exposure ra tes permit monitoring of the effectiveness of targeted interventions and co ntrol measures over time.