Clinical Infectious Disease: Percutaneous Injury: Risks and Management

Health care personnel (HCP) are at increased risk of occupational exposure to bloodborne pathogens such as hepatitis B virus (HBV), hepatitis C virus (HCV), and the human immunodeificiency virus (HIV) from needlesticks and injuries from other sharp objects. Risk factors for transmission of bloodborne pathogens as a result of occupational exposure are likely related to the source patient (eg, titer of virus in his/her blood or body fluid), the injury (eg, quantity of blood or body fluid transferred during the exposure), and the recipient individual (eg, immunologic status). Percutaneous exposures are the most common mechanism for transmission of bloodborne pathogens. It has been estimated that hospital-based HCP in the United States sustain an average of 384 325 (range: 311 091 to 463 922) percutaneous injuries annually. Data from several surveillance systems have demonstrated that the majority of reported injuries occur in the acute care setting, particularly medical floors, operating rooms, and intensive care units. Prevention of contact with blood, percutaneous injuries, and the occupational transmission of bloodborne pathogens requires a diversified approach, including the development of improved engineering controls (eg, safer medical devices), work practices (eg, technique changes to reduce handling of sharp objects), and infection control measures, including personal protective equipment. Another important strategy to prevent infection includes HBV immunization.