Cut and puncture accidents involving health care workers exposed to biological materials

ABSTRACT

The first repor of occupational acquisition of HIV appeared in 1984, and, by june,1997, the Centers for Disease Control and Prevention (CDC) had reported 52 document cases of sero-conversion following occupational exposure to HIV-1 by health care workers of those cases. 47(90.3 percent) were exposed to blood. The most frequent type of accident reported was percutaneous needlestick injury. Prospective studies have estimated that the risk of HIV transmission following percutaneous exposure to infected blood is 0,3 percent (Confidence Interval 95 percent=0,2 percent to 0,5 percent). Following a mucous membrane exposure, the risk is 0,09 percent (CI95 percent=0.006 percent to 0,5 percent). The risk of hepatitis B acquisition ranges from 6 percent to 30 percent, and hepatitis C acquisition, 3 percent to 10 percent. Since 1992, the São Paulo Hospital's Hospital Infectious Prevention and Control Service (SPCIH) has notified and treated all workers exposed to accidents involving biological materials. In the last six years, we have handled approximately 1,300 cases of reported accidents, of which 90 percent were percutaneous, most involving needlesticks. Such cases were frequently caused by the inadequate disposal and reccaping of needles. In these accidents, 20 percent of the source patients were HIV positive, 10 percent were hepatitis C positive, and 7,6 percent were hepatitis B positive. This review summarizes the guidelines for a standardized response When deadling with accidents involving health care workers. Transmission of hepatitis B and HIV can be reduced if adequate preventive measures are taken in advance. If proper prophyllaxis is not being done, it should be initiated immediately.