Occupational exposure to HIV among healthcare workers: Experience at Siriraj Hospital.

ABSTRACT

Objective: To evaluate the incidence and epidemiological data concerning occupational exposure to HIV among healthcare workers (HCWs) at Siriraj Hospital. Methods: We prospectively collected data concerning occupational exposure among HCWs at Siriraj Hospital using a self-reporting system from 1994 to 2001. All exposed individuals were followed up for at least 6 months after exposure. Results: During the years 1994-2001, there were 691 incident reports from 670 individuals, 180 males and 490 females. The groups of HCWs exposed to blood and other body fluids consisted of - 152 (22.0%) nurses, 147 (21.3%) medical students, and 119 (17.2%) externs. Needlestick or sharps injuries accounted for 538 (77.9%) cases, while the number exposed to mucous membranes was 93 (13.5%). The remaining 28 (4.1%) cases were of broken skin and 32 (4.6%) cases of intact skin exposure. Venepuncture was the procedure with highest risk of producing injury (20.7%). The incidents mostly occurred on medical wards 156 (22.6%) cases, operating rooms 121 (17.5%) cases, and in the emergency room 111 (16.1%) cases. The HIV status of the sources was positive in 230 (33.3%) cases, negative in 315 (45.6%) cases, and unknown in 146 (21.1%) cases. Postexposure prophylaxis was given in 206 (29.8%) cases. In terms of HIV seroconversion, only 172 (27.3%) out of 629 cases reported back negative results for anti-HIV at the 6 month follow-up. Conclusion: Occupational exposure to HIV at Siriraj Hospital occurred most frequently among nurses, medical students, and externs as needlestick or sharps injuries on medical wards. According to our data up to this time, no one seroconverted or claimed compensation for work-related HIV infection.