Global prevalence of percutaneous injuries among healthcare workers: a systematic review and meta-analysis.

Background: Healthcare workers (HCWs) are at risk of occupational exposure to blood-borne pathogens through contact with human blood and other body fluids. This study was conducted to estimate the global and regional 1-year prevalence of percutaneous injuries (PCIs) among HCWs. Methods: We systematically searched EMBASE, PubMed, CINAHL and PsychInfo databases for studies published from January 2008 to January 2018 that reported the prevalence of PCIs among HCWs. A random-effects meta-analysis was conducted to estimate pooled prevalence of PCIs among HCWs. Results: Of the 5205 articles identified, 148 studies from 43 countries met the inclusion criteria. The pooled global 1-year prevalence estimate of PCIs was 36.4% [95% confidence interval (CI): 32.9-40.0]. There were substantial regional variations in the 1-year prevalence of PCIs, ranging from 7.7% (95% CI: 3.1-12.4) in South America to 43.2% (95% CI: 38.3-48.0) in Asia. The estimates for Africa and Europe were comparable with values of 34.5% (95% CI: 29.9-39.1) and 31.8% (95% CI: 25.0-38.5), respectively. The highest 1-year prevalence by job category was among surgeons, at 72.6% (95% CI: 58.0-87.2). The estimates for medical doctors (excluding surgeons), nurses (including midwives) and laboratory staff (including laboratory technicians) were 44.5% (95% CI: 37.5-51.5), 40.9% (95% CI: 35.2-46.7) and 32.4% (95% CI: 20.9-49.3), respectively. PCIs commonly occurred among HCWs working in hospital (41.8%, 95% CI: 37.6-46.0) than non-hospital (7.5%, 95% CI: 5.9-9.1) settings. Conclusions: Our findings suggest high rates of PCIs among HCWs with direct patient care across many regions of the world. However, paucity of data from some countries was a major limitation.

Health-care workers' occupational exposures to body fluids in 21 countries in Africa: systematic review and meta-analysis.

OBJECTIVE: To estimate the lifetime and 12-month prevalence of occupational exposure to body fluids among health-care workers in Africa. METHODS: Embase®, PubMed® and CINAHL databases were systematically searched for studies published between January 2000 and August 2017 that reported the prevalence of occupational exposure to blood or other body fluids among health-care workers in Africa. The continent-wide prevalence of exposure was estimated using random-effects meta-analysis. FINDINGS: Of the 904 articles identified, 65 studies from 21 African countries were included. The estimated pooled lifetime and 12-month prevalence of occupational exposure to body fluids were 65.7% (95% confidence interval, CI: 59.7-71.6) and 48.0% (95% CI: 40.7-55.3), respectively. Exposure was largely due to percutaneous injury, which had an estimated 12-month prevalence of 36.0% (95% CI: 31.2-40.8). The pooled 12-month prevalence of occupational exposure among medical doctors (excluding surgeons), nurses (including midwives and nursing assistants) and laboratory staff (including laboratory technicians) was 46.6% (95% CI: 33.5-59.7), 44.6% (95% CI: 34.1-55.0) and 34.3% (95% CI: 21.8-46.7), respectively. The risk of exposure was higher among health-care workers with no training on infection prevention and those who worked more than 40 hours per week. CONCLUSION: The evidence available suggests that almost one half of health-care workers in Africa were occupationally exposed to body fluids annually. However, a lack of data from some countries was a major limitation. National governments and health-care institutions across Africa should prioritize efforts to minimize occupational exposure among health-care workers.