Occupational exposures to blood and risk of HIV transmission in a general hospital (1986-88).

We conducted a study on occupational exposure to blood in a 1500-bed General Hospital in order to define incidence, type and circumstance of each exposure and to assess the risk of HIV transmission. From 1986 to 1988 a total of 548 cases of accidental blood exposure were reported, with an average of 15 accidents/month. The health care workers exposed included 376 nurses (68.6%), 91 manual workers (16.6%), 54 surgeons (9.8%), 14 physicians (2.5%) and 13 laboratory technicians (2.4%). There were 206 (37.6%) incidents related to recapping of needles. Other types of needle-stick injuries accounted for 191 cases (34.8%), cuts with sharp objects for 110 (20%) and skin or mucous membrane exposure for 41 (7.5%). The highest incidence of exposure per month of work (in a total of 85,932 persons/month of work) and employment category was observed in nurses (.008) and the lowest in physicians (.001). Fifty-three (9.7%) employees were exposed to blood from patients with HIV infection: 36 nurses, 16 surgeons and 1 physician. No cases of seroconversion have been observed after a mean follow-up of 9 months (range: 2-18). The highest rate of HIV at-risk exposure per month of work was observed in surgeons (.001) and the lowest in physicians (.00008). Careful adherence to the universal infection-control guidelines published by international health authorities (W.H.O., C.D.C.) is recommended to prevent most at-risk incidents in health-care settings.