[Occupational accidents and incidence of HIV infection and hepatitis B and C at a Mexican institution].

INTRODUCTION

The risk of developing parenterally transmitted infections in health-care personnel has become a challenge because of high costs, laboral incapacity and mortality, and social stigmatization.

OBJECTIVES

To inform the incidence of occupational exposure in our institution, to determine the type of personnel affected and the circumstances of the injuries, and to assess the serologic follow-up of these employees.

METHODS

The occupational injuries spontaneously reported to our infection control program from June 1987 to December 1993, were reviewed. Personnel categories, type of accident, instrument and circumstances of the injury, as well as serologic follow-up for hepatitis B virus (HBV), hepatitis C virus (HCV) or human immunodeficiency virus (HIV) infections, baseline and every three months during the first year were evaluated.

RESULTS

In 6.5 years 260 injuries were registered in 240 workers. Two cases were registered in the second semester of 1987, 23 in 1988, 25 in 1989, 23 in 1990, 36 in 1991, 90 in 1992, and 61 in 1993. Housekeeping and maintenance staff were mainly affected (32%), nursing staff in second place (27%), followed by senior medical students (20%). Eighty-eight percent were sharp injuries (20% considered deep injuries). Most of the injuries occurred after instrumental utilization: sharp devices disposed without the use of adequate containers (18%), inappropriate handling of sharp containers (14%) and recapping needles (11%); 36% of the injuries occurred during specific procedures. One HBV seroconversion occurred in 10 surface antigen exposures, one in nine exposures with an HCV contaminated source, and none in 54 accidents with HIV contamination.

CONCLUSIONS

The increase in the annual incidence of occupational exposures is due most probably to more awareness to report the injuries. Eighty-eight percent were sharp injuries and at least 43% could have been prevented. Our main educational and preventive efforts should be directed to housekeeping staff, nursing staff, and medical students of our institution.