Incidence of the exposure to blood and blood products and its relationship with the medical education accreditation among last grade medical students in Turkey

Abstract

Abstract:
 Backgrounds: The primary aim of this study was to investigate the blood contact and needle-stick injury rates of final-year (year-6) medical students receiving their education and training at medical schools in different regions of Turkey and to analyse the relationships between blood contact and needle-stick injury and the personal variables of students and accreditation certifications of medical schools.
 Methods: In this retrospective cohort study, self-reporting questionnaires were completed anonymously by consenting final-year medical students. The study population (N = 7900) included all final-year medical students attending the 76 medical schools of Turkey. Of the 76 medical schools, 13 were selected by stratified random sampling, according to their accreditation certification and geographical location, which resulted in 2786 final-year medical students being contacted for participation. The dependent variable was percutaneous contact and the timing of the contact. The independent variables were the personal characteristics, occupational health and safety knowledge, invasive medical procedure skills, and blood-borne disease knowledge of final-year medical students, as well as, the accreditation certification of medical schools. Comparisons between groups were analysed using Cox proportional hazards regression.
 Results: 83.8% (n = 2334) of 2786 final-year medical students contacted, consented to participate. Blood contact rates of 75.2% for intact skin contact, 20.0% for mucosal contact, and 35.4% for percutaneous contact were reported; with27.0% of medical students reporting contaminated blood contact. The average percutaneous time-to-contact was 8.95 ± 0.09 months, with the percutaneous contact rate approaching 50% in the 12th month of the hazard analysis. Percutaneous contact was significantly higher in students who received no formal occupational health and safety training (OR: 1.29; 95% CI: 1.11-1.50) and who attended non-accredited medical schools (OR: 1.45; 95% CI: 1.26-1.66). Percutaneous contact increased significantly in medical students with increasing invasive medical procedure applying scores (OR: 1.06; 95% CI: 1.04-1.09).
 Conclusion: The final year of medical education and training is a high-risk period for percutaneous contact, with the evidence suggesting that the high risks could be mediated by implementing appropriate occupational health and safety education and training. The accreditation certification of medical schools is a significant independent variable in exposure risk. The low blood-contact reporting rate among medical students is a serious concern that requires the implementation of appropriate interventional measures.
 Key words:blood contact,needle-stick injury, medical students, accreditation, occupational health and safety