Occupational Exposure Among Medical Students and House Staff at a New York City Medical Center

Abstract

The purpose of the study was to ascertain the prevalence of and reasons for underreporting of occupational exposures to patients' blood and body fluids among students and house staff. A questionnaire surveyed 110 medical students and 275 house staff members regarding the number of reported and unreported exposures to patients' body fluids, and the reasons why the respondents did or did not report their exposures during the previous 6 months. Of 385 surveys returned, representing a response rate of 60%, 122 respondents (32%) experienced 330 occupational exposures during the previous 6 months. Fifty-two percent of surgical house staff, 27% of students, and 20% of medical house staff were exposed. Whereas the exposure risk to surgical house staff increased with training, the risk to medical house staff decreased with training. Only 29% of exposed respondents reported an exposure. Exposures from sources known to be positive or at high risk for human immunodeficiency virus had the highest reporting rates. The most frequent reason for not reporting an exposure was that the patient was thought not to be infectious. Forty-six percent of respondents exposed to sources of unknown human immunodeficiency virus status who did not report chose "patient thought not to be infectious" as the reason. The most common reason for reporting an exposure was "hospital policy." Although limited by recall bias, this study showed that a high proportion of students and house staff experience occupational exposures. The results suggest that populations at high risk for exposures are the more experienced surgical house staff and the junior medical house staff. Exposures from sources known to be positive or at high risk for human immunodeficiency virus were reported more frequently than those from unknown risk sources.