Occupational exposure in healthcare workers: an Italian study of occupational risk of HIV and other blood-borne viral infections

Abstract

From January 1994 to December 1999, 44 hospitals were enrolled in the Studio Italiano Rischio Occupazionale da HIV (SIROH), an Italian hospital network established in 1986 to study, monitor and prevent the risk of occupational transmission of blood-borne pathogens in the healthcare setting. During the study period, 21,118 percutaneous exposure and 6,400 mucocutaneous exposures were reported. Nurses were the most exposed (57%), and had the highest combined (percutaneous and mucocutaneous) exposure rates in all working areas, ranging from 14.1 per 100 full-time equivalent positions in general surgery to 9.5% in medical specialities. Among percutaneous exposures, 66.2% involved a hollow-bore (HB) needle device. Device-specific exposure rates per 100,000 devices used for disposable syringes, winged steel needles, vacuum tube phlebotomy sets, and IV catheters (90% of involved HB devices) were higher for those devices with a more complicated design. Twelve cases of occupational infection were detected; the seroconversion rates following percutaneous and mucocutaneous exposures to HIV, HCV and HBV were all <0.5%. No cases of infection followed non-intact skin exposure. Our study shows that the implementation of a standardised program by a network of acute care hospitals provides us with the ability to address many important questions concerning the safety of HCWs.