Occupational exposure to needlestick injuries and hepatitis B vaccination coverage among health care workers in Egypt

Abstract

Background The health care worker (HCW) is at substantial risk of acquiring bloodborne pathogen infections through exposure to blood or infectious body fluids. Hepatitis B vaccination of HCWs and optimal HCW practices regarding management of sharps can minimize these risks. This study explores the frequency of exposure to needlestick injuries and the hepatitis B vaccination coverage among HCWs in Egypt. Methods All HCWs available in a 25% random sample of different types of health care facilities from 2 governorates in Egypt (Nile Delta and Upper Egypt) were included in the study. A total of 1485 HCWs were interviewed. History of exposure to needlestick injuries, vaccination status, and socioeconomic data were collected. Results Of the 1485 HCWs interviewed, 529 (35.6%) were exposed to at least 1 needlestick injury during the past 3 months with an estimated annual number of 4.9 needlesticks per worker. The most common behavior associated with needlestick injuries was 2-handed recapping. Overall, 64% of HCWs disposed of needles unsafely in nonpuncture-proof containers. Overall 15.8% of HCWs reported receiving 3 doses of hepatitis B vaccine. Vaccination coverage was highest among professional staff (38%) and lowest among housekeeping staff (3.5%). Using Kane's model to predict infections after needlestick exposures, we estimate 24,004 hepatitis C virus and 8617 hepatitis B virus infections occur each year in Egypt as a result of occupational exposure in the health care environment. Conclusion High rates of needlestick injuries and low vaccination coverage contribute highly to the rates of viral hepatitis infections among HCWs. Prevention of occupational infection with bloodborne pathogens should be a priority to the national program for promotion of infection control. Training of HCWs on safe handling and collection of needles and sharps, and hepatitis B vaccination of all HCWs is required to reduce transmission.