Perioperative blood contact and exposures: A comparison of incident reports and focused studies

Abstract

Background: Occupational blood exposures among operating room personnel have been substantially underreported in incident reports. Recent research has indicated several common factors influencing exposure rates: surgical service (thoracic, neurosurgery, orthopedic), length of operation, and emergency status. Methods: This report examines further data from a study of 8502 surgical cases in nine hospitals, in which a site coordinator and circulating nurses reported consecutive case information, including blood contacts that occurred during the procedures. For three of the participating hospitals, incident reports of blood exposures among operating room personnel that occurred during a 12-month period before the study were also tabulated. Results: Incident reports underreported parenteral exposures (punctures, mucous membrane and nonintact skin contact with patient blood) by as much as a factor of 25. Individual hospital rates of occupational surgical blood exposure varied considerably. Conclusions: To ensure that resources to prevent occupational blood exposure are allocated appropriately, on the basis of actual risk, among all personnel, hospitals must actively monitor blood exposures in their operating rooms.