Risk Assessment Guidelines Research Articles

An Assessment Framework for Human Health Risk from Heavy Metals in Coal Chemical Industry Soils in Northwest China

Coal chemical industry (CCI) sites are characterized by complex environmental media, combined heavy metal pollution, and diverse exposure routes. However, existing human health risk assessment (HHRA) methods have multiple drawbacks, such as their small scope of application, limited assessment factors, and insufficient case applications. After 128 soil samples were collected, the contents of Be, V, Ni, Cu, Zn, As, Cd and Hg in the soils were analyzed based on general risk assessment guideline of China. Then, risk levels were calculated based on oral ingestion, skin contact and inhalation as the main exposure routes to compare and screen priority heavy metals. Furthermore, control values were identified through a contribution rate calculation model when CR > 10−6 or HQ > 1. As reference values, risk thresholds were proposed for heavy metals, and then a soil HHRA framework for the CCI site was constructed. Under the three exposure routes, the total CR was As > 10−6, and the total HQ was 1 > As > Cd; the HHRs related to As and V via the oral ingestion, dermal contact, and inhalation pathways were 76.67%, 13.13%, and 10.18% and 1.66%, 0, and 98.34%, respectively. The risk control value of As was 1.59 mg/kg and that of V was 25.1 mg/kg. Based on these results, the threshold values for priority heavy metals should be based on comprehensive considerations of the elemental background of a specific area, the contaminant criteria in different areas, the regional industrial development plan, and the most important control criterion, as well as the control value. Through the development of an HHRA framework and case verification, the authors of this article aim to guide CCI managers in screening priority heavy metals, formulating protection measures, developing improved operational procedures and improving the HHRA system for polluted CCI sites.

Coastal Abrasion Disaster Threat Analysis in North Galesong District, Takalar Regency

Coastal damage due to abrasion can interfere with residents' livelihoods, especially those who work as fishermen. Beaches that experience abrasion will result in more severe beach damage if not addressed. Coastal dynamics caused by wave activity, tides, currents, and human activities cause shoreline changes. This study aims to determine the coastal abrasion disaster threat level in North Galesong District, Takalar Regency. The analytical method used is the analysis of coastal abrasion threat index data in coastal areas, including oceanographic data, namely wave height and current speed, ecological data, mangrove vegetation density, the physical environment, and the shape of the coastline and beach characteristics. Analysis of the data using the analysis table of disaster threat assessment issued by the Head of BNPB Regulation No. 2 of 2012 concerning General Guidelines for Disaster Risk Assessment. The study results have a high category of coastal erosion threat in the coastal area of Galesong Utara District, which is found in all coastal village areas. The high category level represents the high potential threat of coastal abrasion to the incidence of casualties and material losses on the coast of North Galesong District. It is necessary to build structural mitigation to maintain coastal stability in the form of longshore sedimentation retaining structures, abrasion absorbers, and, breakwater structures to reduce the rate of coastal abrasion.

Climate Characteristics and Distribution of Native Organisms in Living Modified Organism Confined Field under the Ministry of Environment, Republic of Korea

In this study, climate variables and distribution patterns of native organisms were investigated in an enclosed field within the institute of living modified organism (LMO) risk assessment designated by the Ministry of Environment (MOE) of South Korea. The data includes changes in temperature, precipitation, humidity, sunlight, wind direction, and velocity within the LMO confined field from 2019 to 2023 as well as information on plant diversity and soil microbial communities. This data can be used as the basic data when establishing LMO safety management policies by the MOE such as preparing guidelines for systematic LMO risk assessment reflecting domestic environmental characteristics and risk assessment of LMOs for environmental remediation and natural ecosystem. In addition, this data can be usefully used as the comparative data for LMO risk assessment by other ministries such as the Ministry of Agriculture, Food and Rural Affairs, the Ministry of Trade, Industry and Energy, and the Ministry of Oceans and Fisheries.

56 Audit of assessment, prevalence, and treatment of osteoporosis for patients attending the inflammatory bowel disease Service in Mullingar Regional Hospital

Abstract Background Courses of steroids are common in patients with Inflammatory Bowel Disease (IBD) and are a risk factor for developing osteoporosis. Osteoporosis is a clinically silent entity and osteoporosis-related fractures are associated with chronic pain, disability, and impact quality of life. Screening of high-risk populations is the mainstay of fracture prevention. In this audit, we aimed to assess adherence to international guidelines for osteoporosis risk assessment and bone protection. Methods A retrospective audit was performed with a random sampling of 10% of the patients attending between October 2021 to October 2022 the IBD outpatient clinic in Mullingar Regional Hospital. Data included demographics, IBD diagnosis, FRAX tool components, FRAX score, bone health screening, DEXA results, and use of bone mineral protection. Clinical practice was compared against European Crohn’s and Colitis Organisation (ECCO) recommendations on bone protection in IBD. Results Of 150 charts reviewed, 39 charts were missing essential data and 8 had a diagnosis other than IBD. All 103 patients included in the analysis had received >3 months of systemic steroid use, of which 50 had a diagnosis of Crohn’s disease and 63 with ulcerative colitis. Two (2%) patients had a FRAX risk assessment for osteoporosis, and 22 (21%) had a DEXA ordered, of which 7 (7%) were by the IBD clinic. Two (2%) patients had a previous fragility fracture and 3 (3%) had been diagnosed with osteoporosis. Bone protection was used in 21 (20%) patients receiving steroids, including calcium and vitamin D supplementation (n = 19), and bisphosphonate (n = 2). Conclusion There are low rates of osteoporosis screening for IBD patients attending this service. There was inadequate data in the charts to calculate FRAX scores to assess osteoporosis prevalence. An intervention tool is currently being designed and the audit cycle will be completed with a repeat audit after implementation.

1024 Current Adherence to Local Health Board Guidelines for Venous Thromboembolism Risk Assessment in Orthopaedic Trauma Lists

Abstract Aim This audit aims to assess the current adherence to the local health board guidelines for Venous Thromboembolism (VTE) risk assessment in Orthopaedic Trauma lists. Method Data was collected for all patients who underwent operation on trauma lists between 1st June 2022 and 31st June 2022. Data collected included the operation type, if VTE risk assessment was completed on admission and pre-operatively. Plan post-operatively and on discharge was also noted as well as the length of VTE prophylaxis prescribed. Results There were 172 patients in total, 117 lower limb procedures and 55 upper limb procedures. Of these procedures 42 lower limb patients and two upper limb patients had risk assessments on admission. 110 patients with lower limb injuries received VTE prophylaxis on admission compared to eight of the non-day case upper limb. Seven lower limb patients and five upper limb did not have a VTE plan post-operatively. There was variation in length of prophylaxis prescribed post-operatively in relation to procedure and guidelines ranging from nine days to six weeks. Conclusions As per local health board guidelines all patients that are admitted or undergo operation as part of the Orthopaedic Department should have VTE assessment carried out. This audit concludes that approximately 25% of VTE assessments on admission are clearly documented. Despite the lack of formal assessment most patients receive VTE prophylaxis but questions whether prescription is appropriate. We also conclude that most patients have a well-documented post-operative VTE plan. Re-audit with intervention is due to end 4th January 2023.

Pemeliharaan Lereng Pada Ruas Jalan Nasional Cikembang – Bagbagan Berdasarkan Kategori Risiko

The incidence of landslides increases during the rainy season, especially in hilly areas or valleys. Cikembang - Bagbagan road is a national road that connects Pelabuhanratu - Sukabumi City with the condition of the area in the form of hilly areas with many slopes. This study aims to assess the level of slope risk and mitigation recommendations needed. The data collection method used is using secondary data in the form of inspection data and inventory of related slopes. The analysis method was carried out by determining the index value based on the Guidelines for road slope risk assessment (2018) and then analyzed to obtain the risk category. The results of 4 slopes obtained 2 slopes with high risk, 1 slope with medium risk, and 1 slope with low risk. In the risk assessment, the parameters of engineering buildings, geometry and geology of slopes play a major role in determining the risk category. Mitigation carried out on the 4 slopes is carried out in accordance with the risk category such as routine maintenance, rehabilitation, and slope instrumentation. The mitigation prioritization is done first on slope D then slope A, slope B, and slope C.

Overview of The Infection Control Risk Assessment (ICRA) Implementation in Dental Practice at RSGM Unimus

Infections present while undergoing treatment or obtained from health services are called Healthcare-Associated Infections (HAIs). The impact of this incident is the length of treatment and costs provided, increased morbidity, and can result in death. One of the many occupations in the world with the highest risk of infection transmission is health workers working in dentistry since most of human microbial pathogens originate from oral secretions. In contrast, these health workers require their proximity to the patient’s oropharynx. The increase in HAIs occurs due to the lack of application of infection control, so we need to assess this implementation. The Centers for Disease Control and Prevention (CDC), in 2016, issued standardized Infection Control Risk Assessment (ICRA) guidelines to assess the risk of infection in dental and oral health services. This research aims to describe ICRA in the dentist practice at RSGM Unimus. The type of research used was observational, with quantitative analysis methods and a descriptive research design. The results showed that overall, infection control at RSGM Unimus had a percentage of 82%, which was included in the low infection risk category. RSGM Unimus was good at implementing infection control programs.

Re-evaluation of a microbiological acceptable daily intake for tylosin based on its impact on human intestinal microflora

As veterinary drugs available for fish is very restricted, there is growing trials for repurposing livestock drugs as aquatic animal drugs. Tylosin is one of the most effective antibiotics to treat bacterial infections approved for livestock, and would be used in fish. Hence, we investigated the toxicological and microbiological aspects of tylosin to establish health-based guidance value (HBGV) and maximum residue limit (MRL) in fishes, and reevaluated the microbiological acceptable daily intake (mADI) based on updated relevant data and international guildeline. Lastly, exposure assessment was performed to confirm the appropriateness of MRL. By investigating available microbiologcial studies on tylosin, the microbiological point of departure was determined as 0.308 μg/mL, which was mean 50% minimum inhibitory concentration (MIC50), obtained from the Food Safety Committee of Japan (FSCJ) evaluation report. Furthermore, as a factor for the derivation of mADI, the volume of colon content was recently changed to 500 mL in compliance with the International Cooperation on Harmonization of Technical Requirements for Registration of Veterinary Medicinal Products (VICH) guidelines. This was previously defined as the mass of colon content (220 g). We applied correction factor 0.224 to the mean MIC50 for tylosin in the equation of mADI, since the drug is transformed to metabolites with reduced activity prior to entering the colon and bound to fecal materials within the colon of human. The mADI was evaluated as 0.01 mg/kg bw/day. Finally, the hazard index, calculated by dividing the estimated chronic dietary exposure by mADI, did not exceed 100%, suggesting that chronic dietary exposure to tylosin residues from veterinary use was unlikely to be a public health concern. Overall, this study contributes significantly in updating HBGV by application of the concept of mADI for the first time in Korea based on the revised microbiological risk assessment guidelines and in providing scientific rationale for the risk management of veterinary drug residues in food.

Evidence supporting the choice of a new cardiovascular risk equation for Australia.

This article reviews the risk equations recommended for use in international cardiovascular disease (CVD) primary prevention guidelines and assesses their suitability for use in Australia against a set of a priori defined selection criteria. The review and assessment were commissioned by the National Heart Foundation of Australia on behalf of the Australian Chronic Disease Prevention Alliance to inform recommendations on CVD risk estimation as part of the 2023 update of the Australian CVD risk assessment and management guidelines. Selected international risk equations were assessed against eight selection criteria: development using contemporary data; inclusion of established cardiovascular risk factors; inclusion of ethnicity and deprivation measures; prediction of a broad selection of fatal and non-fatal CVD outcomes; population representativeness; model performance; external validation in an Australian dataset; and the ability to be recalibrated or modified. Of the ten risk prediction equations reviewed, the New Zealand PREDICT equation met seven of the eight selection criteria, and met additional usability criteria aimed at assessing the ability to apply the risk equation in practice in Australia.

Providers Respond to USPSTF Report on Screening for Breast Cancer

Providers Respond to USPSTF Report on Screening for Breast Cancer

Detecting Enteric Pathogens in Low-Risk Drinking Water in Dhaka, Bangladesh: An Assessment of the WHO Water Safety Categories.

The microbiological quality of water is usually assessed by fecal coliform bacteria, and the presence of E. coli as an indicator of fecal contamination is widely recommended by international guidelines. This study aimed to assess the prevalence of diarrheagenic pathogens, in both public and personal domain water sources and examine the reliance on the WHO drinking water risk assessment guidelines. This study was conducted in a low-income urban community in Dhaka, Bangladesh between September 2014 and October 2015. Polymerase chain reaction (PCR) was used to detect the marker and virulence genes of Escherichia coli, Vibrio cholerae, Salmonella species, and Campylobacter species, and the culture method was employed for the quantitative assessment of E. coli. According to the WHO guidelines, 48% of the public domain source water and 21% of the personal domain point-of-drinking water were classified in the low-risk group, i.e., 0 CFU of E. coli/100 mL. However, when using PCR, we detected pathogens in 39% (14/36) of the point-of-drinking water samples and 65% (74/114) of the public domain water source samples classified in the low-risk group. Our study showed that relying solely on E. coli detection as a measure of water quality may overlook the presence of other pathogens in the drinking water. In addition to the culture-based method, the detection of virulence genes by PCR should also be considered to add more scrutiny to the detection of diverse types of pathogens.

Evaluating genetic screening/counseling for patients diagnosed with prostate cancer who meet hereditary risk assessment based on NCCN Guidelines.

e17117 Background: Prostate cancer is most common cancer among men and is the second leading cause of cancer deaths in American men. Genetic predisposition to cancer is increasingly noted as a cause in many cancers including prostate cancer. Genetic testing and counseling are recommended in certain groups of men; Men with or without a personal history of prostate cancer who have a family history of prostate, breast, colon, ovarian, or pancreatic cancers, especially if any of these were diagnosed under age 50 and those with metastatic prostate cancer. A recent study of 3,600 men with prostate cancer found that 17% had inherited genetic mutations that may have contributed to their cancer. Of those men, 31% of the mutations were in the BRCA genes. Because of this, familiarity and understanding of the most current clinical guidelines for genetic risk assessment are of great importance in the survivorship care of men with prostate cancer. The National Comprehensive Cancer Network (NCCN) guidelines recommends genetic assessment/counseling for genetic/familial high-risk individuals diagnosed with prostate cancer. This retrospective study reports on adherence to genetic screening based on NCCN guidelines for newly diagnosed Prostate cancer patients who were receiving treatment at Northeast Georgia Medical Center (NGMC). Methods: We obtained data using EPIC database from NGMC electronic medical records to identify patients who were diagnosed between 1/1/20-12/31/20. Data included patients who were high risk and fit the criteria for genetic testing based on NCCN as well as identifying patients who were sent for genetic testing/counsellng. The dataset was de-identified and analyzed using appropriate descriptive statistical testing. Results: A total of 42 cases for prostate cancer were reviewed. All 42 of the cases were under the age of 60 at diagnosis. A total of 13 of the cases meet the genetic/familial high-risk assessment based on NCCN guidelines. Of the 13 of the cases, only 1 case was referred for genetic counseling which was 7.6% compliance with NCCN guidelines for genetic counseling/referral. In terms of high-penetrance prostate cancer risk screening, none of the 13 cases (0%) meeting genetic/familial high-risk were screened. Based on our findings, there was poor adherence in genetic testing/counseling in high risk patients with prostate cancer at NGMC. Conclusions: This study points out poor adherence to NCCN guideline directed genetic counseling/testing in high risk patients with prostate cancer. Based on findings, it is clear that high importance should be placed on awareness on the current guidelines in relation to gene testing for patients who are high risk as this would play an important role in identifying family members who at risk and ensure early screening.

Types and Source Apportionment of Polycyclic Aromatic Hydrocarbons (PAHs) in Soil-Groundwater of a Closed Coking Plant in Shanxi Province, China

To clarify the impact of coking industry activities on the soil-groundwater Polycyclic aromatic hydrocarbon (PAH) occurrence, a typical coking site in Shanxi Province was taken as the study area, and soil and groundwater samples were collected to analyze the pollution level, composition, and distribution of PAHs in soil-groundwater. The sources of PAHs in the study area were identified based on the positive matrix decomposition model (PMF); the health risks of PAHs were calculated based on the carcinogenic and non-carcinogenic health risk model from the Technical Guidelines for Risk Assessment of Soil Pollution for Construction Land (HJ 25.3-2019) and toxicity equivalent quantity (TEQ). The results showed that ∑PAHs of soil ranged from 0 to 6077.7 mg/kg, with an average value of 198.02 mg/kg; ∑PAHs of groundwater ranged from 0 to 18.30 mg/L, with an average value of 9.39 mg/L. In horizontal distribution, ∑PAH content and types in the tar processing area were much higher than those in the surrounding area, and PAHs might migrate to the southwest through infiltration; in vertical distribution, ∑PAH content reached a peak at 5 m underground. According to the PMF model results, four primary sources of ∑PAHs were identified, which were the coking production source (55.0%), coal and petroleum combustion source (22.6%), atmospheric deposition source (13.1%) and residents living source (9.3%). The total average ∑PAH carcinogenic and non-carcinogenic health risks of soil in the study area were 7.05 × 10−6 and 0.695; the average TEQBaP−∑PAHs was 1.650 mg·TEQ/g; as for groundwater, they were 3.08 × 10−6 and 32.04; the average TEQBaP−∑PAHs was 9.390 μg·TEQ/L, indicating that PAHs both in soil and groundwater had potential health risks. This study provides a basis for the same coking site type for pollution control, secondary utilization, and data support for future site restoration.

Cardiometabolic risk in people under 40 years with severe mental illness: reading between the guidelines.

People with severe mental illness (SMI) have a shorter life expectancy than the rest of the population. Multimorbidity and poorer physical health contribute to this health inequality. Cardiometabolic multimorbidity confers a significant mortality risk in this population. Multimorbidity is not restricted to older people and people with SMI present with multimorbidity earlier in life. Despite this, most screening, prevention and treatment strategies target older people. People under 40 years with SMI are underserved by current guidelines for cardiovascular risk assessment and reduction. Research is needed to develop and implement interventions to reduce cardiometabolic risk in this population.

Endometrial cancer survivors' perceptions of their cardiovascular disease risk (results from WF-1804CD AH-HA)

ObjectiveDespite considerable burden of cardiovascular disease (CVD), data on endometrial cancer survivors' CVD perceptions are lacking. We assessed survivors' perspectives on addressing CVD risk during oncology care. MethodsThis cross-sectional analysis utilized data from an ongoing trial of an EHR heart health tool (R01CA226078 & UG1CA189824) conducted through the NCI Community Oncology Research Program (NCORP, WF-1804CD). Endometrial cancer survivors post-potentially curative treatment were recruited from community practices and completed a pre-visit baseline survey, including American Heart Association Simple 7 CVD factors. Likert-type questions assessed confidence in understanding CVD risk, CVD risk perception, and desired discussion during oncology care. Medical record abstraction ascertained data on CVD and cancer characteristics.Results: Survivors (N = 55, median age = 62; 62% 0–2 years post-diagnosis) were predominately white, non-Hispanic (87%). Most agreed/strongly agreed heart disease poses a risk to their health (87%) and oncology providers should talk to patients about heart health (76%). Few survivors reported smoking (12%) but many had poor/intermediate values for blood pressure (95%), body mass index (93%), fasting glucose/A1c (60%), diet (60%), exercise (47%) and total cholesterol (53%). 16% had not seen a PCP in the last year; these survivors were more likely to report financial hardship (22% vs 0%; p = 0.02). Most reported readiness to take steps to maintain or improve heart health (84%). ConclusionsDiscussions of CVD risk during routine oncology care are likely to be well received by endometrial cancer survivors. Strategies are needed to implement CVD risk assessment guidelines and to enhance communication and referrals with primary care.Clinical Trials #: NCT03935282

Insights into the management of pulmonary arterial hypertension patients in Spain

Introduction and objectivesAccurate risk stratification is pivotal to tailor therapy according to the prognosis of pulmonary arterial hypertension (PAH) patients to positively impact the course of the disease. We conducted a nationwide study to assess how the current European Society of Cardiology/European Respiratory Society guidelines for risk assessment and management of PAH patients are followed in real-world practice in Spain. MethodsHospital-based physicians answered an online questionnaire describing their yearly caseload of PAH patients and their management of virtual cases scenarios for Word Health Organization functional class (FC) II–III PAH patients. ResultsThe main tests requested for a regular risk assessment were echocardiography, 6-minute walk test, measurement of brain natriuretic peptide/N-terminal pro-B-type natriuretic peptide plasma levels and right heart catheterization. The main treatment prescribed was an oral double-combination therapy with an endothelin receptor antagonist (ERA) and a phosphodiesterase type 5 inhibitor (PDE5i) or guanylate cyclase stimulator. Around 20% of the clinicians would also add the selective prostacyclin-receptor agonist (selexipag) to ERA and PDE5i as initial therapy for FC III patients, and nearly all clinicians (99%) would add a prostacyclin pathway agent to FC III PAH patients presenting multiple new intermediate-risk parameters despite a 6-month dual therapy with ERA and PDE5i. ConclusionsThe main decisive factor for the management of PAH patients in Spanish hospitals is their functional class and intermediate-risk parameters. Selexipag was more frequently prescribed than parenteral prostacyclin-analogs in triple-combination therapy for FC II–III PAH patients presenting low-risk and intermediate-risk parameters.

Privacy risks of whole-slide image sharing in digital pathology

Access to large volumes of so-called whole-slide images—high-resolution scans of complete pathological slides—has become a cornerstone of the development of novel artificial intelligence methods in pathology for diagnostic use, education/training of pathologists, and research. Nevertheless, a methodology based on risk analysis for evaluating the privacy risks associated with sharing such imaging data and applying the principle “as open as possible and as closed as necessary” is still lacking. In this article, we develop a model for privacy risk analysis for whole-slide images which focuses primarily on identity disclosure attacks, as these are the most important from a regulatory perspective. We introduce a taxonomy of whole-slide images with respect to privacy risks and mathematical model for risk assessment and design . Based on this risk assessment model and the taxonomy, we conduct a series of experiments to demonstrate the risks using real-world imaging data. Finally, we develop guidelines for risk assessment and recommendations for low-risk sharing of whole-slide image data.

A comprehensive early warning system for karst water sources contamination risk, case study of the Unica springs, SW Slovenia

Water suppliers should provide safe drinking water following preventive measures. This is especially important for karst water sources, as they are among the most vulnerable. Recently, there has been a strong focus on the early warning system, which mainly involves monitoring proxy parameters, but does not consider drainage area conditions and other monitoring recommendations. Here, we present an innovative strategy for assessing contamination risk of karst water sources that covers spatio-temporal dimensions and can be integrated into management practices. It is based on event-based monitoring and risk mapping and has been tested in a well-known study area. The holistic early warning system provides accurate spatial hazard and risk assessment and operational monitoring guidelines, including locations, indicator parameters, and temporal resolution and duration. In the study area, the high contamination risk, representing 0.5 % of the area, was spatially delineated. The highest probability of source contamination occurs during recharge events when proxy parameters such as bacteria, ATP, Cl, and Ca/Mg ratio should be monitored in addition to continuous monitoring of turbidity, EC, and T. Monitoring of sinking streams should serve as a preventive measure, since water transfer from ponors to springs has been shown to take about one day, and poor quality water is present for at least another day. Therefore, intensive monitoring should be conducted at intervals of a few hours for at least a week. Although hydrologic systems vary, the proposed strategy is particularly useful in systems where water flows rapidly and where remediation is not feasible.

Risk analysis of landslide disaster in Pati Regency, Central Java Province

Landslide is one of the disasters that often occurs in Pati Regency. This study aims to analyze the risk of landslides in Pati Regency. The landslide risk index in Pati Regency is carried out by analyzing three components: the hazard index, vulnerability, and capacity according to BNPB head regulation No. 2 the year 2012 concerning General Guidelines for Disaster Risk Assessment. The results showed a high landslide risk index in 49 villages out of 406 throughout Pati Regency. The sub-districts with the highest landslide risk index are Sukolilo District with nine villages and Gunungwungkal with seven villages. The high-risk index in the area is influenced by the high danger of landslides and the lack of existing capacity. The recommended recommendations include installing EWS, socializing knowledge on disaster preparedness, improving emergency response management, increasing community participation, evaluating RTRW, and reviewing vegetation types.

Formal and informal venous thromboembolism risk assessment and impact on prescribing of thromboprophylaxis: a retrospective cohort study

BackgroundHospital-acquired thrombosis (HAT) is a leading cause of preventable death and disability worldwide. HAT includes any venous thromboembolic (VTE) event occurring in-hospital or within 90-days of hospitalisation. Despite availability of evidence-based guidelines for HAT risk assessment and prophylaxis, guidelines are still underutilised.AimTo determine the proportion of patients who developed HAT that could have been potentially prevented with appropriate VTE risk assessment and prophylaxis at a large public hospital in New Zealand. Additionally, the predictors of VTE risk assessment and thromboprophylaxis were examined.MethodVTE patients admitted under general medicine, reablement, general surgery, or orthopaedic surgery service were identified using ICD-10-AM codes. Data were collected on patient characteristics, VTE risk factors, and the thromboprophylaxis regimen prescribed. The hospital VTE guidelines were used to determine rates of VTE risk assessment and the appropriateness of thromboprophylaxis.ResultsOf 1302 VTE patients, 213 HATs were identified. Of these, 116 (54%) received VTE risk assessment, and 98 (46%) received thromboprophylaxis. Patients who received VTE risk assessment were 15 times more likely to receive thromboprophylaxis (odds ratio [OR] = 15.4; 95% CI 7.65–30.98) and 2.8 times more likely to receive appropriate thromboprophylaxis (OR = 2.79; 95% CI 1.59–4.89).ConclusionA large proportion of high-risk patients who were admitted to medical, general surgery and reablement services and who developed HAT did not receive VTE risk assessment and thromboprophylaxis during their index admission, demonstrating a significant gap between guideline recommendations and clinical practice. Implementing mandatory VTE risk assessment and adherence to guidelines to improve thromboprophylaxis prescription in hospitalised patients may help reduce the burden of HAT.