Effect of time of day and duration into shift on hazardous exposures to biological fluids.
OBJECTIVE
To determine whether hospital employee biological hazardous exposure rates varied with time of day or increased with time interval into shift.


METHODS
This was a retrospective occurrence report review conducted at a university hospital with an emergency medicine residency program. Health care worker biological hazardous exposure data over a 30-month period were reviewed. Professional status, date, time, and type of exposure (needlestick, laceration, splash), time interval into shift of exposure, and hospital location of exposure were recorded. Hourly employee counts and risky procedure counts were matched by location with each reported exposure, to determine hourly rates of biological hazardous exposures.


RESULTS
Analysis of 411 recorded exposures demonstrated that more people were exposed between 9:00 AM and 11:00 AM (p < 0.05), yet the exposure risk did not vary significantly when expressed as the number of exposures per worker or per procedure. Of the 393 exposures with data describing time interval into shift when the exposure occurred, significant numbers of exposures occurred during the first hour and at shift's end [when corrected for exposures per worker (p < 0.05) or exposures per procedure (p < 0.05)].


CONCLUSIONS
While the number of exposures are increased in the AM hours, the exposure rate (as a function of workers or procedures) does not vary with time of the day. However, the exposure rate is increased during the first hour and last 2 hours of a shift. Efforts to increase worker precautions at the beginning and end of shifts are warranted.
Macias
D J
DJ
University of New Mexico, Department of Emergency Medicine, Albuquerque, USA. drmacias@medusa.unm.edu
Hafner
J
J
Brillman
J C
JC
Tandberg
D
D
D017848:Blood-Borne Pathogens; D001826:Body Fluids; D002940:Circadian Rhythm; D004635:Emergency Medicine / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D006525:Hepatitis, Viral, Human / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data*; D016602:Needlestick Injuries / Q000453:epidemiology / Q000517:prevention & control; D009516:New Mexico / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000517:prevention & control; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D014940:Work Schedule Tolerance