Risk of hepatitis C virus transmission to surgeons and nurses from infected patients: model-based estimates in France.
OBJECTIVE
The aim of this study was to estimate the annual number of cases of hepatitis C virus transmission from infected patients to uninfected surgeons or nurses due to percutaneous injury during invasive procedures.


METHODS
The risk of transmission was estimated using a model involving three probabilities: A, that a health care worker sustains at least one percutaneous injury during a procedure; B, that 1 to 10% of patients are seropositive for hepatitis C virus; and C, that infection by this virus is transmitted to the Health Care Worker after such exposure. Probability A was estimated from the results of 2 French multicentric prospective trials. Probability C was estimated from the results of 9 international prospective studies. A ten-fold decreased risk was assumed for surgeons who wear gloves and use solid-bore suture needles.


RESULTS
During a single procedure, the estimated probability of hepatitis C virus transmission from an infected patient to an uninfected surgeon ranged from 4.2x10(-5)% to 4.2x10(-4)%, and from 2.98x10(-6)% to 2.98x10(-5)% to an uninfected nurse. For surgeons, the estimated annual cumulative risk of occupational infection ranged from 0.01% to 0.1% (1 in 10000 to 1 in 1000), and for nurses from 0.0054% to 0.054% (1 in 18700 to 1 in 1900).


CONCLUSIONS
Between 2 and 21 surgeons out of a total 20000 are estimated to acquire occupationally-related hepatitis C virus infection, and between 16 and 167 nurses out of a total 300000. These estimates strongly justify introducing preventive measures to protect health care workers from bloodborne infection.
Yazdanpanah
Y
Y
INSERM Unit 444, Institut Fédératif Saint-Antoine de Recherche sur la Santé, Paris, France.
Boëlle
P Y
PY
Carrat
F
F
Guiguet
M
M
Abiteboul
D
D
Valleron
A J
AJ
D005602:France / Q000453:epidemiology; D013502:General Surgery; D005932:Gloves, Surgical; D006526:Hepatitis C / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data*; D015233:Models, Statistical; D009339:Needles; D009740:Nursing Staff; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D011336:Probability; D018570:Risk Assessment; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000592:standards; D013537:Sutures