The nature and frequency of blood contacts among home healthcare workers.
OBJECTIVE
To estimate the frequency of, and assess risk factors for, percutaneous, mucous membrane, and cutaneous blood contacts sustained by healthcare workers (HCWs) during the delivery of infusion therapy and the performance of procedures involving sharp instruments in the home setting.


METHODS
Prospective surveillance of percutaneous, mucous membrane, and cutaneous blood contacts.


METHODS
Eleven home healthcare agencies in the United States and Canada from August 1996 through June 1997.


METHODS
HCWs who provided home infusion therapy or performed procedures using hollow-bore needles and other sharp instruments in the home setting.


METHODS
Each participating worker recorded information about the procedures performed and blood contacts experienced during each of his or her home visits for a 2- to 4-week period using standard questionnaires. HCWs also completed questionnaires regarding job duties, reporting of previous occupational blood contacts, and their use of protective barriers in the home setting.


RESULTS
Participating HCWs provided information about 33,606 home visits. A total of 19,164 procedures were performed during 14,744 procedure visits. Fifty-three blood contacts occurred during these visits, for a blood-contact rate of 2.8 blood contacts per 1,000 procedures and 0.6 percutaneous injuries per 1,000 procedures with needles or lancets. Gloves were worn for 52%, masks for 5%, gowns for 3%, and protective glasses or goggles for 2% of all procedure visits. HCWs used barriers for 53% of visits during which at least 1 procedure was performed and for 27% of other visits.


CONCLUSIONS
HCWs involved in home health care are at risk for blood contact. Infection control barrier use was low in our study. The majority of skin contacts could have been prevented by glove use.
Beltrami
E M
EM
HIV Infections Branch, Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
McArthur
M A
MA
McGeer
A
A
Armstrong-Evans
M
M
Lyons
D
D
Chamberland
M E
ME
Cardo
D M
DM
D017848:Blood-Borne Pathogens; D017575:Gloves, Protective; D019538:Health Care Surveys; D018576:Home Health Aides; D018718:Home Infusion Therapy; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D016602:Needlestick Injuries / Q000453:epidemiology; D016273:Occupational Exposure