title: Trends in bloodborne pathogen exposure and follow-up at an urban teaching hospital: 1987 to 1997.
abstract: Health care workers (HCWs) risk occupational exposure to bloodborne pathogens. Effective postexposure treatment and testing depend on compliance with follow-up, but compliance rates are poorly understood. We examined trends in exposure and follow-up at a large teaching hospital after interventions to improve compliance. We reviewed exposures from October 1987 to September 1988 (group 1) and July 1996 to June 1997 (group 2). Data were analyzed for HCW demographics, source patient characteristics, and follow-up outcomes. We found that group 2 source patient serologic data were obtained more often. Group 1 source patients were more likely to be positive for the human immunodeficiency virus (HIV). Group 2 HCWs were more likely to be immune to hepatitis B virus, to agree to HIV testing, and to comply with follow-up. Follow-up rates remained suboptimal, even after high-risk exposures. Non-licensed HCWs were less likely to accept postexposure testing than physicians or nurses in group 2. General and targeted interventions to improve compliance and follow-up are still needed.
authors.affiliation: Division of Occupational Medicine, Department of Emergency Medicine, University of Pennsylvania Health System, One Silverstein Pavilion, 3400 Spruce Street, Philadelphia, PA 19104, USA. behrman@mail.med.upenn.edu
authors.forename: A J
authors.initials: AJ
authors.lastname: Behrman
authors.forename: F S
authors.initials: FS
authors.lastname: Shofer
authors.forename: J
authors.initials: J
authors.lastname: Green-McKenzie
mesh_terms: D000328:Adult; D017848:Blood-Borne Pathogens; D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology*; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data*; D008297:Male; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data*; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data; D017010:Reminder Systems; D012189:Retrospective Studies; D014481:United States