Occupational blood-borne diseases in surgery.
BACKGROUND
Human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV) infections are transmitted by blood exposure. Surgeons have been concerned about the risks of blood exposure in the operating room as a potential source of occupational infections from these viruses. The actual risk and frequency of operating room transmission remains poorly understood by many surgeons.


METHODS
The pertinent recent literature on the pathophysiology, diagnosis, prevention, and treatment of HIV, HBV and HCV were reviewed to address the current understanding of these viruses as occupational risks to surgeons.


RESULTS
HIV transmission to surgeons has not been documented in the United States by the Centers for Disease Control. HIV transmission from a surgeon to a patient in the environment of the operating room, as well as transmission from an HIV-infected surgeon to a patient, has not been documented. HBV infection of surgeons has declined with the general acceptance of the HBV vaccine. HCV infection remains a real risk for transmission in the operating room, given that no vaccine is currently available and that the overall number of chronically infected patients remains quite high.


CONCLUSIONS
The risk of occupational infection from known viral pathogens for surgeons is low, but it is not zero. Effective barriers, modified patterns of behavior, and prompt responses to blood exposure events are the best methods for prevention.
Fry
Donald E
DE
Department of Surgery, 1 University of New Mexico, Albuquerque, NM 87131, USA. dfry@salud.unm.edu
D017848:Blood-Borne Pathogens / Q000302:isolation & purification*; D005260:Female; D013502:General Surgery; D015658:HIV Infections / Q000175:diagnosis / Q000635:transmission*; D006509:Hepatitis B / Q000635:transmission*; D006526:Hepatitis C / Q000635:transmission*; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000458:organization & administration*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology / Q000517:prevention & control; D009873:Operating Rooms; D011322:Primary Prevention / Q000379:methods; D011379:Prognosis; D018570:Risk Assessment