[Occupational exposure to blood and body fluids in haemodialysis health care workers: epidemiological data and prevention in France].
Health care workers (HCW) in haemodialysis units are confronted with a significant risk of occupational exposure to blood and body fluids. The prevalence of bloodborne viruses is high among haemodialysis patients. The data presented here relates to the extraction of 121 occupational exposures notified to occupational health departments by haemodialysis HCW, documented between January 1995 and December 1999 in a network of 54 volunteer hospitals in Northern France. The exposures notified in haemodialysis wards were needlestick injuries in 85 cases (70.2%), splashes to the eyes or non-intact skin in 30 cases (24.8%) and cuts in 6 cases (5.0%). Connection and disconnection of dialysis catheters to fistulae, blood sampling procedures and injections alone were involved in approximately 3 notified exposures out of 4 (46.3, 14.9 and 11.6% respectively for a total of 72.8%). The principal mechanisms for exposure were the handling of blood-soiled needles and instruments or involved the handling of sharps containers. Haemodialysis fistula needles were involved in only 12 (13.2%) of notified percutaneous injuries. Nearly 2/3 (63%) of 91 notified percutaneous injuries could have been avoided by the observance of universal/standard precautions alone and the use of safety devices which were available at the time. The collection and analysis of occupational exposures can serve as basis for an assessment of practices, devices and safety equipment to increase HCW safety in haemodialysis wards.
Tarantola
Arnaud
A
CCLIN Paris-Nord, institut biomédical des Cordeliers, 15-21 rue de l'Ecole-de-Médecine, 75006 Paris, France. cclin@jussieu.fr
Lheriteau
François
F
Astagneau
Pascal
P
Bouvet
Elisabeth
E
D017848:Blood-Borne Pathogens; D004866:Equipment Contamination; D005602:France / Q000453:epidemiology; D006801:Humans; D017053:Infection Control; D016602:Needlestick Injuries / Q000453:epidemiology; D016273:Occupational Exposure / Q000517:prevention & control / Q000706:statistics & numerical data*; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation*