title: [Regional surveillance of occupational percutaneous and mucocutaneous exposure to blood-borne pathogens in health care workers: strategies for prevention].
abstract: BACKGROUND
  Several studies have investigated both the frequency and modality of occurrence of occupational exposure of health-care workers to blood-borne pathogens. At the moment no complete epidemiological data are available covering the hospitals of an entire Region.
  
  
  OBJECTIVE
  To describe the characteristics of mucocutaneous and percutaneous exposure to body fluids of the healthcare workers in 47 out of the 56 public hospitals (90% of a total 15,000 beds, 28,000 health-care workers full time equivalent) in Piedmont, Northern Italy (4.5 million inhabitants) over a three-year period (1999-2002), using SIROH (Studio Italiano Rischio Occupazionale da HIV) model to collect the data.
  
  
  CONCLUSIONS
  5174 percutaneous injuries (12.7/100 beds) and 1724 mucocutaneous exposure (4.1/100 beds) were recorded. Surveillance data were similar to those collected in other multi-hospital studies. The variability of rates between hospitals was high, most likely due to the amount of underreporting. The categories most at risk of percutaneous and mucocutaneous exposure were, respectively, surgeons (9.3/100 surgeons) and midwives (2.9/100 midwives). Needles (syringe, winged steel, suture) were the medical devices most frequently involved in percutaneous injuries, 60% of which occurred after the use of such devices. Eighty-three per cent of healthcare workers had been HBV-vaccinated versus only 45% of cleaning staff. After percutaneous injuries with exposure to an HIV positive source only 40% of those exposed received post-exposure prophylaxis; in the case of mucocutaneous exposure the rate was 11%. We recorded 2 seroconversions following occupational exposure to an HCV positive source (risk of seroconversion: 0,2%). In order to implement preventive programmes the use of safety devices, an increase in the number of HBV-vaccinated contract workers, the use of chemoprophylaxis for HIV exposure, and the use of protective equipment are deemed necessary.
authors: Ospedale di Rivoli - ASL 5 - Regione Piemonte. argenter@libero.it
authors: P A
authors: PA
authors: Argentero
authors: Carla Maria
authors: CM
authors: Zotti
authors: Francesca
authors: F
authors: Abbona
authors: C
authors: C
authors: Mamo
authors: Annalisa
authors: A
authors: Castella
authors: Alessandra
authors: A
authors: Vallino
authors: Beatrice
authors: B
authors: Luzzi
authors: Gabriella
authors: G
authors: De Carli
mesh_terms: D017848:Blood-Borne Pathogens; D006282:Health Personnel; D006801:Humans; D016602:Needlestick Injuries / Q000453:epidemiology*; D016273:Occupational Exposure / Q000517:prevention & control*; D011159:Population Surveillance