Costs of management of occupational exposures to blood and body fluids.
OBJECTIVE
To determine the cost of management of occupational exposures to blood and body fluids.


METHODS
A convenience sample of 4 healthcare facilities provided information on the cost of management of occupational exposures that varied in type, severity, and exposure source infection status. Detailed information was collected on time spent reporting, managing, and following up the exposures; salaries (including benefits) for representative staff who sustained and who managed exposures; and costs (not charges) for laboratory testing of exposure sources and exposed healthcare personnel, as well as any postexposure prophylaxis taken by the exposed personnel. Resources used were stratified by the phase of exposure management: exposure reporting, initial management, and follow-up. Data for 31 exposure scenarios were analyzed. Costs were given in 2003 US dollars.


METHODS
The 4 facilities providing data were a 600-bed public hospital, a 244-bed Veterans Affairs medical center, a 437-bed rural tertiary care hospital, and a 3,500-bed healthcare system.


RESULTS
The overall range of costs to manage reported exposures was $71-$4,838. Mean total costs varied greatly by the infection status of the source patient. The overall mean cost for exposures to human immunodeficiency virus (HIV)-infected source patients (n=19, including those coinfected with hepatitis B or C virus) was $2,456 (range, $907-$4,838), whereas the overall mean cost for exposures to source patients with unknown or negative infection status (n=8) was $376 (range, $71-$860). Lastly, the overall mean cost of management of reported exposures for source patients infected with hepatitis C virus (n=4) was $650 (range, $186-$856).


CONCLUSIONS
Management of occupational exposures to blood and body fluids is costly; the best way to avoid these costs is by prevention of exposures.
O'Malley
Emily M
EM
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Scott
R Douglas
RD
Gayle
Julie
J
Dekutoski
John
J
Foltzer
Michael
M
Lundstrom
Tammy S
TS
Welbel
Sharon
S
Chiarello
Linda A
LA
Panlilio
Adelisa L
AL
D006678:HIV; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D006509:Hepatitis B / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D017053:Infection Control / Q000191:economics* / Q000379:methods; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D016602:Needlestick Injuries / Q000517:prevention & control; D016273:Occupational Exposure / Q000191:economics* / Q000517:prevention & control*; D010564:Personnel, Hospital; D012308:Risk Management / Q000191:economics / Q000379:methods