Occupational exposure to blood and other bodily fluids at a military hospital in Iraq.
BACKGROUND
Exposure to bloodborne pathogens, namely HIV, hepatitis B, and hepatitis C, remains a risk for healthcare workers. Given the austere and challenging environments in a combat zone, it is unclear to what extent blood and other bodily fluid occupational exposures pose a risk of infection for military healthcare workers deployed to a level III military treatment facility in support of Operation Iraqi Freedom.


METHODS
This is a retrospective review of electronic infection control records at the Air Force Theater Hospital in Iraq in which blood and other bodily fluid occupational exposure data were available: October 1, 2005 through May 31, 2006 and January 15, 2007 through April 30, 2007.


RESULTS
During the first study period, there were 46 exposures for an average monthly exposure of 5.8 (range, 2-16 per month). The majority of exposures were percutaneous fingersticks (74%), whereas the remainder were splashes (17%) or not documented (9%). During the second study period, there were 19 exposures with percutaneous device and splash exposure encompassing 68% and 32% of cases, respectively. The majority of occurrences were in the intensive care unit (53%) and primarily among nurses (37%). Overall, there were 65 exposures per 1,000 persons during the year review.


CONCLUSIONS
During the time periods evaluated, a substantial number of blood and other bodily fluid exposures occurred in a combat zone military healthcare facility. This finding is comparable to US civilian institutions. Maintaining programs for preventing, tracking, and implementing postexposure prophylaxis remain a worthy and achievable goal at every military treatment facility, regardless of the austerity of the environment.
Murray
Clinton K
CK
Infectious Disease Service, San Antonio Military Medical Center, Fort Sam Houston, Texas 78234, USA. clinton.murray@amedd.army.mil
Johnson
Erica N
EN
Conger
Nicholas G
NG
Marconi
Vincent C
VC
D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D017848:Blood-Borne Pathogens; D006772:Hospitals, Military / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D054542:Iraq War, 2003-2011; D016602:Needlestick Injuries / Q000453:epidemiology*; D010564:Personnel, Hospital / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014193:Trauma Centers / Q000706:statistics & numerical data*