title: Occupational transmission of hepatitis C in healthcare workers and factors associated with seroconversion: UK surveillance data.
abstract: The study aims were to describe a case series of occupationally acquired hepatitis C (HCV) infections in UK healthcare workers and examine factors associated with transmission using exposure data reported to the Health Protection Agency between July 1997 and December 2007. Fifteen reported cases of documented HCV seroconversion occurred after percutaneous exposure, the majority from hollow-bore needles used in the source patient's vein or artery and contaminated with blood or blood-stained fluid. The seroconversion rate was 2.2% (14/626). In multivariable analysis of healthcare workers with percutaneous exposure to blood or blood-stained fluid, we demonstrate that blood sampling procedures (odds ratio [OR], 5.75; 95% CI, 1.33-24.91; P = 0.01) and depth of injury (OR for deep vs superficial injury, 21.99; 95% CI, 2.02-239.61; P = 0.02) are independently associated with a greater risk of HCV seroconversion. This is the first UK study of occupationally acquired HCV in healthcare workers. It has reinforced our knowledge of risk factors for HCV transmission. Most of these exposures and transmissions were preventable. Healthcare employers should provide regular education on the risks of occupational exposure and prevention through standard infection control procedures. They should ensure the availability of effective prevention measures and facilitate prompt reporting and adequate follow-up of exposures.
authors.affiliation: HIV & STIs Department, Health Protection Services - Colindale, Health Protection Agency, London, UK. sarah.tomkins@hpa.org.uk
authors.forename: S E
authors.initials: SE
authors.lastname: Tomkins
authors.forename: J
authors.initials: J
authors.lastname: Elford
authors.forename: T
authors.initials: T
authors.lastname: Nichols
authors.forename: J
authors.initials: J
authors.lastname: Aston
authors.forename: S J
authors.initials: SJ
authors.lastname: Cliffe
authors.forename: K
authors.initials: K
authors.lastname: Roy
authors.forename: P
authors.initials: P
authors.lastname: Grime
authors.forename: F M
authors.initials: FM
authors.lastname: Ncube
mesh_terms: D000328:Adult; D005260:Female; D006282:Health Personnel; D016174:Hepacivirus / Q000276:immunology; D006526:Hepatitis C / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D017053:Infection Control; D017758:Infectious Disease Transmission, Patient-to-Professional; D008297:Male; D008875:Middle Aged; D016602:Needlestick Injuries / Q000453:epidemiology; D016273:Occupational Exposure; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult