title: Danger in the streets: exposures to bloodborne pathogens after community sharp injuries in Rio de Janeiro, Brazil.
abstract: OBJECTIVE
  Exposures to sharps injuries occurring in the community are relatively frequent. We describe characteristics of community sharp exposures reported in the city of Rio de Janeiro from 1997 to 2010.
  
  
  METHODS
  A cross-sectional analysis of exposure reports to sharps in the community reported to a surveillance system, designed for health care workers, of the Municipal Health Department of Rio de Janeiro. The characteristics of exposed individuals analyzed included types of exposure, the circumstances of the accident, and the prophylaxis offered.
  
  
  RESULTS
  582 exposures were studied. Median age was 30 years and 83 (14%) involved children with less than 10 years of age. Two hundred and seventeen (37%) occurred with sharps found in the streets. The exposure was percutaneous in 515 (89%) and needles where involved in 406 (70%) of them. The sharps were present in the trash in 227 (39%) or in the environment in 167 (29%) of the reports. Professionals who work with frequent contact with domestic or urban waste were 196 (38%). The source was known in 112 (19%) of the exposures and blood was involved in 269 (46%). Only 101 (19%) of the injured subjects reported a complete course of vaccination for hepatitis B. Antiretroviral prophylaxis was prescribed for 392 (68%) of the exposed subjects.
  
  
  CONCLUSIONS
  Sharps injuries occurring in the community are an important health problem. A great proportion would be avoided if practices on how to dispose needles and sharps used outside health units were implemented.
authors.affiliation: Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Departamento de Medicina Preventiva, Rio de Janeiro, RJ, Brazil; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia, Rio de Janeiro, RJ, Brazil. Electronic address: marcellus.costa@ini.fiocruz.br.
authors.forename: Marcellus Dias
authors.initials: MD
authors.lastname: Costa
authors.affiliation: Riscobiologico.org Network, Rio de Janeiro, RJ, Brazil.
authors.forename: Cristiane
authors.initials: C
authors.lastname: Rapparini
authors.affiliation: Fundação Oswaldo Cruz, Instituto Nacional de Infectologia, Rio de Janeiro, RJ, Brazil.
authors.forename: Carolina Arana Stanis
authors.initials: CAS
authors.lastname: Schmaltz
authors.affiliation: Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Departamento de Medicina Preventiva, Rio de Janeiro, RJ, Brazil; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia, Rio de Janeiro, RJ, Brazil.
authors.forename: Mari
authors.initials: M
authors.lastname: Tuyama
authors.affiliation: Secretaria Municipal de Saúde e Defesa Civil do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Lilian de Mello
authors.initials: LM
authors.lastname: Lauria
authors.affiliation: Secretaria Municipal de Saúde e Defesa Civil do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Valeria
authors.initials: V
authors.lastname: Saraceni
authors.affiliation: Hospital Universitário Clementino Fraga Filho, Departamento de Medicina Preventiva, Serviço de Doenças Infecciosas, Rio de Janeiro, RJ, Brazil.
authors.forename: Paulo Feijó
authors.initials: PF
authors.lastname: Barroso
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017848:Blood-Borne Pathogens; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles / Q000706:statistics & numerical data; D016602:Needlestick Injuries / Q000453:epidemiology*; D012111:Residence Characteristics; D014866:Waste Products / Q000009:adverse effects
chemical_list: D014866:Waste Products
keywords: Bloodborne; HIV; Hepatitis; Medical waste; Needlestick; Postexposure prophylaxis; Sharp injuries