ASSESSMENT OF EXPOSURE TO BODY FLUIDS AMONG HEALTH CARE WORKERS

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CHAPTER ONE

INTRODUCTION

1.1         Background to the Study

Body fluids are liquids originating from inside the bodies of living humans. They include fluids that are excreted or secreted from the body. Human body fluids and other body tissues are widely recognized as vehicles for the transmission of human disease. Body fluid visibly contaminated with blood should be considered capable of transmitting hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Semen and vaginal secretions should also be considered potentially able to transmit these viruses. Similarly, cerebrospinal fluid, amniotic fluid, pleural fluid, synovial fluid, and peritoneal and pericardial fluids carry a significant risk of transmitting these viruses. In contrast, unless blood is visibly present, saliva, sputum, sweat, tears, feces, nasal secretions, urine, and vomitus carry a very low risk of transmission of HCV and HIV. It should be noted that saliva can also carry HBV. (Lohiya, Tan-Figueroa, Lohiya, Lohiya. 2013)

Exposure to body fluids among health care workers constitute a major occupational hazard globally, with an estimate of 2.6% of healthcare workers exposed to Hepatitis C virus (HCV), 59% to Hepatitis B virus (HBV) and 0.5% to Human Immunodeficiency virus (HIV), annually which equates to approximately 16,000 HCV infections, 66,000 HBV infections and 200-600 HIV infections, through occupational exposure, (Elliott, Ketton and Holt, 2005). The three body fluids pathogens that are the most commonly involved in occupational exposures in healthcare workers are hepatitis B, hepatitis C, and HIV (Weber, Rutala, Eron, 2012; Deuffic-Burbank, Delaroccque-Astagneau, Abitedoul, 2011).

Healthcare workers exposures to these pathogen are widespread. Some studies have estimated that there are more than 400,000 parental exposures suffered by healthcare workers in the United States every year and that every year, 1 out of 10 healthcare workers in the United States suffer a splash exposure or a needle stick injury (Karmon, Mehta, Brehm, 2013; Henderson, 2012). The exact number of exposures is not known and part of the problem is under reporting: it has been estimated that approximately 50-67% of all needlesticks and exposures to bloodborne pathogens are not reported (Bernard, Dattilo, Laporte, 2013; CDC, 2008).

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ASSESSMENT OF EXPOSURE TO BODY FLUIDS AMONG HEALTH CARE WORKERS