Skip to main content
×
×
Home

Surgical Procedure Characteristics and Risk of Sharps-Related Blood and Body Fluid Exposure

  • Douglas J. Myers (a1) (a2), Hester J. Lipscomb (a1), Carol Epling (a1), Debra Hunt (a3), William Richardson (a4), Lynn Smith-Lovin (a5) and John M. Dement (a1)...
Abstract
OBJECTIVE

To use a unique multicomponent administrative data set assembled at a large academic teaching hospital to examine the risk of percutaneous blood and body fluid (BBF) exposures occurring in operating rooms.

DESIGN

A 10-year retrospective cohort design.

SETTING

A single large academic teaching hospital.

PARTICIPANTS

All surgical procedures (n=333,073) performed in 2001–2010 as well as 2,113 reported BBF exposures were analyzed.

METHODS

Crude exposure rates were calculated; Poisson regression was used to analyze risk factors and account for procedure duration. BBF exposures involving suture needles were examined separately from those involving other device types to examine possible differences in risk factors.

RESULTS

The overall rate of reported BBF exposures was 6.3 per 1,000 surgical procedures (2.9 per 1,000 surgical hours). BBF exposure rates increased with estimated patient blood loss (17.7 exposures per 1,000 procedures with 501–1,000 cc blood loss and 26.4 exposures per 1,000 procedures with >1,000 cc blood loss), number of personnel working in the surgical field during the procedure (34.4 exposures per 1,000 procedures having ≥15 personnel ever in the field), and procedure duration (14.3 exposures per 1,000 procedures lasting 4 to <6 hours, 27.1 exposures per 1,000 procedures lasting ≥6 hours). Regression results showed associations were generally stronger for suture needle–related exposures.

CONCLUSIONS

Results largely support other studies found in the literature. However, additional research should investigate differences in risk factors for BBF exposures associated with suture needles and those associated with all other device types.

Infect. Control Hosp. Epidemiol. 2015;37(1):80–87

Copyright
Corresponding author
Address correspondence to Douglas J. Myers, ScD, West Virginia University, Occupational and Environmental Health Sciences Department, 1 Medical Center Drive, PO Box 6190, Morgantown, WV 26506 (djmyers@hsc.wvu.edu).
References
Hide All
1. Beekmann, SE, Henderson, DK. Protection of healthcare workers from bloodborne pathogens. Curr Opin Infect Dis 2005;18:331336.
2. Laramie, AK, Pun, VC, Fang, SC, Kriebel, D, Davis, L. Sharps injuries among employees of acute care hospitals in Massachusetts, 2002–2007. Infect Control Hosp Epidemiol 2011;32:538544.
3. Babcock, HM, Fraser, V. Differences in percutaneous injury patterns in a multi-hospital system. Infect Control Hosp Epidemiol 2003;24:731736.
4. Doebbeling, BN, Vaughn, TE, McCoy, KD, et al. Percutaneous injury, blood exposure, and adherence to standard precautions: are hospital-based health care providers still at risk? Clin Infect Dis 2003;37:10061013.
5. Dement, JM, Epling, C, Ostbye, T, Pompeii, LA, Hunt, DL. Blood and body fluid exposure risks among health care workers: results from the Duke Health and Safety Surveillance System. Am J Ind Med 2004;46:637648.
6. Bakaeen, F, Awad, S, Albo, D, et al. Epidemiology of exposure to blood borne pathogens on a surgical service. Am J Surg 2006;192:e18e21.
7. Jagger, J, Berguer, R, Phillips, EK, Parker, G, Gomaa, AE. Increase in sharps injuries in surgical settings versus nonsurgical settings after passage of national needlestick legislation. AORNJ 2011;93:322330.
8. Jagger, J, Bentley, M, Tereskerz, P. A study of patterns and prevention of blood exposures in OR personnel. AORNJ 1998;67:979981; 983–984, 986–987 passim.
9. Makary, MA, Al-Attar, A, Holzmueller, CG, et al. Needlestick injuries among surgeons in training. N Engl J Med 2007;356:26932699.
10. McCormick, RD, Meisch, MG, Ircink, FG, Maki, DG. Epidemiology of hospital sharps injuries: a 14-year prospective study in the pre-AIDS and AIDS eras. Am J Med 1991;91:301S307S.
11. Radecki, S, Abbott, A, Eloi, L. Occupational human immunodeficiency virus exposure among residents and medical students: an analysis of 5-year follow-up data. Arch Intern Med 2000;160:31073111.
12. White, MC, Lynch, P. Blood contacts in the operating room after hospital-specific data analysis and action. Am J Infect Control 1997;25:209214.
13. Gerberding, JL, Littell, C, Tarkington, A, Brown, A, Schecter, WP. Risk of exposure of surgical personnel to patients’ blood during surgery at San Francisco General Hospital. N Engl J Med 1990;322:17881793.
14. Panlilio, AL, Foy, DR, Edwards, JR, et al. Blood contacts during surgical procedures. JAMA 1991;265:15331537.
15. Quebbeman, EJ, Telford, GL, Hubbard, S, et al. Risk of blood contamination and injury to operating room personnel. Ann Surg 1991;214:614620.
16. Tarantola, A, Golliot, F, L’Heriteau, F, et al. Assessment of preventive measures for accidental blood exposure in operating theaters: a survey of 20 hospitals in Northern France. Am J Infect Control 2006;34:376382.
17. Tokars, JI, Bell, DM, Culver, DH, et al. Percutaneous injuries during surgical procedures. JAMA 1992;267:28992904.
18. White, MC, Lynch, P. Blood contact and exposures among operating room personnel: a multicenter study. Am J Infect Control 1993;21:243248.
19. Florman, S, Burgdorf, M, Finigan, K, Slakey, D, Hewitt, R, Nichols, RL. Efficacy of double gloving with an intrinsic indicator system. Surg Infect 2005;6:385395.
20. Vaughn, TE, McCoy, KD, Beekmann, SE, Woolson, RE, Torner, JC, Doebbeling, BN. Factors promoting consistent adherence to safe needle precautions among hospital workers. Infect Control Hosp Epidemiol 2004;25:548555.
21. Sohn, S, Eagan, J, Sepkowitz, KA, Zuccotti, G. Effect of implementing safety-engineered devices on percutaneous injury epidemiology. Infect Control Hosp Epidemiol 2004;25:536542.
22. Centers for Disease Control and Prevention. Evaluation of blunt suture needles in preventing percutaneous injuries among health-care workers during gynecologic surgical procedures--New York City, March 1993-June 1994. MMWR Morb Mortal Wkly Rep 1997;46:2529.
23. Stafford, M, Uthayakumar, S, Falder, S, Thomas, P, Jolly, M, Smith, JR. Techniques for reducing needlestick injury in surgical practice. Infect Control Hosp Epidemiol 1994;15:350.
24. Vose, JG, McAdara-Berkowitz, J. Reducing scalpel injuries in the operating room. AORNJ 2009;90:867872.
25. Goob, TC, Yamada, SM, Newman, RE, Cashman, TM. Bloodborne exposures at a United States Army Medical Center. Appl Occup Environ Hyg 1999;14:2025.
26. Puro, V, De Carli, G, Petrosillo, N, Ippolito, G. Risk of exposure to bloodborne infection for Italian healthcare workers, by job category and work area. Studio Italiano Rischio Occupazionale da HIV Group. Infect Control Hosp Epidemiol 2001;22:206210.
27. Venier, AG, Vincent, A, L’Heriteau, F, et al. Surveillance of occupational blood and body fluid exposures among French healthcare workers in 2004. Infect Control Hosp Epidemiol 2007;28:11961201.
28. Myers, DJ, Epling, C, Dement, J, Hunt, D. Risk of sharp device-related blood and body fluid exposure in operating rooms. Infect Control Hosp Epidemiol 2008;29:11391148.
29. Dement, JM, Pompeii, LA, Ostbye, T, et al. An integrated comprehensive occupational surveillance system for health care workers. Am J Ind Med 2004;45:528538.
30. Loomis, D, Richardson, DB, Elliott, L. Poisson regression analysis of ungrouped data. Occup Environ Med 2005;62:325329.
31. StataCorp. Stata Statistical Software: Release 11. College Station, TX: StataCorp, 2009.
32. Tokars, JI, Culver, DH, Mendelson, MH, et al. Skin and mucous membrane contacts with blood during surgical procedures: risk and prevention. Infect Control Hosp Epidemiol 1995;16:703711.
33. Macias, DJ, Hafner, J, Brillman, JC, Tandberg, D. Effect of time of day and duration into shift on hazardous exposures to biological fluids. Acad Emerg Med 1996;3:605610.
34. Voide, C, Darling, KE, Kenfak-Foguena, A, Erard, V, Cavassini, M, Lazor-Blanchet, C. Underreporting of needlestick and sharps injuries among healthcare workers in a Swiss university hospital. Swiss Med Wkly 2012;142:w13523.
35. Au, E, Gossage, JA, Bailey, SR. The reporting of needlestick injuries sustained in theatre by surgeons: are we under-reporting? J Hosp Infect 2008;70:6670.
36. Donnelly, AF, Chang, YH, Nemeth-Ochoa, SA. Sharps injuries and reporting practices of U.S. dermatologists. Dermatol Surg 2013;39:18131821.
37. DeGirolamo, KM, Courtemanche, DJ, Hill, WD, Kennedy, A, Skarsgard, ED. Use of safety scalpels and other safety practices to reduce sharps injury in the operating room: what is the evidence? Can J Surg 2013;56:263269.
38. Berguer, R, Heller, PJ. Preventing sharps injuries in the operating room. J Am Coll Surg 2004;199:462467.
39. Association of Perioperative Regiestered Nurses. AORN guidance statement: sharps injury prevention in the perioperative setting. AORNJ 2005;81:662665.
40. National Institute for Occupational Safety and Health. Use of blunt-tip suture needles to decrease percutaneous injuries to surgical personnel. CDC website. http://www.cdc.gov/niosh/docs/2008-101/. Published 2007. Updated June 6, 2014. Accessed September 16, 2015.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 7
Total number of PDF views: 89 *
Loading metrics...

Abstract views

Total abstract views: 493 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 20th August 2018. This data will be updated every 24 hours.