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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)...

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.


A 10-year retrospective cohort design.


A single large academic teaching hospital.


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


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.


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.


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

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 (
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1. SE Beekmann , DK Henderson . Protection of healthcare workers from bloodborne pathogens. Curr Opin Infect Dis 2005;18:331336.

4. BN Doebbeling , TE Vaughn , KD McCoy , 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. JM Dement , C Epling , T Ostbye , LA Pompeii , DL Hunt . 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.

7. J Jagger , R Berguer , EK Phillips , G Parker , AE Gomaa . Increase in sharps injuries in surgical settings versus nonsurgical settings after passage of national needlestick legislation. AORNJ 2011;93:322330.

8. J Jagger , M Bentley , P Tereskerz . A study of patterns and prevention of blood exposures in OR personnel. AORNJ 1998;67:979981; 983–984, 986–987 passim.

9. MA Makary , A Al-Attar , CG Holzmueller , et al. Needlestick injuries among surgeons in training. N Engl J Med 2007;356:26932699.

10. RD McCormick , MG Meisch , FG Ircink , DG Maki . Epidemiology of hospital sharps injuries: a 14-year prospective study in the pre-AIDS and AIDS eras. Am J Med 1991;91:301S307S.

12. MC White , P Lynch . Blood contacts in the operating room after hospital-specific data analysis and action. Am J Infect Control 1997;25:209214.

13. JL Gerberding , C Littell , A Tarkington , A Brown , WP Schecter . Risk of exposure of surgical personnel to patients’ blood during surgery at San Francisco General Hospital. N Engl J Med 1990;322:17881793.

14. AL Panlilio , DR Foy , JR Edwards , et al. Blood contacts during surgical procedures. JAMA 1991;265:15331537.

15. EJ Quebbeman , GL Telford , S Hubbard , et al. Risk of blood contamination and injury to operating room personnel. Ann Surg 1991;214:614620.

17. JI Tokars , DM Bell , DH Culver , et al. Percutaneous injuries during surgical procedures. JAMA 1992;267:28992904.

18. MC White , P Lynch . Blood contact and exposures among operating room personnel: a multicenter study. Am J Infect Control 1993;21:243248.

25. TC Goob , SM Yamada , RE Newman , TM Cashman . Bloodborne exposures at a United States Army Medical Center. Appl Occup Environ Hyg 1999;14:2025.

29. JM Dement , LA Pompeii , T Ostbye , et al. An integrated comprehensive occupational surveillance system for health care workers. Am J Ind Med 2004;45:528538.

30. D Loomis , DB Richardson , L Elliott . Poisson regression analysis of ungrouped data. Occup Environ Med 2005;62:325329.

35. E Au , JA Gossage , SR Bailey . The reporting of needlestick injuries sustained in theatre by surgeons: are we under-reporting? J Hosp Infect 2008;70:6670.

36. AF Donnelly , YH Chang , SA Nemeth-Ochoa . Sharps injuries and reporting practices of U.S. dermatologists. Dermatol Surg 2013;39:18131821.

37. KM DeGirolamo , DJ Courtemanche , WD Hill , A Kennedy , ED Skarsgard . 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.

39. Association of Perioperative Regiestered Nurses. AORN guidance statement: sharps injury prevention in the perioperative setting. AORNJ 2005;81:662665.

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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
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