Prevalence of body fluid exposures and associated risk factors amongst healthcare workers at Avicenne Military Hospital, Morocco
DOI:
https://doi.org/10.3396/ijic.v18.21399Keywords:
body fluid, blood, risk, occupational exposure, healthcare workers, hepatitis B, vaccination, prevention, MoroccoAbstract
Objectives: The purpose of this study is to determine the prevalence of body fluid exposures (BFE) and associated risk factors amongst healthcare workers (HCWs), and to evaluate hepatitis B (HBV) vaccination coverage, at Avicenne Military Hospital.
Materials and methods: A descriptive and analytical cross-sectional study was conducted over 6 months amongst HCWs at the Avicenne Military Hospital. Data were collected using an anonymous questionnaire. Blood samples were collected from consenting participants, for assaying HBV surface antibodies.
Results: One hundred thirty-four HCWs were interviewed, and 86 (64.2%) reported at least one BFE. The median age was 28 (27–34) years, with male gender predominating (54%). Percutaneous exposure was the most common BFE (95%), and the hollow bore needle the most implicated (45%). Only 34% of victims reported their BFE. The multivariate analysis showed that HCWs in a surgical department are 10 times more exposed to BFE (P = 0.003; odds ratio [OR] = 10, 95% confidence interval [CI]: 2–47) compared to HCWs in medical departments (P = 0.009; OR = 0.06, 95% CI: 0.007–0.49) and laboratories (P = 0.04; OR = 0.1, 95% CI: 0.01–0.88). The HBV vaccination rate was 67%. Amongst HCWs tested, 42% were immune to HBV. Immune status between physicians and paramedical staff was significantly different (P = 0.005; OR = 0.2, 95% CI: 0.04–0.55). The immunization rate rose significantly with seniority (P = 0.016; OR = 17, 95% CI: 1.67–169).
Conclusion: Our findings highlight the importance of information and continuous training on BFE for HCWs, and the development of strategies to promote and simplify access to the HBV vaccine.
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References
Ministry of Employment and Solidarity. DGS circular: DH no 98/249 of April 20, 1998 relating to the prevention of the transmission of infectious agents conveyed by blood or biologicalfluids during care in health establishments. Available from: http://www.sante.gouv.fr [cited 13 May 2019].
Order of July 10, 2013 relating to the prevention of biological risks affecting certain professionals who are susceptible to be in contact with perforating objects – Official Journal No. 0202 of August 31, 2013- Article1- available on www.legifrance.gouv.fr
L’Hériteau F. Infectious risks associated with accidents exposing to blood (OBEs) and biological fluids. Rev Francoph Lab 2005; 2005(376): 37–43. doi: 10.1016/S1773-035X(05)80105-4
Benbouker M, Marnissi BE, Nhili A, Rhazi KE. Connaissances, attitudes et pratiques vis-à-vis des précautions standard chez les soignants du Centre hospitalier universitaire Hassan II de Fès (Maroc). East Mediterr Health J 2017; 23(1): 8. doi: 10.26719/2017.23.1.5
Laraqui O, Laraqui S, Tripodi D, Zahraoui M, Caubet A, Verger C, et al. Assessment of knowledge, attitudes and practices on blood exposure accidents in healthcare settings in Morocco. Med Mal Infect 2008; 38(12): 658–66. doi: 10.1016/j.medmal.2008.09.009
Atiki N. Epidemiological profile of accidents involving exposure to blood among nursing staff at Ibn Sina hospital in Rabat. Faculty of medicine and pharmacy of rabat; 2011.
Seida YAM, Moemen MMH, Moustafa MSA, Raouf MMEM, Elshaer NSM. Hepatitis C virus infection and exposure to blood and body fluids among nurses and paramedics at university hospitals in Alexandria, Egypt. Alex J Med 2018; 54(3): 265–71. doi: 10.1016/j.ajme.2017.06.005
Lahuerta M, Selenic D, Kassa G, Mwakitosha G, Hokororo J, Ngonyani H, et al. Reporting and case management of occupational exposures to blood-borne pathogens among health workers in three health facilities in Tanzania. J Infect Prev 2016; 17(4): 153–60. doi: 10.1177/1757177416645343
Kassa G, Selenic D, Lahuerta M, Gaolathe T, Liu Y, Letang G, et al. Occupational exposure to bloodborne pathogens among health care workers in Botswana: reporting and utilization of postexposure prophylaxis. Am J Infect Control 2016; 44(8): 879–85. doi: 10.1016/j.ajic.2016.01.027
Martins A, Coelho AC, Vieira M, Matos M, Pinto ML. Age and years in practice as factors associated with needlestick and sharps injuries among health care workers in a Portuguese hospital. Accid Anal Prev 2012; 47: 11–5. doi: 10.1016/j.aap.2012.01.011
Butsashvili M, Kamkamidze G, Kajaia M, Morse DL, Triner W, DeHovitz J, et al. Occupational exposure to body fluids among health care workers in Georgia. Occup Med 2012; 62(8): 620–6. doi: 10.1093/occmed/kqs121
Yasin J, Fisseha R, Mekonnen F, Yirdaw K. Occupational exposure to blood and body fluids and associated factors among health care workers at the University of Gondar Hospital, Northwest Ethiopia. Environ Health Prev Med 2019; 24(1): 18. doi: 10.1186/s12199-019-0769-9
Mandić B, Mandić-Rajčević S, Marković-Denić L, Bulat P. Occupational exposure to blood and bodily fluids among healthcare workers in Serbian general hospitals. Arch Ind Hyg Toxicol 2018; 69(1): 61–8. doi: 10.2478/aiht-2018-69-3047
Gabr HM, El-Badry AS, Younis FE. Risk factors associated with needlestick injuries among health care workers in Menoufia Governorate, Egypt. Int J Occup Environ Med 2018; 9(2): 63–8. doi: 10.15171/ijoem.2018.1156
Ghanei Gheshlagh R, Aslani M, Shabani F, Dalvand S, Parizad N. Prevalence of needlestick and sharps injuries in the healthcare workers of Iranian hospitals: an updated meta-analysis. Environ Health Prev Med 2018; 23: 44. doi: 10.1186/s12199-018-0734-z
Moukafih B. Assessment of occupational risks in medical analysis laboratories: case of the bacteriology-serology-hygiene laboratory HIS. Thesis. 2012. Available from: http://ao.um5.ac.ma/xmlui/handle/123456789/1752 [cited 21 January 2020].
Chauvin A, Hutin A, Leredu T, Plaisance P, Pateron D, Yordanov Y. Accidental blood exposures among emergency medicine residents and young physicians in France: a national survey. Intern Emerg Med 2017; 12(2): 221–7. doi: 10.1007/s11739-016-1458-y
Alemayehu T, Worku A, Assefa N. Sharp injury and exposure to blood and body fluids among health care workers in health care centers of eastern Ethiopia. Int J Occup Environ Med 2016; 7(3): 172–80. doi: 10.15171/ijoem.2016.714
Afridi AAK, Kumar A, Sayani R. Needle stick injuries – risk and preventive factors: a study among health care workers in tertiary care hospitals in Pakistan. Glob J Health Sci 2013; 5(4): 85. doi: 10.5539/gjhs.v5n4p85
Papadopoli R, Bianco A, Pepe D, Pileggi C, Pavia M. Sharps and needle-stick injuries among medical residents and healthcare professional students: pattern and reporting in Italy – a cross-sectional analytical study. Occup Environ Med 2019; 76(10): 739–45. doi: 10.1136/oemed-2019-105873
Bekele T, Gebremariam A, Kaso M, Ahmed K. Factors associated with occupational needle stick and sharps injuries among hospital healthcare workers in Bale Zone, southeast Ethiopia. PLoS One 2015; 10(10): e0140382. doi: 10.1371/journal.pone.0140382
Lebossé A. Accidents of exposure to the blood of interns in the Rennes subdivision. University of Rennes 1; 2017.
Samargandy S, Bukhari L, Samargandy S, Bahlas R, Aldigs E, Alawi M, et al. Epidemiology and clinical consequences of occupational exposure to blood and other body fluids in a university hospital, Jeddah, Kingdom of Saudi Arabia. Saudi Med J 2016; 37(7): 783–90. doi: 10.15537/smj.2016.7.14261
Lee JH, Cho J, Kim YJ, Im SH, Jang ES, Kim J-W, et al. Occupational blood exposures in health care workers: incidence, characteristics, and transmission of bloodborne pathogens in South Korea. BMC Public Health 2017; 17(1): 827. doi: 10.1186/s12889-017-4844-0
Omar AA, Abdo NM, Salama MF, Al-Mousa HH. Occupational injuries prone to infectious risks amongst healthcare personnel in Kuwait: a retrospective study. Med Princ Pract 2014; 24(2): 123–8. doi: 10.1186/s12889-017-4844-0
Musharrafieh UM, Bizri ARN, Nassar NT, Rahi AC, Shoukair AM, Doudakian RM, et al. Health care workers’ exposure to blood-borne pathogens in Lebanon. Occup Med 2008; 58(2): 94–8. doi: 10.1093/occmed/kqm139
Occupational blood exposures: experience of the reference center for the management pf patients living wth HIV in Rabat-Salékénitra. Retrospective study on 314 cases.Thesis number 618. Faculty of medicine and pharmacy of rabat; 2017.
Surveillance of blood exposure accidents in French health care facilities. AES-Raisin network, France – 2015 results. Saint-Maurice: Santé publique France; published on January 1, 2017. Available from: http://www.santepubliquefrance.fr [cited December 2019].
Rice BD, Tomkins SE, Ncube FM. Sharp truth: health care workers remain at risk of bloodborne infection. Occup Med 2015; 65(3): 210–4. doi: 10.1093/occmed/kqu206
Contribution to the cartography of some sexually transmitted diseases in the Wilaya of Jijel. Faculty of nature and life sciences – Algeria. Year 2018. Available from: http://dspace.univ-jijel.dz:8080/xmlui/bitstream/handle/123456789/672/M-T.F.A.%2015-19.pdf?sequence=1 [cited December 2019].
Goel V, Kumar D, Lingaiah R, Singh S. Occurrence of needlestick and injuries among health-care workers of a tertiary care teaching hospital in North India. J Lab Physicians 2017; 9(1): 20. doi: 10.4103/0974-2727.187917
Wicker S, Jung J, Allwinn R, Gottschalk R, Rabenau HF. Prevalence and prevention of needlestick injuries among health care workers in a German university hospital. Int Arch Occup Environ Health 2007; 81(3): 347–54. doi: 10.1007/s00420-007-0219-7
AES-Raisin Network, France. Monitoring of AES in health establishments in France-Results 2015. 2015.
Napolitano F, Bianco A, D’Alessandro A, Papadopoli R, Angelillo IF. Healthcare workers’ knowledge, beliefs, and coverage regarding vaccinations in critical care units in Italy. Vaccine 2019; 37(46): 6900–6. doi: 10.1016/j.vaccine.2019.09.053
Mast ST, Woolwine JD, Gerberding JL. Efficacy of gloves in reducing blood volumes transferred during simulated needlestick injury. J Infect Dis 1993; 168(6): 1589–92. doi: 10.1093/infdis/168.6.1589
El Guazzar A. Blood exposure accidents at the Mohammed V Military Training Hospital. Knowledge, attitudes and practices of nursing staff year 2008. Thesis number: M0922009, Faculty of Medicine and Pharmacy of Rabat, 2009.
Wilburn SQ, Eijkemans G. Preventing needlestick injuries among healthcare workers: a WHO-ICN collaboration. Int J Occup Environ Health 2004; 10(4): 451–6. doi: 10.1179/oeh.2004.10.4.451
Jacomet DC, Perrier DC. Clermont-Fd Chu G. Montpied. ACCIDENT OF EXPOSURE TO VIRAL RISK. Information and follow-up booklet. Clermont-Fd: consultation de Maladies Infectieuses Gabriel Montpied Hospital. Available from: https://www.chu-clermontferrand.fr/sites/default/files/media/202112/D%C3%A9pliant%20AESsanguin%202018.pdf [cited December 2019].
Mikulich VJ, Schriger DL. Abridged version of the updated US Public Health Service guidelines for the management of occupational exposures to hepatitis B virus, hepatitis C virus, and human immunodeficiency virus and recommendations for postexposure prophylaxis. Ann Emerg Med 2002; 39: 321–8.
Legifrance.gouv.fr. Article L3111-4. Modified by the law n°2017–220 the 23 february 2017 – art. 4 (V). Version in effect since May23.2017. Available from: www.legifrance.gouv.fr/codes/article_lc/LEGIARTI000034079710/ [cited December 2019].
Cantineau A, Brauer G, Deiss V, Guillet N, Hecht MT. Prevention of AES and training-action. Care 2002; 671: 42–4.
Abebaw T-A, Aderaw Z, Gebremichael B. Hepatitis B virus vaccination status and associated factors among health care workers in Shashemene Zonal Town, Shashemene, Ethiopia: a cross sectional study. BMC Res Notes 2017; 10(1): 260. doi: 10.1186/s13104-017-2582-0
Areej MN, Athraa E, Sadoon A.KAP Study about hepatitis B among Medical and Paramedical Staff in Tikrit City. Tikrit Med J 2012; 18(2): 261–8.
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