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Journal ArticleDOI

Estimation of the global burden of disease attributable to contaminated sharps injuries among health‐care workers

01 Dec 2005-American Journal of Industrial Medicine (Am J Ind Med)-Vol. 48, Iss: 6, pp 482-490
TL;DR: Occupational exposures to percutaneous injuries are substantial source of infections with bloodborne pathogens among health-care workers (HCWs).
Abstract: Background The global burden of hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) infection due to percutaneous injuries among health care workers (HCWs) is estimated. Methods The incidence of infections attributable to percutaneous injuries in 14 geographical regions on the basis of the probability of injury, the prevalence of infection, the susceptibility of the worker, and the percutaneous transmission potential are modeled. The model also provides the attributable fractions of infection in HCWs. Results Overall, 16,000 HCV, 66,000 HBV, and 1,000 HIVinfections may have occurred in the year 2000 worldwide among HCWs due to their occupational exposure to percutaneous injuries. The fraction of infections with HCV, HBV, and HIV in HCWs attributabletooccupationalexposuretopercutaneousinjuriesfractionreaches39%,37%, and 4.4% respectively. Conclusions Occupational exposures to percutaneous injuries are substantial source of infections with bloodborne pathogens among health-care workers (HCWs). These infections are highly preventable and should be eliminated. Am. J. Ind. Med. 48:482–490, 2005. 2005 Wiley-Liss, Inc.
Citations
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Journal ArticleDOI
TL;DR: The present assessment finds a global prevalence of 2.35%, affecting 160 million chronically infected individuals, and there is an urgent need for more accurate Information on the costs and burden of HCV to society.

1,275 citations

01 Jan 2016
TL;DR: The main message emerging from this new comprehensive global assessment is that premature death and disease can be prevented through healthier environments – and to a significant degree.
Abstract: The main message emerging from this new comprehensive global assessment is that premature death and disease can be prevented through healthier environments – and to a significant degree. Analysing the latest data on the environment-disease nexus and the devastating impact of environmental hazards and risks on global health, backed up by expert opinion, this report covers more than 130 diseases and injuries.

585 citations

Journal ArticleDOI
TL;DR: Surgeons in training in training at 17 medical centers had had a needlestick injury during training; the mean number of needlesticks during residency increased according to the postgraduate year, and for 53%, the injury had involved a high-risk patient.
Abstract: Methods We surveyed surgeons in training at 17 medical centers about previous needlestick injuries. Survey items inquired about whether the most recent injury was reported to an employee health service or involved a “high-risk” patient (i.e., one with a history of infection with human immunodeficiency virus, hepatitis B or hepatitis C, or injection-drug use); we also asked about the perceived cause of the injury and the surrounding circumstances. Results The overall response rate was 95%. Of 699 respondents, 582 (83%) had had a needlestick injury during training; the mean number of needlestick injuries during residency increased according to the postgraduate year (PGY): PGY-1, 1.5 injuries; PGY-2, 3.7; PGY-3, 4.1; PGY-4, 5.3; and PGY-5, 7.7. By their final year of training, 99% of residents had had a needlestick injury; for 53%, the injury had involved a high-risk patient. Of the most recent injuries, 297 of 578 (51%) were not reported to an employee health service, and 15 of 91 of those involving high-risk patients (16%) were not reported. Lack of time was the most common reason given for not reporting such injuries among 126 of 297 respondents (42%). If someone other than the respondent knew about an unreported injury, that person was most frequently the attending physician (51%) and least frequently a “significant other” (13%).

295 citations

Journal ArticleDOI
TL;DR: Exposure to occupational hazards accounts for a significant proportion of the global burden of disease and injury, which could be substantially reduced through application of proven risk prevention strategies.
Abstract: BACKGROUND: Around the globe, work has a heavy impact on health. To better advise policy makers, we assessed the global burden of disease and injury due to selected occupational hazards. This article presents an overview, and describes the methodology employed in the companion studies. METHODS: Using the World Health Organization (WHO) Comparative Risk Assessment methodology, we applied relative risk measures to the proportions of the population exposed to selected occupational hazards to estimate attributable fractions, deaths, and disability-adjusted life years (DALYs). Numerous occupational risk factors had to be excluded due to inadequate global data. RESULTS: In 2000, the selected risk factors were responsible worldwide for 37% of back pain, 16% of hearing loss, 13% of chronic obstructive pulmonary disease (COPD), 11% of asthma, 8% of injuries, 9% of lung cancer, and 2% of leukemia. These risks at work caused 850,000 deaths worldwide and resulted in the loss of about 24 million years of healthy life. Needlesticks accounted for about 40% of Hepatitis B and Hepatitis C infections and 4.4% of HIV infections in health care workers. CONCLUSIONS: Exposure to occupational hazards accounts for a significant proportion of the global burden of disease and injury, which could be substantially reduced through application of proven risk prevention strategies.

200 citations

Journal ArticleDOI
TL;DR: This article reviews Radiation Dose Management for Fluoroscopically Guided Interventional Medical Procedures, Bethesda, MD, 2010.
Abstract: This article reviews Radiation Dose Management for Fluoroscopically Guided Interventional Medical Procedures , Bethesda, MD, 2010. 325 pp. (hardcover), Price: $150.00. ISBN: 978-0-9823843-6-7.

191 citations

References
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Journal Article
TL;DR: In this paper, the U.S. Public Health Service (USPS) recommended HIV post-exposure prophylaxis (PEP) regimens have been changed.
Abstract: Summary This report updates U.S. Public Health Service recommendations for the management of health-care personnel (HCP) who have occupational exposure to blood and other body fluids that might contain human immunodeficiency virus (HIV). Although the principles of exposure management remain unchanged, recommended HIV postexposure prophylaxis (PEP) regimens have been changed. This report emphasizes adherence to HIV PEP when it is indicated for an exposure, expert consultation in management of exposures, follow-up of exposed workers to improve adherence to PEP, and monitoring for adverse events, including seroconversion. To ensure timely postexposure management and administration of HIV PEP, clinicians should consider occupational exposures as urgent medical concerns.

1,310 citations

Journal ArticleDOI
TL;DR: The data suggest that PAT had a major role in the spread of HCV throughout Egypt, and this intensive transmission established a large reservoir of chronic HCV infection, responsible for the high prevalence ofHCV infection and current high rates of transmission.

1,122 citations


"Estimation of the global burden of ..." refers background in this paper

  • ...HCV prevalence has reached alarming levels over recent decades in a number of countries of the Emr and Afr region [Khan et al., 2000; Frank et al., 2000; World Health Organization, 2000a]....

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  • ...HCV prevalence has reached alarming levels over recent decades in a number of countries of the Emr and Afr region [Khan et al., 2000; Frank et al., 2000; World Health Organization, 2000a]....

    [...]

Journal ArticleDOI
TL;DR: A case–control study of health care workers with occupational, percutaneous exposure to HIV-infected blood showed that significant risk factors for seroconversion were deep injury, injury with a device that was visibly contaminated with the source patient's blood, and a procedure inv...
Abstract: Background The average risk of human immunodeficiency virus (HIV) infection after percutaneous exposure to HIV-infected blood is 0.3 percent, but the factors that influence this risk are not well understood. Methods We conducted a case–control study of health care workers with occupational, percutaneous exposure to HIV-infected blood. The case patients were those who became seropositive after exposure to HIV, as reported by national surveillance systems in France, Italy, the United Kingdom, and the United States. The controls were health care workers in a prospective surveillance project who were exposed to HIV but did not seroconvert. Results Logistic-regression analysis based on 33 case patients and 665 controls showed that significant risk factors for seroconversion were deep injury (odds ratio = 15; 95 percent confidence interval, 6.0 to 41), injury with a device that was visibly contaminated with the source patient's blood (odds ratio = 6.2; 95 percent confidence interval, 2.2 to 21), a procedure inv...

976 citations

Journal ArticleDOI
TL;DR: With HBIG coverage from birth, the timing of the start of vaccination does not seem to be of importance within the first month of life, but to maximise compliance and minimise costs hepatitis B vaccination should be initiated during the confinement.

738 citations


"Estimation of the global burden of ..." refers background in this paper

  • ...Furthermore, PEP of HBV infection in the case of occupational exposures has been adopted in many industrialized countries [Beasley et al., 1983; Stevens et al., 1985; CDC, 2001], and efforts should be made to vaccinate HCWs as early as possible in their career....

    [...]

  • ...The efficacy of the PEP regimen was estimated to be 90% for HBV [Beasley et al., 1983; Stevens et al., 1985; CDC, 2001] and 81% for HIV [Cardo et al., 1997]....

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