The latest Health Protection Agency report on the occupational exposure of healthcare workers (HCWs) to bloodborne viruses (BBVs) shows that nine healthcare workers were infected with hepatitis C through needlestick injuries over the last six years, with seven reported between July 2003 and June 2004.

Between 1996 and 2004, 2140 incidents of significant occupational exposure to BBVs were reported to the Agency; 47% (997/2140) of these HCWs were exposed to hepatitis C and 26% (551/2140) to HIV. These figures, gathered through the Agency’s monitoring programme, which looks at exposures to BBVs in healthcare settings, indicate that there are still too many exposures occurring. Although over half of the injuries looked at occurred during the procedure, over a third were after the procedure and during disposal of clinical waste, including exposures sustained while recapping needles or clearing clinical waste left by another worker.

Dr Fortune Ncube from the Health Protection Agency said, "The fact that preventable exposures are still occurring highlights the continued need to ensure that correct procedures are followed in the handling of sharps and in the disposal of clinical waste. Although the last case of a HCW occupationally contracting HIV was in 1999, it is vital that healthcare workers are aware of the importance of immediately reporting incidences following injury. Appropriate referral, testing and prompt treatment are also very important and can prevent the onset of infection and the need for specialist aftercare. It is also vital that healthcare workers infected through an occupational exposure are aware of the treatment options now available to them. Employers should support frontline staff and ensure that safety information and appropriate facilities for a safe working environment are available.

"This report also recommends improvements in surveillance techniques, to ensure that the guidelines to reduce exposure incidents are as effective as possible. Our current methods of surveillance have worked well in identifying and dealing with incidents of exposure, but we need to identify further ways of gathering information. As well as encouraging better data collection of incidents, we have recommended that the Agency, alongside partners such as the Department of Health, looks at establishing a sentinel surveillance system to support existing work. This would allow for more detailed examination of the risks facing healthcare workers, and would lead to a greater understanding of the factors involved in occupational exposures to bloodborne viruses, helping us develop more targeted and appropriate prevention measures."

"At present, information on follow-up testing of healthcare workers exposed to bloodborne viruses is also incomplete. It is essential that HCWs are properly tested and followed-up to ensure that they have not been infected with a BBV through their occupational exposure."

Notes to editors:

1. For further information: Please contact the Health Protection Agency Press Office on 020 8327 7098/7097/6055/6647.

2 This report includes significant occupational exposures incidents reported to the Health Protection Agency between 1st July 1996 and 30th June 2004 from reporting centres, currently 150, geographically scattered throughout England with four actively reporting centres in Wales and one actively reporting centre in Belfast, Northern Ireland.

3. Hepatitis means swelling or inflammation of the liver. The most common causes of hepatitis are viral infections. Hepatitis C infection (also known as Hep C or HCV) is one such virus that can cause long-lasting infection and can lead to liver disease including liver cancer. In the absence of treatment it is estimated that around 15-20% of infected people clear their infections naturally within the first 6 months of infection. For the remainder, hepatitis C is a chronic infection that can span several decades and can be life-long.

4. The surveillance of significant occupational exposures to bloodborne viruses (BBVs) in health care workers looks at the type of exposures reported to the scheme and the situation surrounding the event. The scheme collects data on the number of health care workers exposed to hepatitis B (HBV), hepatitis C (HCV) and HIV, and information on the use and management of treatment following exposure to these viruses.

5. The first documented case in the UK of a health care worker acquiring HIV following an occupational exposure was in 1984. Following this, a passive surveillance system was established, involving health care workers in England, Wales and Northern Ireland for exposures to HIV. This was changed to a more active surveillance system in July 1997, and was expanded to include hepatitis B and hepatitis C.

6. The full report can be accessed here www.hpa.org.uk

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