Incidence of biological fluid-related accidents among interns of a University-Hospital

Background: The Hospital meant as work environment differs from most of the work environments for the plurality of executed activities. One of the primary risks is the biological one for parenteral transmission diseases connected to occupational injuries during health-care activity. The exposure to biological risk is very common in health workers, and hepatitis B and C and acquired immunodeficiency syndrome are the most frequent infectious diseases. Objectives: To identify, over a period of nine years (2002-2010), the prevalence and the main causes of occupational biological exposure accidents, and the possible prevention tools, in the interns of the University Hospital of Ferrara. Methods: We used a retrospective cohort study including a mean annual number of 537 interns (32 ± 4 years). Data on biological incidents were collected during a surveillance programme of occupational exposure to blood and fluids. Results: There were 331 incidents which occurred in the all period with an increase from 31 in 2002 to 41 in 2010. Needles were the medical device most frequently involved in percutaneous injuries (82.8%), and 84.3% were blood contacts. An interview to a subgroup of interns who had a biological incident showed important errors in their use of personal protective equipment. Although some contacts were with infected blood, no seroconversion has been registered. In the analysed subgroup of 20 sample subject, only 4 out of 20 doctors during specialty professional training declared to have participated to formation courses and only 13 out of 20 were wearing the individual protection disposals (I.P.D.) when the accident occurred. The principal reason reported by the people concerned about the lack of usage of I.P.D. was they had underestimated the dangerousness of the maneuver they had to carry out . Discussion and Conclusions: The study underlines the importance of HBV vaccinations and access to HIV post-exposure prophylaxis. The interns are at high risk of contact with biological fluids. Prevention requires a global strategy including the availability and the proper use of protective and safety devices, the application of the universal rules of prevention, and training programs. More effort in preventive strategies is necessary to decrease biological accidents in young physicians. Therefore an appropriate prevention can be reached taking into consideration all the organizational and educational measures to reduce the accidental events concerning the health-care workers; among these measures the organization of specific educational courses, the availabili