Occupational exposure to blood-borne or body fluid pathogens among medical interns at Addington Hospital, Durban

Abstract

Background: Healthcare workers are at risk of transmission of hepatitis B and C and human immunodeficiency viruses following accidental exposure to blood and body fluids. Interns are a vulnerable group of healthcare workers, cited as having the highest incidence of accidental needle-stick injuries and splashes with blood or body fluids. The main reason is thought to be a lack of experience and confidence, and underdeveloped dexterity skills, all of which increase risk of exposure. Since the introduction of the new two-year internship, to date no study has been carried out in South Africa comparing the incidence of occupational exposure between first- and second-year interns.

Methods: A descriptive study design was devised and a structured questionnaire distributed to all interns employed at Addington Hospital in December 2008. All the interns had completed either one or two years of internship. Data were analysed using the SPSS software package and chi-square tests were applied for comparable variables.

Results: The response rate was 83% (53/64). During 2008, 29 (55%) interns had at least one incident of accidental exposure to blood or body fluids. Eighteen (62%) were first-year interns and 11 (38%) were second-year interns (p < 0.01). In total, there were 42 exposures, of which 64% (27/42) were percutaneous and 36% (15/42) mucosal. First-year interns experienced 70% (19/27) of the needle-stick injuries and 73% (11/15) of the mucosal exposures (p < 0.01). A significant difference was noted between the first- and second-year interns (p < 0.01).

Conclusion: The high level of exposure of interns to blood and blood products highlights the need for improvement in occupational health safety to prevent transmission of pathogens. Closer supervision of first-year interns and more focus on undergraduate awareness and skills development is necessary.