Abstract

Objective: Risky exposure of healthcare workers to blood and body fluids is one of the most critical global issues. This study aimed to determine the frequency, conditions, and interventions of risky contacts and provide guidance on infection control measures to enhance occupational safety.

Methods: Healthcare workers’ risky contact with blood and body fluids was investigated from January 2013 to December 2022. The contact tracking forms for blood and body fluid exposures in the Infection Control Committee (ICC) were retrospectively examined. Furthermore, the effects of the regulatory activities implemented by the ICC on the problems detected during the active surveillance of risky contacts and the effects of the COVID-19 pandemic during the monitoring process were evaluated.

Results: During the ten-year follow-up period, a total of 700 risky contacts were identified in 625 healthcare workers, with 643 (91.9%) resulting from needlestick and sharp injuries and 57 (8.1%) from skin and mucosal contact. Of the risky contacts, 262 (37.4%) occurred in internal medicine units, 171 (24.4%) in surgical units, and 112 (16%) in the emergency department, making these the most common locations for risky contacts. The most frequently reported occupational groups were, respectively, 267 (38%) interns, 185 (26%) nurses, and 173 (25%) cleaning staff. When evaluating how risky contacts occurred, it was determined that 215 (30.7%) occurred during invasive procedures, 108 (15.4%) while recapping the needle, and 528 (75%) resulted from needlestick injuries. It was determined that 13% of risky contacts applied to the ICC after 72 hours, and 79% used appropriate personal protective equipment (PPE). The highest rate of PPE usage, at 93%, was observed in 2020, when the COVID-19 pandemic began. In 2013, it was observed that the most common risky contacts occurred during waste collection, and over the years, injuries during waste collection decreased with training. Although the source was unknown in 32% of risky contacts, a decrease in the rate of risky contacts with unknown sources was achieved over time. Out of 478 risky contacts with known sources, 71 (14.9%) occurred with patients infected with hepatitis B, 35 (7.3%) with hepatitis C, and seven (1.5%) with HIV. Ninety-six per cent of the nurses were exposed to risky contacts, 93% of interns, 87% of doctors, 56% of cleaning personnel, and 84% of other healthcare workers were immune to hepatitis B. After a one-year follow-up period with post-exposure prophylaxis, no healthcare worker developed hepatitis B or HIV infection, while one person was found to be anti-HCV positive.

Conclusion: Needlestick-sharp object injuries remain a significant issue. All healthcare institutions must regularly monitor risky contacts with blood and bodily fluids, identify problems, develop targeted infection control measures, and plan periodic training.