Sammendrag
Health Care Workers (HCWs) exposure to blood and body fluids is frequent during health care practice, through various procedures (surgical procedures, injections, disposal of used sharps, cleaning etc) and in the different departments of the hospital. These exposures carry a risk of infection by Blood Borne Pathogens (BBP), especially viral: (Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV)). HBV is the most easily transmissible BBP to the HCWs and the most common infection acquired occupationally. The objectives of this study were to estimate the prevalence of HBV infection and NSIs among the Palestinian HCWs in Hebron governmental hospital, to describe the existing safety
instructions in different medical and para-medical working tasks, to investigate the knowledge of transmission of HBV in medical personnel and to investigate the presence of routine safety standards in Palestinian hospitals. In order to identify hospital occupational categories at potential risk of HBV infection through exposure to Needle stick and other Sharp related Injuries (NSIs), we conducted a
cross sectional occupational health study in the year 2002. We applied a self-reporting questionnaire for life time experience. All full time medical personnel including: physicians, nurses, medical technicians, and ambulance workers were recruited to determine HBV
prevalence, immunization coverage, rate of NSIs, safety routines and workers' adherence in the Hebron governmental general hospital in the West Bank of Palestine. Two phases of the study were performed: first, a self-reporting questionnaire to the medical personnel in the Hebron governmental hospital in Hebron district, second a telephone
call inquiry to nine randomly selected hospitals from various health sectors, in addition to, one UNRWA hospital in the West Bank of Palestine. A total number of 207 medical personnel were recruited into the study and 85% of HCWs completed the survey, including: nurses (59.7%), physicians (25%), medical technicians (14.8%), and ambulance workers (0.5%). 17.4% of respondent workers had evidence of
hepatitis B infection (HBsAg positive or HBsAb positive). The prevalence of HBV infection (HBsAg (+)) among them was 5.8%. HBV vaccination coverage rate was 89.1%. The cumulative prevalence of NSIs across different categories was 62.5%: in medical technicians
was 76.9%, in physicians was 63.6%, and in nurses was 59%. More than half (54.5%) of NSIs ABSTRACT Health Care Workers (HCWs) exposure to blood and body fluids is frequent during health care practice, through various procedures (surgical procedures, injections, disposal of used sharps, cleaning etc) and in the different departments of the hospital. These exposures carry a risk of infection by Blood Borne Pathogens (BBP), especially viral: (Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV)).
HBV is the most easily transmissible BBP to the HCWs and the most common infection acquired occupationally. The objectives of this study were to estimate the prevalence of HBV infection and NSIs
among the Palestinian HCWs in Hebron governmental hospital, to describe the existing safety instructions in different medical and para-medical working tasks, to investigate the knowledge of transmission of HBV in medical personnel and to investigate the presence of routine safety standards in Palestinian hospitals.
In order to identify hospital occupational categories at potential risk of HBV infection through exposure to Needle stick and other Sharp related Injuries (NSIs), we conducted a cross sectional occupational health study in the year 2002. We applied a self-reporting questionnaire for life time experience. All full time medical personnel including: physicians, nurses, medical technicians, and ambulance workers were recruited to determine HBV prevalence, immunization coverage, rate of NSIs, safety routines and workers' adherence in the Hebron governmental general hospital in the West Bank of Palestine. Two phases of the study were performed: first, a self-reporting questionnaire to the medical personnel in the Hebron governmental hospital in Hebron district, second a telephone call inquiry to nine randomly selected hospitals from various health sectors, in addition to, one UNRWA hospital in the West Bank of Palestine. A total number of 207 medical personnel were recruited into the study and 85% of HCWs completed the survey, including: nurses (59.7%), physicians (25%), medical technicians (14.8%), and ambulance workers (0.5%). 17.4% of respondent workers had evidence of hepatitis B infection (HBsAg positive or HBsAb positive). The prevalence of HBV infection (HBsAg (+)) among them was 5.8%. HBV vaccination coverage rate was 89.1%. The cumulative prevalence of NSIs across different categories was 62.5%: in medical technicians was 76.9%, in physicians was 63.6%, and in nurses was 59%. More than half (54.5%) of NSIABSTRACT Health Care Workers (HCWs) exposure to blood and body fluids is frequent during health care practice, through various procedures (surgical procedures, injections, disposal of used sharps, cleaning etc) and in the different departments of the hospital. These exposures carry a risk of infection by Blood Borne Pathogens (BBP), especially viral: (Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV)). HBV is the most easily transmissible BBP to the HCWs and the most common infection acquired occupationally. The objectives of this study were to estimate the prevalence of HBV infection and NSIs among the Palestinian HCWs in Hebron governmental hospital, to describe the existing safety instructions in different medical and para-medical working tasks, to investigate the knowledge of transmission of HBV in medical personnel and to investigate the presence of routine safety
standards in Palestinian hospitals. In order to identify hospital occupational categories at potential risk of HBV infection
through exposure to Needle stick and other Sharp related Injuries (NSIs), we conducted a cross sectional occupational health study in the year 2002. We applied a self-reporting questionnaire for life time experience. All full time medical personnel including: physicians, nurses, medical technicians, and ambulance workers were recruited to determine HBV prevalence, immunization coverage, rate of NSIs, safety routines and workers' adherence in the Hebron governmental general hospital in the West Bank of Palestine.
Two phases of the study were performed: first, a self-reporting questionnaire to the medical personnel in the Hebron governmental hospital in Hebron district, second a telephone call inquiry to nine randomly selected hospitals from various health sectors, in addition to, one UNRWA hospital in the West Bank of Palestine.
A total number of 207 medical personnel were recruited into the study and 85% of HCWs completed the survey, including: nurses (59.7%), physicians (25%), medical technicians (14.8%), and ambulance workers (0.5%). 17.4% of respondent workers had evidence of hepatitis B infection (HBsAg positive or HBsAb positive). The prevalence of HBV infection (HBsAg (+)) among them was 5.8%. HBV vaccination coverage rate was 89.1%. The cumulative prevalence of NSIs across different categories was 62.5%: in medical technicians was 76.9%, in physicians was 63.6%, and in nurses was 59%. More than half (54.5%) of NSI occurred from the sharp tools being used on patients. More than three fourths (77.3%) of these accidents occurred in the wards (the departments where patients usually were admitted). The most exposed part of the body to injury was the fingers of the non-dominant hand (left hand fingers 60%). The item most commonly involved in NSIs across different job categories was needle sticks pricking. However, suture needles with physicians and glass items with nurses and medical technicians were listed as a second item. The procedures most commonly involved were recapping (50%) and giving injections (49.1%).
Standardized safety measures were lacking in the hospital; 67% of the workers indicated the absence of a special protocol to be followed after NSIs, while 52.3% of the workers reported the absence of guidelines in the department where they were working. Most of NSIs
was not reported: 74.3% of all workers said they never reported their NSIs and 64.2% of them said there was no policy to do so. 79.1% did not consult the responsible doctor after exposure. Only 28.4% received training about protecting themselves from NSIs. Sharp s boxes were present in the departments, but these containers were not suitable for disposal of sharp objects. Workers adherence to safety routines was not satisfactory since half of the procedures that caused the injuries were due to the recapping of the needles despite their knowledge of not recapping needles (67.6% knew that recapping is not allowed) and many of these injuries occurred after the tool had been used on the patient.
In conclusion, prevalence of HBV infection among medical personnel in Palestine was high, despite the policy of offering hepatitis B vaccination and high vaccination rate. This may be due to the lack of methods and rules in vaccination and the high prevalence of NSIs that occur as a result of inadequate safety routines and poor HCWs compliance.