The long-established needlestick surveillance system, EPINet — now known as the International Safety Center — has issued a consensus statement and call to action to reduce unexpected exposures to blood and body fluids.

The group calls for more surveillance and research on protective clothing in healthcare. These are situations where exposure is not anticipated and PPE worn, calling for innovative new approaches like protective wearables for healthcare workers, the International Safety Center argues.

The statement cited EPINet data from 2010-2014, which revealed that about 70% of all reported occupational splash or splatter exposures involving body fluids were contaminated with blood. However, some 40% of the exposed workers indicated that they were wearing everyday clothes or nonprotective scrubs or uniforms during the exposure. Only 17% were wearing a protective gown.

According to EPINet data, compliance with PPE use even when an exposure to blood, body fluid, or biologic hazard is anticipated, is lower than ideal. It can range from more than 70% (glove use) to less than 2% (goggle use), depending on the body location and type of incident, the Safety Center said in the statement.

“Engineering controls can be in the form of safer medical devices that protect workers from a needle or sharp, closed systems used for suctioning, HEPA-filtration in HVAC systems, and now ‘smarter’ textiles that can allow fluids to roll off of the worker rather than contaminating the worker’s skin,” according to the Safety Center.1 “…Microbes thrive on porous surfaces like textiles, specifically on the most commonly used textiles in healthcare: work wear and uniforms. Contaminated textiles like work wear are known to become colonized with [pathogens].”

The Safety Center recommended that work-wear contamination data be collected by hospitals and shared among government public health agencies. In addition, the CDC and NIOSH should support research that evaluates this risk to workers. Moreover, professional groups and manufacturers should join forces to encourage development of work wear that provides the best protection for workers when they are not wearing PPE or barrier garments, the Safety Center recommended.


  1. International Safety Center. Improving Work Wear for Workers at Risk of Exposure to Blood, Body Fluids, and Other Biologic Hazards: A Consensus Statement and Call to Action. 2017: