More HCWs join list of HIV/AIDS infections
More HCWs join list of HIV/AIDS infections
Occupational seroconversions rise
Some 49 U.S. health care workers have documented occupationally acquired HIV/AIDS infections, and 102 more may have acquired HIV/AIDS through occupational transmission, according to the most recent estimates released by the federal Centers for Disease Control and Prevention in Atlanta.
The numbers represent infections reported through December 1995. (See list, this page.) December 1994 figures reflected 42 documented and 91 possible occupational infections. Nurses and clinical laboratory technicians continue to head the list, but Russ Metler, RN, MSPH, a nurse epidemiologist in the CDC's division of HIV/AIDS prevention, warns against interpreting those numbers as indicative of the relative risks associated with particular health care professions.
"Some workers, such as housekeepers and maintenance personnel, may not be as conscious of reporting sharps injuries as nurses might be, while for others, such as physicians, there may be a big disincentive to report in terms of the risk of losing their careers," he says.
Nevertheless, Metler says that of the percutaneous exposures reflected in the list, most were associated with starting or manipulating intravenous lines, collecting blood in vacuum tubes, or moving or rearranging contents in overfilled sharps disposal boxes.
In recent years the CDC list has been criticized as a gross underrepresentation of the problem of occupational HIV transmission. The CDC collects data on HCW seroconversions through routine AIDS case surveillance by state health departments. An additional surveillance system allows state health departments to report cases of infected HCWs who may have acquired HIV through occupational transmission. The CDC has acknowledged that the numbers represent minimal estimates, but officials claim the necessary voluntary reporting aspect limits their ability to obtain data. (See related story in Hospital Employee Health, November 1995, pp. 133-135.)
Of the 49 HCWs who have been documented as having seroconverted to HIV after occupational exposure, the exposures were as follows: 42 had percutaneous exposure, five had mucocutaneous exposure, one had both percutaneous and mucocutaneous exposure, and one had an unknown route of exposure. Forty-four exposures were to HIV-infected blood, three to concentrated virus in a laboratory, one to visibly bloody fluid, and one to unspecified fluid. Twenty-two of these HCWs have developed AIDS.
HCWs included in the list of possible occupational transmission have been investigated and are without identifiable behavioral or transfusion risks. Each reported percutaneous or mucocutaneous occupational exposures to blood, body fluids, or laboratory solutions containing HIV, but HIV seroconversion resulting specifically from an occupational exposure was not documented. *
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