Occupational exposures to blood and body fluids (BBF): Assessment of knowledge, attitude and practice among health care workers in general hospitals in Lebanon — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
Occupational exposures to blood and body fluids (BBF): Assessment of knowledge, attitude and practice among health care workers in general hospitals in Lebanon
Faculty of Public Health, Lebanese University, Saida, Lebanon
,
Faculty of Economic Sciences and Business Administration, Lebanese University, Nabatieh, Lebanon
,
Doctoral School of Literature, Humanities & Social Sciences-Lebanese University, Beyrouth, Lebanon
,
Faculty of Public Health, Lebanese University, Saida, Lebanon
,
Faculty of Public Health, Lebanese University, Saida, Lebanon
1 Faculty of Public Health, Lebanese University, Saida, Lebanon
2 Faculty of Economic Sciences and Business Administration, Lebanese University, Nabatieh, Lebanon
3 Doctoral School of Literature, Humanities & Social Sciences-Lebanese University, Beyrouth, Lebanon
4 Faculty of Public Health, Lebanese University, Saida, Lebanon
5 Faculty of Public Health, Lebanese University, Saida, Lebanon
Healthcare workers (HCWs) who are employed in traditional health care workplaces face a serious danger that may threaten their life; it is their exposure to blood and body fluids (BBF). In Lebanon, the introduction of a hospital accreditation system has put a particular emphasis on staff safety, and on the evaluation of profes sional practice (EPP) programs. Methods: A cross-sectional survey was conducted amongst 277 HCWs working in 4 general hospitals in South Lebanon. Objective: 1) describe the prevalence and the risk factors for occupational exposure to BBF among HCWs; 2) evaluate knowledge, attitude, and practices of HCW concerning blood-borne pathogens and adherence to universal safety precautions. Results: The mean age of the respondents was 32.14 years (SD = 10.33), 57.4% were females. 43.3% of HCWs expressed that they use gloves all the time for every active ity of care . 67.1% were aware that needles should not be recapped after use; registered nurses and nursing students were more aware than physicians and nursing assistants (nurse) in this subject . 30% of HCWs declared having had at least one occupational exposure to BBF; 62.7% of all accidental exposure was reported to the department responsible for managing expo sures. Percutaneous injuries were the most frequently reported. Vaccination coverage was 88.4% for hepatitis B, and 48.4% against influenza. The source patient was tested in 43.4% of reported BBF exposures. Accidental exposure to BBF was more frequent in older people (OR = 3.42; p = 0.03) and the more experienced. Subjects working in intensive care unit ward reported more exposure to BBF (OR = 3; p = 0.04). Participants incurring exposure to BBF resorted to different measures after the injury suggesting a lack of a uniform policy for post-exposure prophylaxis. Conclusion: Exposure to BBF represents an important and frequently preventable occupational hazard for HCWs in Lebanon that requires continuous EPP of HCWs, and a comprehensive approach for prevention and management.
KeywordsOccupational exposure to blood and body fluidsEvaluation of the Professional PracticeKnowledgeAttitudeand Practices (KAP)Controlled Language
World Health Organization (WHO) (2010) Exposure to blood or other body. International Travel and Health: Situation as on 1 January 2010. World Health Organization, Geneva, 165-170. http://www.who.int/ith/ITH2010.pdf
World Health Organization (2003) For a strategy to protect health workers from infection with bloodborne viruses. AIDE-MEMOIRE. World Health Organization, Geneva. WHO/BCT/03.11. http://www.who.int/injection_safety/toolbox/en/AM_HCW_Safety_EN.pdf
Sangwan, M.C.B.R., Kotwal, C.A. and Verma, B.A.K. (2011) Occupational exposure to blood and body fluids amongst health care workers in a teaching hospital of the armed forces. Medical Journal Armed Forces India, 67, 21-24. http://medind.nic.in/maa/t11/i1/maat11i1p21.pdf
Bassil, A.A. (2012) Sharps safety in hospitals. Human & Health, 18, 12-16.
Gupta, A., Anand, S., Sastry, J., Krisagar, A., Ba-savaraj, A., Bhat, S.M., Gupte, N., Bollinger, R C. and Kakrani, A.L. (2008) High risk for occupational exposure to HIV and utilization of post-exposure prophylaxis in a teaching hospital in Pune, India. BMC Infectious Diseases, 8, 142. doi:10.1186/1471-2334-8-142
Gonzalez-Medina, D. and Le, Q.V. (2011) Infectious diseases and interpersonal trust: International evidence. Health, 3, 206-210. doi:10.4236/health.2011.34037
Mathieu, N., Waseem, M., Gernsheimer, J.R., Kulkarni, R., Keim, S.M., Looneyand, D.G., et al. (2012) Body Fluid Exposures Treatment & Management, 6 p. http://emedicine.medscape.com/article/782611-overview#showall
Wilburn, S.Q. and Eljkemans G. Y., (2004) Preventing needlestick injuries among healthcare workers: A WHO-ICN collaboration. International Journal of Occupational and En-vironmental Health, 10, 451-456. http://www.who.int/occupational_health/activities/5prevent.pdf
Department of Health & Human Services, CDC (2008) Exposure to blood what healthcare personnel need to know. Centers for Disease Control and Prevention (CDC). http://www.cdc.gov/HAI/pdfs/bbp/Exp_to_Blood.pdf
Guthmann, J.P. and Abiteboul, D. (2011) Vaccinations chez les soignants des établissements de soins de France, 2009. Cou-verture Vaccinale, Connaissances et Perceptions vis-à-vis des Vaccinations, Rapport Final 2011. Institut de Veille Sanitaire, Saint-Maurice, 76 p. http://opac.invs.sante.fr/doc_num.php?explnum_id=7347.
Monge, V., Mato, G., Mariano, A., Fernández, C. and Fereres, J. (2001) Epidemiology of biological-exposure incidents among Spanish healthcare workers. Infection Control and Hospital Epidemiology, 22, 776-780. doi:10.1086/501862
Healthcare Workers
Kahhaleh, J.G. and Jurjus, A.R. (2005) Adherence to universal precautions among laboratory personnel in Lebanon. Eastern Mediterranean Health Journal, 11, 929-942. http://applications.emro.who.int/emhj/1105_6/11_5-6_2005_929_942.pdf
Musharra?eh, U.M., Bizri, A.R.N., Nassar, N.T., Rahi, A.C., Shoukair, A.M., Doudakian, R.M., and Hamadeh, G.N. (2008) Health care workers’ exposure to blood-borne pathogens in Lebanon. Occupational Medicine, 58, 94-98. doi:10.1093/occmed/kqm139
Khader, Y., Burgan, S. and Amarin, Z. (2009) Self-re- ported needle-stick injuries among dentists in north Jordan. Eastern Mediterranean Health Journal, 15, 185-189. http://applications.emro.who.int/emhj/1501/15_1_2009_0185_0189.pdf
Sreedharan, J., Muttappallymyalil, J. and Venkatramana, M. (2010) Knowledge and practice of standard measures in occupational exposure to blood and body fluids among nurses in a University Hospital in the United Arab Emi-rates. Italian Journal of Public Health, 7, 90-94.
Ammar, W., Wakim, R. and Hajj, I. (2007) Accreditation of hospitals in Lebanon: A challenging experience. Eastern Mediterranean Health Journal, 13, 138-149. http://applications.emro.who.int/emhj/1301/13_1_2007_138_149.pdf
Salès-Wuillemin, E., Morlot, R., Fontaine, A., Pullin, W., Galand, Ch., Talon, D. and Minary-Dohen, P. (2011) Evolution of nurses’ social representation of hospital hygiene: From training to practice. Revue Européenne de Psychologie Appliquée, 61, 51-63. doi:10.1016/j.erap.2010.06.001
Haute Autorité de Santé (HAS) (2012) Professional practice assessment. http://www.hassante.fr/portail/jcms/c_408940/evaluation-des-pratiques-professionnelles
MOPH (2008) Evaluation of Professional Practices (EPP) or clinical practice assessment. Lebanon, 4 p. http://www.moph.gov.lb/HospitalAccreditation/Documents/EPP.pdf
MOPH (2008) PS: Patient safety and risk management. Lebanon. http://www.moph.gov.lb/HospitalAccreditation/Documents/PatientSafetyandRiskManagement.pdf
World Health Organization (2007) Standard precautions in health care. WHO, Geneva. http://www.who.int/csr/resources/publications/EPR_AM2_E7.pdf
Ndiaye, M., Cissokho, B.D. and Sow, M.L.L. (2011) Les accidents avec exposition au sang (AES) au CHNU de Fan de Dakar (Senegal). CAMIP—L’Actualite de la Sante au Travail, 1, 10 p. http://www.camip.info/IMG/pdf/AES_Senegal.pdf
Wicker, S., Jung, J., Allwinn, R., Gottschalk, R. and Rabenau, H.F. (2007) Prevalence and prevention of needlestick injuries among health care workers in a German university hospital. International Archives of Occupational and Environmental Health, 81, 347-354. doi:10.1007/s00420-007-0219-7
The National Surveillance System for Healthcare Workers (NaSH) (2007) Summary report for blood and body fluid exposure data collected from participating healthcare facilities. Centers for Disease Control and Prevention, 25 p. http://www.cdc.gov/nhsn/PDFs/NaSH/NaSH-Report-6-2011.pdf
Fabin, C. and Fu-Prudhomot, P. (2008) Observatoire ACMS des accidents avec exposition au sang (AES) bilan de 5 ans de fonctionnement. Cahier de Medecine Inter Profession-nelle, 2, 117-124. http://www.camip.info/IMG/pdf/ObservatoireAESACMS5ans2008-2-2.pdf
Siegel, J.D., Rhinehart, E., Jackson, M., Chiarello, L., The Healthcare Infection Control Practices Advisory Committee (2007) Guideline for isolation precautions: Preventing transmission of infectious agents in healthcare settings. CDC, 225 p. http://www.cdc.gov/ncidod/dhqp/pdf/isolation2007.pdf
Aiken, L.H., Sloane, D.M. and Klocinski J.L. (1997) Hospital nurses’ occupational exposure to blood: Prospective, retrospective, and institutional reports. American Journal of Public Health, 87, 103-107. doi:10.2105/AJPH.87.1.103
Miceli, M., Herrera, F., Temporiti, E., Li, D., Vila, A. and Bonvehí, P. (2005) Adherence to an occupational blood borne pathogens exposure management program among healthcare workers and other groups at risk in Argentina. The Brazilian Journal of Infectious Diseases, 9, 454-458. doi:10.1590/S1413-86702005000600002
Shiva, F., Sanaei, A., Shamshiri, A.R. and Ghotbi, F. (2011) Survey of needle-stick injuries in paediatric health personnel of 5 University Hospitals in Tehran. Journal of Pakistan Medical Associa-tion, 61, 127-131.
Guthmann, J.-P., Fonteneau, L., Ciotti, C., Bouvet, E., Pellissier, G., Lévy-Bruhl, D. and Abiteboul, D. (2011) Couverture vaccinale des soignants travaillant dans les établissements de soins de France. Résultats de l’enquête nationale Vaxisoin, 2009. Bulletin épidémiologique Hebdomadaire, 35-36, 371-376.
Panlilio, A.L., Cardo, D.M., Grohskopf, L.A., Heneine, W. and Ross, C.S. (2005) Updated US public health service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis. Morbidity and Mortality Weekly Report, 54, No. RR-9. http://www.cdc.gov/mmwr/PDF/rr/rr5409.pdf
Baudu, A., Lot, F., Abiteboul, D., L’Hériteau, F., Touche, S., Giard, M., Jarno, P., Venier, A.-G., Bouvet, E., Rabaud, C., Floret, N., pour le Comité de Pilotage National de la Surveillance AES-Raisin-Geres (2011) Suivi des accidents exposant au sang chez les professionnels de santé non immunisés et exposés au VHB, 2005-2007 (France). Bulletin épidémiologique Hebdo-madaire, 35-36, 388-391. http://www.invs.sante.fr/Publications-eoutils/BEH-Bulletin-epidemiologique-hebdomadaire
Ghofranipour, F., Asadpour, M., Ardebili, H.E., Niknami, S. and Hajizadeh, E. (2009) Needle sticks/sharps injuries and determinants in nursing care workers. European Journal of Social Sciences, 11, 191-197.
Haute Autorité de Santé (HAS) (2012) Découvrez les recommandations cliquables “Reco2clics”. HAS, France. http://www.has-sante.fr/portail/jcms/c_1103133/decouvrez-les-recommandations-cliquables
Dabis, F., Drucker, J. and Moren, A. (1992) Epidemiologie d’intervention. Arnette, Paris, 589 p.
Sabbah, I., Vuitton, D.-A., Droubi, N., Sabbah, S. and Mercier, M. (2007) Morbidity and associated factors in rural and urban populations of South Lebanon: A cross- sectional community-based study of self-reported health in 2000. Tropical Medicine and International Health, 12, 907-919. doi:10.1111/j.1365-3156.2007.01886.x
Janjua, N.Z., Ra-zaq, M., Chandir, S., Rozi, S. and Mahmood, B. (2007) Poor knowledge—Predictor of nonadherence to universal precautions for blood borne pathogens at first level care facilities in Pakistan. BMC Infectious Diseases, 7, 81. doi:10.1186/1471-2334-7-81
Cardey, S., Anantapochal, R., Beddar, M., Devitre, D., Greenfield, P., Jin, G., Renahy, J., Spaggiari, L., Vuitton, D. (2009) Model for automatic translation system. Multilingual Project TACT Lise (Linguistics and Security). In: Actes du WISG’09, Workshop Interdisciplinaire sur la Sécurité Globale, Université de Technologie de Troyes, Troyes, 27-28 January 2009, CD-ROM, 10 p.