Volume 7, number 2, 2004 (published December 2004)

Advances in Exposure Prevention: summary of latest issue

·De Carli G, Perry J, Black L, Jagger J. “Occupational Co-Infection with HIV and HCV: Reported Cases Worldwide from the Medical Literature and News Reports” (pp. 13-18). Simultaneous co-infection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) following an occupational exposure in healthcare settings is, fortunately, a rare event. Since the first documented case of occupational HIV transmission was reported 20 years ago, ten cases of co-infection in healthcare workers (HCWs) have been reported worldwide in the medical literature. The first part of this article provides information on post-exposure follow-up of healthcare workers who sustain exposures to known or suspected HIV/HCV co-infected patients, and on management of healthcare workers in the event co-infection occurs; topics include risk assessment, diagnosis, and treatment during the acute and chronic phases of infection. The second part of the article provides summaries of the ten known cases of occupational co-infection: the country where each case occurred, year of exposure, and any other available details about the cases. A reference or source for each case is also provided.

·Perry J. “What Does Co-Infection Cost? Cost of Drugs to Treat a Healthcare Worker Occupationally Infected with HIV and HCV” (p. 15). The costs for treating an occupationally co-infected healthcare worker (Lisa Black, RN) are detailed.

·Perry J, Parker G, Jagger J. “EPINet Report: 2002 Percutaneous Injury Rates.” In 2002, the International Healthcare Worker Safety Center collected data on percutaneous injuries and blood and body fluid exposures from 47 healthcare facilities in the United States that use the EPINet surveillance program to track exposure incidents. These facilities voluntarily participate in the collaborative EPINet network coordinated by the Center, and their exposure data were combined into an aggregate database. In this article we report findings from the 2002 data, and provide percutaneous injury rates for teaching and non-teaching hospitals. Included in the article are EPINet data reports for 2002 for needlesticks and sharp-object injuries (47 healthcare facilities; 1,693 injuries) and blood and body fluid exposures (47 healthcare facilities, 469 exposures).

·David, Mark S.. “Take ‘Time Out’ for Patient Safety and Worker Safety in the OR: Meet JCAHO and OSHA Requirements at the Same Time” (p. 22-23). Mark Davis, M.D., an OR safety consultant, argues that patient safety and worker safety go hand-in-hand. He recommends that surgical teams take a “time out” before any procedure to ensure compliance with both patient safety and worker safety requirements.  Building on JCAHO’s suggestion that ORs use a preoperative checklist to prevent wrong-site/wrong-patient/wrong-procedure surgical errors, Dr. Davis has developed a brief worker safety checklist that can be used in conjunction with the patient safety list. Incorporating such a list—which includes checking that appropriate PPE has been donned and blunt suture are utilized whenever appropriate— into an OR’s standard safety protocol helps ensure that OR personnel work in the safest possible environment.