Health care workers have higher HCV prevalence

Last Updated: 2015-10-30

By Lisa Rapaport

NEW YORK (Reuters Health) - The prevalence of hepatitis c infection is higher than average among health care workers, a research review suggests.

Compared to the general population, health workers had 60% greater odds of having hepatitis C, and those who worked directly with blood had almost triple the risk, in an analysis reported online October 5 in Occupational and Environmental Medicine.

"Contact with blood . . . continues to be the major threat to the health of health care workers," lead author Claudia Westermann of the University Medical Center Hamburg-Eppendorf in Germany told Reuters Health by email.

"Exposure to blood cannot completely be avoided when using `safe' instruments, as they reduce the risk of needle-stick injuries but do not completely prevent them," Westermann added. "Therefore blood-borne virus infections will remain a threat to health care workers for some time to come."

To assess the prevalence of HCV among health care workers, Westermann and colleagues analyzed data from 44 published studies.

In the U.S. and Europe, where HCV prevalence is relatively low, health care workers are more than twice as likely as other individuals to be infected, the data showed.

The risk for health workers was also doubled in North Africa, the Middle East, and South Asia, although infection rates in Japan were similar to the rest of the population.

Male health workers had triple the odds of HCV infection, compared with a 50% greater risk for female workers.

Medical staff had 2.2 times the odds of HCV, while odds were 3.5 times greater for dentists and increased by just 70% for nurses.

Professionals who came in regular contact with blood had 2.7 times the risk of infections.

Limitations of the analysis include a lack of data on personal risk factors such as use of injected drugs or engagement in sexual practices such as anal intercourse, the authors acknowledge.

It is unlikely, however, that health workers have unprotected sex or use injected drugs more often than the general population, Dr. William Buchta, medical director of the occupational medicine practice at the Mayo Clinic in Rochester, Minnesota, told Reuters Health by email.

"Inadvertent exposure to patients' blood and other infectious fluids is common among health care workers and grossly under-reported, so exposure to infected patients is a far more credible cause for this disparity," said Dr. Buchta, who wasn't involved in the study.

Virus transmission can be reduced in health care settings when proper infection control practices are followed, including the use of personal protective equipment, proper cleansing of infected tools, use of blunt needles for certain surgical procedures, and many other practical and relatively cheap and effective measures, Dr. Buchta added.

"We simply need to get the message out to health care workers that they are at risk but can almost eliminate that risk without compromising the care they deliver," Dr. Buchta said.

The authors reported no funding or disclosures.

SOURCE: http://bit.ly/1Ml4OVx

Occup Environ Med 2015.