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Clinical Microbiology Reviews, July 2000, p. 385-407, Vol. 13, No. 3
0893-8512/00/$04.00+0

Risk and Management of Blood-Borne Infections in Health Care Workers

Elise M. Beltrami,1,* Ian T. Williams,2 Craig N. Shapiro,2 and Mary E. Chamberland1

HIV Infections Branch, Hospital Infections Program,1 and Hepatitis Branch, Division of Viral and Rickettsial Diseases,2 National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia

Exposure to blood-borne pathogens poses a serious risk to health care workers (HCWs). We review the risk and management of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in HCWs and also discuss current methods for preventing exposures and recommendations for postexposure prophylaxis. In the health care setting, blood-borne pathogen transmission occurs predominantly by percutaneous or mucosal exposure of workers to the blood or body fluids of infected patients. Prospective studies of HCWs have estimated that the average risk for HIV transmission after a percutaneous exposure is approximately 0.3%, the risk of HBV transmission is 6 to 30%, and the risk of HCV transmission is approximately 1.8%. To minimize the risk of blood-borne pathogen transmission from HCWs to patients, all HCWs should adhere to standard precautions, including the appropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments. Employers should have in place a system that includes written protocols for prompt reporting, evaluation, counseling, treatment, and follow-up of occupational exposures that may place a worker at risk of blood-borne pathogen infection. A sustained commitment to the occupational health of all HCWs will ensure maximum protection for HCWs and patients and the availability of optimal medical care for all who need it.

* Corresponding author. Mailing address: Hospital Infections Program, Mailstop E-68, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333. Phone: (404) 639-6425. Fax: (404) 639-6459. E-mail: ebj4{at}cdc.gov.

Clinical Microbiology Reviews, July 2000, p. 385-407, Vol. 13, No. 3
0893-8512/00/$04.00+0


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