Over the past few years , exposures to the head and face make up about 80 percent of all exposure incidents reported and the greatest majority of those are to unprotected eyes . This past year , eye protection use is a tad improved , but still only 11.2 percent of workers indicate they are wearing protective eyewear or face shields .” — Amber Hogan Mitchell , DrPH ,
MPH
effective exposure management services can be challenging . Bloodborne pathogen exposures among healthcare personnel are significantly underreported , some experts say . Time constraints , fear of reprimand , lack of information on how to report exposures , and cost coverage of exposure management have been identified as factors in not reporting exposures . While many healthcare personnel may be guaranteed cost coverage for job-related exposure and illness by workers ’ compensation laws , not all healthcare personnel , such as volunteers and trainees , may have this benefit .
One strong advocate for the occupational health of care providers is the International Safety Center ( ISC ), which focuses on collecting and analyzing data that better identifies healthcare worker safety hazards . The ISC helps healthcare institutions measure blood and body fluid exposures , sharps injuries and needlesticks to help prevent worker exposures to dangerous pathogens . The Center ’ s Exposure Prevention Information Network ( EPINet ) surveillance system has provided healthcare facilities with a standardized system for tracking the occupational exposures that put healthcare staff at risk . The latest reports from EPINet tell the story . The 2021 Sharp Object Injury Report provides data from the reporting period of Jan 1 , 2021 to Dec 31 , 2021 and information is collected from 41 hospitals participating . Out of 1,660 records , 16.2 percent of physicians who were interns , residents or fellows sustained sharp-object injuries , as did 14.7 percent of attending or staff physicians . Nurses fared worse , with 39.4 percent of them being injured . The report shows that 2.9 percent of allied healthcare professionals such as phlebotomists were injured , as were 1.6 percent of certified nursing assistants . Approximately 1 percent of environmental services workers were injured by a sharp object during the performance of their duties . Out of 1,647 records , 37.4 percent of these injuries happened in the operating room ; 30 percent of these injuries occurred in a patient room ; 8 percent in the emergency department , 2.5 percent in the ICU or critical care unit , and the rest occurring in various other areas of the healthcare environment . The source patient was identifiable in 91.7 percent of the injuries , and in 74.5 percent of cases , the healthcare professional was injured . In 89.5 percent of the cases the sharp object was considered to be contaminated , and blood was visible on the sharp in 69.5 percent of cases . An injection was responsible for the injury in 29.2 percent of cases , and suturing in 27.5 percent of cases . Injuries occurred during use of the sharp object in 57.5 percent of cases . Notably , in 62.4 percent of cases , the item causing the injury was a needle or sharp medical device not considered to be a safety design with a shielded , recessed , retractable , or blunted needle or blade .
The EPINet Report for Blood and Body Fluid Exposures , with data collected from the same time period , shows that in 55.6 percent of 554 records from 41 hospitals , nurses were the ones exposed , followed by 16.4 percent of physicians . The data show that 40.9 percent of these exposures occurred in the patient room , followed by 21.9 percent in the operating room , 12.1 percent in the emergency department , and the rest occurring elsewhere in the healthcare facility . The source patient was identifiable in 92.7 percent of cases , and blood or blood products were involved in 58 percent of cases . Of 376 records , eyes ( conjunctiva ) were exposed in 73.1 percent of cases , and blood and / or body fluids touched unprotected skin in 74.1 percent of cases , raising the alarm among safety experts .
The continued lack of eye protection is concerning for decades that EPINet data has been collected from network facilities , says Amber Hogan Mitchell , DrPH , MPH , CPH president and executive director of the International Safety Center . “ We publish data publicly every year and it continues to be frustrating that people don ’ t seem to pay attention to it . Over the past few years , exposures to the head and face make up about 80 percent of all exposure incidents reported and the greatest majority of those are to unprotected eyes . This past year , eye protection use is a tad improved , but still only 11.2 percent of workers indicate they are wearing protective eyewear or face shields . In years past it was a low as 3 percent . Infection preventionists have focused more in the past on protecting a patient from a worker when a patient is in isolation or on contact precautions . Occupational health officers focused more on protecting a worker and using PPE for chemical , radiologic , or physical hazards . It is now glaringly obvious that the two need to come together , broaden focus and create synergies . This means making protective eyewear and face shields available when and where needed . It is not enough for them to be on infection control or isolation carts , but also in patient and procedure rooms .”
According to EPINet data , most blood / body fluid exposures occurred while healthcare personnel were wearing a surgical mask ( 73 percent ) or single pair of gloves ( 60.5 percent ). Personnel were wearing a double pair of gloves in 11.1 percent of cases , non-protective eyeglasses in 11 . 1 percent of cases , and protective eyewear / goggles in 5.1 percent of cases . A face shield was worn in only 3.4 percent of exposures . And less than 1 percent of healthcare workers were wearing any other items of personal protective equipment ( PPE ) at the time of the exposure .
As OSHA ’ s Bloodborne Pathogen Standard mandates , “ Masks in combination with eye protection devices , such as goggles or glasses with solid side shields , or chin-length face shields , shall be worn whenever splashes , spray , spatter , or droplets of blood or other potentially infectious materials may be generated and eye , nose , or mouth contamination can be reasonably anticipated .”