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 1 Prevalence and risk factors for bloodborne exposure and infection in correctional healthcare workers
Authors Gershon-RR; Sherman-M; Mitchell-C; Vlahov-D; Erwin-MJ; Lears-MK; Felknor-S; Lubelczyk-RA; Alter-MJ 
Source Infect Control Hosp Epidemiol 2007 Jan; 28(1):24-30 
Link http://dx.doi.org/10.1086/510813 
NIOSHTIC No. 20031716 
AbstractOBJECTIVE: To determine the prevalence and risk factors for bloodborne exposure and infection in correctional healthcare workers (CHCWs).Design. Cross-sectional risk assessment study with a confidential questionnaire and serological testing performed during 1999-2000. SETTING: Correctional systems in 3 states. RESULTS: Among 310 participating CHCWs, the rate of percutaneous injury (PI) was 32 PIs per 100 person-years overall and 42 PIs per 100 person-years for CHCWs with clinical job duties. Underreporting was common, with only 25 (49%) of 51 PIs formally reported to the administration. Independent risk factors for experiencing PI included being age 45 or older (adjusted odds ratio [aOR], 2.41 [95% confidence interval (CI), 1.31-4.46]) and having job duties that involved needle contact (aOR, 3.70 [95% CI, 1.28-10.63]) or blood contact (aOR, 5.05 [95% CI, 1.45-17.54]). Overall, 222 CHCWs (72%) reported having received a primary hepatitis B vaccination series; of these, 150 (68%) tested positive for anti-hepatitis B surface antigen, with negative results significantly associated with receipt of last dose more than 5 years previously. Serologic markers of hepatitis B virus infection were identified in 31 individuals (10%), and the prevalence of hepatitis C virus infection was 2% (n=7). The high hepatitis B vaccination rate limited the ability to identify risk factors for infection, but hepatitis C virus infection correlated with community risk factors only. CONCLUSION: Although the wide coverage with hepatitis B vaccination and the decreasing rate of hepatitis C virus infection in the general population are encouraging, the high rate of exposure in CHCWs and the lack of exposure documentation are concerns. Continued efforts to develop interventions to reduce exposures and encourage reporting should be implemented and evaluated in correctional healthcare settings. These interventions should address infection control barriers unique to the correctional setting. 
KeywordsBlood-disorders; Blood-analysis; Blood-poisoning; Bloodborne-pathogens; Blood-tests; Risk-factors; Risk-analysis; Infectious-diseases; Pathogenicity; Health-care-personnel; Health-surveys; Health-hazards; Serology; Skin-disorders; Age-factors; Needlestick-injuries; Vaccines 
ContactMailman School of Public Health, Columbia University, New York, NY 10032 
CODENICEPE3 
Publication Date20070101 
Document TypeJournal Article 
Email Addressrg405@columbia.edu 
Funding Amount148530 
Funding TypeGrant 
Fiscal Year2007 
NTIS Accession No. 
NTIS Price 
Identifying No.Grant-Number-R01-OH-003459 
Issue of Publication
ISSN0899-823X 
Source NameInfection Control and Hospital Epidemiology 
StateMD 
Performing OrganizationJohns Hopkins University, Baltimore, Maryland 
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