Page updated 30 April 2007
Inoculation Accidents
Health care workers face a potential risk of infection with HBV, HCV or HIV from used "Sharps". It is essential that inoculation accidents are avoided by staff taking meticulous care with contaminated needles and knife blades. The risk to non-immune staff of contracting HBV from a carrier is 1-20% depending on the infectivity of the blood. HBeAg + blood is very infectious.
The risk of catching HCV from HCV positive blood is ~5%. That of contracting HIV from HIV-positive blood is 0.3%. The risks depend on the DOSE of blood inoculated and the infectivity of the blood (ie the number of infectious virus particles/ml).
The risks of catching HBV are enormously reduced by being successfully immunised. For those who are not immune (those unable to respond to vaccine or have never been immunised), passive immunisation with HBV immunogolobulin is offered after accidents with "Sharps" used on patients infected with HBV. Active immunisation can be started at the same time if appropriate.
After an accident with HIV positive blood, staff will be offered what is currently considered to be optimal antiviral treatment. This is chosen with due consideration of the availability of drugs and their toxicity against their likely benefit in reducing risks of infection. The risk of infection depends on the nature of the accident, the volume of blood injected and the status of the patient (donor). The antiviral treatment will be made freely available.
At present, there is no passive immunisation or proven active treatment for staff who have accidents with "Sharps" used on HCV infected patients. Therefore the only protection available is PREVENTION. Antiviral agents may be offered to staff who acquire HCV (RNA detection) to reduce the risk of fully established chronic infection.
Note that it is the responsibility of the injured staff member (the recipient) to make sure that the "Sharps" injury procedure is carried out.
Surgeons who have Sharps injuries in the Operating Theatre are regarded as donors and will be tested for these blood borne viruses as a protection to the patient.
This policy updates and summarizes the detailed document entitled
District AIDS and Hepatitis B policy dated April 1986.
Details about HCV were added in 1996.
See Sharps Policy for more information
 |
 |