Page 6 - OOHNA Spring-Summer 2017
P. 6
Practice n
OccupatiO nal Healt H Service S:
cOmmunicable Di SeaSe preventiO n anD
management – part 1: Overview of Occupationally
acquired infections, biological Hazard risk assessment
and Hierarchy of control measures by Maureen Cividino
Background 1990s (Pike, Harding, liberman, ciated with lack of vaccination,
occupationally acquired infections 1995). Brucellosis, Q Fever, tuber- poor hand hygiene practices and
failure to promptly place patients
culosis (tB), and hepatitis B (HBV)
in health care settings continue to continue to be in the “top 10” of into appropriate isolation.
be reported due to unprotected reported cases (Harding & Byers,
exposures to biological hazards. 2006). More recently infections
HBV: u.S. serologic studies in the
Many of these incidents could 1970s reported HcWs were 10
with N. meninigitidis, hantavirus,
have been prevented by vaccina- West Nile virus, and vaccinia have times more likely to be infected
tion or other control measures. contributed to cases. only 30% with HBV than the general popu-
occupational Health Services lation, with an estimated 17,000
of cases are associated with a
(oHS) perform a crucial role in HcWs infected in 1983 (cdc
known incident (collins & Ken-
protecting the health and safety nedy, 1999); (Pike, 1976); (Harding MMWr Schillie et al., 2013). With
of health care workers (HcWs) and & Byers, 2006). the most common the advent of recombinant HBV
patients by preventing, reducing occurrences were due to mouth vaccine available to HcWs in
and managing communicable dis- pipetting (now prohibited), nee- 1982, routine infant vaccinations
ease exposure risks. dle/syringe and spills. in 1991, and legislated sharps
Part 1 will review risks to HcWs safety programs in 2001, the inci-
HcWs are at occupational
of occupationally acquired infec- risk for acquiring infections that dence of HBV in u.S. HcWs had
tions, discuss the role of an orga- cause serious illness and occa- decreased over 90% by 2011 and
nizational risk assessment and has remained stable.
sional deaths. Sepkowitz complet-
application of the hierarchy of haz- ed a review (1996) on oais in Schillie et al. reports HBV occu-
ard control measures. in the next HcWs acquired through different pational infection risk through
issue, Part 2 will focus on specific routes of transmission: airborne percutaneous (i.e., needlesticks),
communicable diseases relevant (tB, measles, varicella), blood- mucosal, or non-intact skin (e.g.,
to oHS programs and review pre- borne pathogens (HBV, hepatitis c psoriasis, eczema, burns, wounds)
placement vaccination require- [HcV], human immunodeficiency and exposure to infectious blood
ments, serology, surveillance, or body fluids. the highest risk
virus [HiV], fecal-oral (Salmonella,
exposure and post-exposure man- hepatitis a virus), and direct con- for HBV infection was exposure
agement, work restrictions, and tact (herpes simplex virus, Sarcop- to hepatitis B e antigen-posi-
required reporting. tes scabiei). respiratory syncytial tive source patients; (22% to 31%
Laboratory Acquired Infections virus, influenza and Ebola are also clinical hepatitis and 37% to 62%
seroconversion). risk for clini-
recorded as causes of oais. total
(LAIs), Occupationally Acquired outbreak-associated attack rates cal infection to Hbeag-negative
Infections (OAIs) reported ranged from 15% to 40%. blood was 1% to 6% with 23% to
37% seroconversion.
the term lai refers to all symptom- the most common serious
atic and asymptomatic infections oais reported are HBV, HcV and the total rate of reported cases
acquired through laboratory work tB, (Sepkowitz & Eisenberg, 2005). of acute HBV infection in canada
Nurses, physicians, and laboratory
or laboratory-related activities (PHac, 2013) decreased steadily
(PHac 2016). lais are a subset of technologists are the most likely between 2005 and 2013 from 304
oais. over 5000 cases of lais and by occupation to be exposed or cases in 2005 (1.0 per 100,000)
over 200 deaths were documented become ill with an oai. Sepkowitz to 178 cases (0.5 per 100,000).
between the late 1950s and mid- notes transmission is usually asso- the canadian Needle Stick Sur-
4 OOHNA JOURNAL n spRiNg/sUmmeR 2017
OccupatiO nal Healt H Service S:
cOmmunicable Di SeaSe preventiO n anD
management – part 1: Overview of Occupationally
acquired infections, biological Hazard risk assessment
and Hierarchy of control measures by Maureen Cividino
Background 1990s (Pike, Harding, liberman, ciated with lack of vaccination,
occupationally acquired infections 1995). Brucellosis, Q Fever, tuber- poor hand hygiene practices and
failure to promptly place patients
culosis (tB), and hepatitis B (HBV)
in health care settings continue to continue to be in the “top 10” of into appropriate isolation.
be reported due to unprotected reported cases (Harding & Byers,
exposures to biological hazards. 2006). More recently infections
HBV: u.S. serologic studies in the
Many of these incidents could 1970s reported HcWs were 10
with N. meninigitidis, hantavirus,
have been prevented by vaccina- West Nile virus, and vaccinia have times more likely to be infected
tion or other control measures. contributed to cases. only 30% with HBV than the general popu-
occupational Health Services lation, with an estimated 17,000
of cases are associated with a
(oHS) perform a crucial role in HcWs infected in 1983 (cdc
known incident (collins & Ken-
protecting the health and safety nedy, 1999); (Pike, 1976); (Harding MMWr Schillie et al., 2013). With
of health care workers (HcWs) and & Byers, 2006). the most common the advent of recombinant HBV
patients by preventing, reducing occurrences were due to mouth vaccine available to HcWs in
and managing communicable dis- pipetting (now prohibited), nee- 1982, routine infant vaccinations
ease exposure risks. dle/syringe and spills. in 1991, and legislated sharps
Part 1 will review risks to HcWs safety programs in 2001, the inci-
HcWs are at occupational
of occupationally acquired infec- risk for acquiring infections that dence of HBV in u.S. HcWs had
tions, discuss the role of an orga- cause serious illness and occa- decreased over 90% by 2011 and
nizational risk assessment and has remained stable.
sional deaths. Sepkowitz complet-
application of the hierarchy of haz- ed a review (1996) on oais in Schillie et al. reports HBV occu-
ard control measures. in the next HcWs acquired through different pational infection risk through
issue, Part 2 will focus on specific routes of transmission: airborne percutaneous (i.e., needlesticks),
communicable diseases relevant (tB, measles, varicella), blood- mucosal, or non-intact skin (e.g.,
to oHS programs and review pre- borne pathogens (HBV, hepatitis c psoriasis, eczema, burns, wounds)
placement vaccination require- [HcV], human immunodeficiency and exposure to infectious blood
ments, serology, surveillance, or body fluids. the highest risk
virus [HiV], fecal-oral (Salmonella,
exposure and post-exposure man- hepatitis a virus), and direct con- for HBV infection was exposure
agement, work restrictions, and tact (herpes simplex virus, Sarcop- to hepatitis B e antigen-posi-
required reporting. tes scabiei). respiratory syncytial tive source patients; (22% to 31%
Laboratory Acquired Infections virus, influenza and Ebola are also clinical hepatitis and 37% to 62%
seroconversion). risk for clini-
recorded as causes of oais. total
(LAIs), Occupationally Acquired outbreak-associated attack rates cal infection to Hbeag-negative
Infections (OAIs) reported ranged from 15% to 40%. blood was 1% to 6% with 23% to
37% seroconversion.
the term lai refers to all symptom- the most common serious
atic and asymptomatic infections oais reported are HBV, HcV and the total rate of reported cases
acquired through laboratory work tB, (Sepkowitz & Eisenberg, 2005). of acute HBV infection in canada
Nurses, physicians, and laboratory
or laboratory-related activities (PHac, 2013) decreased steadily
(PHac 2016). lais are a subset of technologists are the most likely between 2005 and 2013 from 304
oais. over 5000 cases of lais and by occupation to be exposed or cases in 2005 (1.0 per 100,000)
over 200 deaths were documented become ill with an oai. Sepkowitz to 178 cases (0.5 per 100,000).
between the late 1950s and mid- notes transmission is usually asso- the canadian Needle Stick Sur-
4 OOHNA JOURNAL n spRiNg/sUmmeR 2017
