Since 1983, we have conducted national surveillance of health care workers exposed to blood or body fluids from persons infected with the human immunodeficiency virus (HIV), to assess the risk of HIV transmission by such exposures. As of July 31, 1988, 1201 health care workers with blood exposures had been examined, including 751 nurses (63 percent), 164 physicians and medical students (14 percent), 134 laboratory workers (11 percent), and 90 phlebotomists (7 percent). The exposures resulted from needle-stick injuries (80 percent), cuts with sharp objects (8 percent), open-wound contamination (7 percent), and mucous-membrane exposure (5 percent). We concluded that 37 percent of the exposures might have been prevented. Of 963 health care workers whose serum has been tested for HIV antibody at least 180 days after exposure, 4 were positive, yielding a seroprevalence rate of 0.42 percent (upper limit of 95 percent confidence interval, 0.95 percent). Three subjects experienced an acute retroviral syndrome associated with documented seroconversion; serum collected within 30 days of exposure was not available from the fourth person. Two exposures that resulted in seroconversion were caused by coworkers during resuscitation procedures. We conclude that the risk of HIV infection after exposure to the blood of a patient infected with HIV is low, but at least six months of follow-up is recommended. Many exposures can be prevented by careful adherence to existing infection-control precautions, even during emergencies.
Source Information
Hospital Infections Program, Centers for Disease Control, Atlanta, GA 30333.
This article has been cited by other articles:
Anstadt, M. P., Lowe, J. E.
(2008). Cardiopulmonary Resuscitation. Card Surg Adult
3: 487-506
[Full Text]
Scully, C., Greenspan, J.S.
(2006). Human Immunodeficiency Virus (HIV) Transmission in Dentistry. JDR
85: 794-800
[Abstract][Full Text]
Burton, J L
(2003). Health and safety at necropsy. J. Clin. Pathol.
56: 254-260
[Abstract][Full Text]
Anstadt, M. P., Lowe, J. E.
(2003). Cardiopulmonary Resuscitation. Card Surg Adult
2: 471-494
[Full Text]
Radecki, S., Abbott, A., Eloi, L.
(2000). Occupational Human Immunodeficiency Virus Exposure Among Residents and Medical Students: An Analysis of 5-Year Follow-up Data. Arch Intern Med
160: 3107-3111
[Abstract][Full Text]
Committee on Pediatric AIDS and Committee on Infec,
(1999). Issues Related to Human Immunodeficiency Virus Transmission in Schools, Child Care, Medical Settings, the Home, and Community. Pediatrics
104: 318-324
[Abstract][Full Text]
Henderson, D. K.
(1997). Postexposure Treatment of HIV -- Taking Some Risks for Safety's Sake. NEJM
337: 1542-1543
[Full Text]
Gallo, D., George, J. R., Fitchen, J. H., Goldstein, A. S., Hindahl, M. S.
(1997). Evaluation of a System Using Oral Mucosal Transudate for HIV-1 Antibody Screening and Confirmatory Testing. JAMA
277: 254-258
[Abstract]
Yedidia, M. J., Berry, C. A.
(1996). The Impact of Residency Training on Physicians' Outlook on AIDS: A Cohort Analysis. Med Care Res Rev
53: 207-224
[Abstract]
Olubuyide, I.O.
(1996). Doctors at risk of hepatitis B and HIV infection from patients in Nigeria. The Journal of the Royal Society for the Promotion of Health
116: 157-160
[Abstract]
Pell, J., Gruer, L., Christie, P., Goldberg, D.
(1996). Management of HIV infected health care workers: lessons from three cases. BMJ
312: 1150-1152
[Full Text]
Lurie, P., Avins, A. L., Phillips, K. A., Kahn, J. G., Lowe, R. A., Ciccarone, D.
(1994). The Cost-effectiveness of Voluntary Counseling and Testing of Hospital Inpatients for HIV Infection. JAMA
272: 1832-1838
[Abstract]
Forseter, G., Joline, C., Wormser, G. P.
(1994). Tolerability, Safety, and Acceptability of Zidovudine Prophylaxis in Health Care Workers. Arch Intern Med
154: 2745-2749
[Abstract]
Thomas, G. R., Myers, E. M., Nunez, A.
(1994). Tracheotomy in Patients With Acquired Immunodeficiency Syndrome: Is It Necessary?. Arch Otolaryngol Head Neck Surg
120: 1126-1129
[Abstract]
Clerici, M., Levin, J. M., Kessler, H. A., Harris, A., Berzofsky, J. A., Landay, A. L., Shearer, G. M.
(1994). HIV-Specific T-Helper Activity in Seronegative Health Care Workers Exposed to Contaminated Blood. JAMA
271: 42-46
[Abstract]
Ippolito, G., Puro, V., Carli, G. D., the Italian Study Group on Occupational Risk of HI,
(1993). The Risk of Occupational Human Immunodeficiency Virus Infection in Health Care Workers: Italian Multicenter Study. Arch Intern Med
153: 1451-1458
[Abstract]
Miller, K. M., Apt, L.
(1993). Unsuspected Glove Perforation During Ophthalmic Surgery. Arch Ophthalmol
111: 186-193
[Abstract]
Galetto, G., Levine, A.
(1993). AIDS-Associated Primary Central Nervous System Lymphoma. JAMA
269: 92-93
[Abstract]
(1993). Surveillance for Occupationally Acquired HIV Infection--United States, 1981-1992. Arch Dermatol
129: 31-32
[Abstract]
(1992). Surveillance for Occupationally Acquired HIV Infection--United States, 1981-1992. JAMA
268: 3294-3294
(1992). Adult Basic Life Support. JAMA
268: 2184-2198
[Abstract]
Tokars, J. I., Chamberland, M. E., Schable, C. A., Culver, D. H., Jones, M., McKibben, P. S., Bell, D. M., the American Academy of Orthopaedic Surgeons Seros, , Benson, D. R., Lane, J. M., Luck, J. V. Jr, Malinin, T. I., Nelson, C. L., Robb, W. J. III, Glasser, D. B., Peterson, R. N.
(1992). A Survey of Occupational Blood Contact and HIV Infection Among Orthopedic Surgeons. JAMA
268: 489-494
[Abstract]
O'Neill, T. M., Abbott, A. V., Radecki, S. E.
(1992). Risk of Needlesticks and Occupational Exposures Among Residents and Medical Students. Arch Intern Med
152: 1451-1456
[Abstract]
Ramsey, S. D., Nettleman, M. D.
(1992). Cost - Effectiveness of Prophylactic AZT Following Neediestick Injury in Health Care Workers. Med Decis Making
12: 142-148
[Abstract]
Ou, C.-Y., Ciesielski, C. A., Myers, G., Bandea, C. I., Luo, C.-C., Korber, B. T. M., Mullins, J. I., Schochetman, G., Berkelman, R. L., Economou, A. N., Witte, J. J., Furman, L. J., Satten, G. A., Maclnnes, K. A., Curran, J. W., Jaffe, H. W., Laboratory Investigation Group, , Epidemiologic Investigation Group,
(1992). Molecular Epidemiology of HIV Transmission in a Dental Practice. Science
256: 1165-1171
[Abstract]
Ciesielski, C., Marianos, D., Ou, C.-Y., Dumbaugh, R., Witte, J., Berkelman, R., Gooch, B., Myers, G., Luo, C.-C., Schochetman, G., Howell, J., Lasch, A., Bell, K., Economou, N., Scott, B., Furman, L., Curran, J., Harold, J.
(1992). Transmission of Human Immunodeficiency Virus in a Dental Practice. ANN INTERN MED
116: 798-805
[Abstract]
Chamberland, M. E., Conley, L. J., Bush, T. J., Ciesielski, C. A., Hammett, T. A., Jaffe, H. W.
(1991). Health Care Workers With AIDS: National Surveillance Update. JAMA
266: 3459-3462
[Abstract]
Kelen, G. D., Green, G. B., Hexter, D. A., Fortenberry, D. C., Taylor, E., Fleetwood, D. H., Sivertson, K. T.
(1991). Substantial Improvement in Compliance With Universal Precautions in an Emergency Department Following Institution of Policy. Arch Intern Med
151: 2051-2056
[Abstract]
Wright, J. G., McGeer, A. J., Chyatte, D., Ransohoff, D. F.
(1991). Mechanisms of Glove Tears and Sharp Injuries Among Surgical Personnel. JAMA
266: 1668-1671
[Abstract]
(1991). From the Centers for Disease Control. JAMA
266: 771-776
LOWENFELS, A. B., JAIN, R., WORMSER, G. P.
(1991). Human Immunodeficiency Virus: Occupational Risk for Surgeons-Reply. Arch Surg
126: 789-790
[Abstract]
Wong, E. S., Stotka, J. L., Chinchilli, V. M., Williams, D. S., Stuart, C. G., Markowitz, S. M.
(1991). Are Universal Precautions Effective in Reducing the Number of Occupational Exposures Among Health Care Workers? A Prospective Study of Physicians on a Medical Service. JAMA
265: 1123-1128
[Abstract]
(1990). Possible Transmission of Human Immunodeficiency Virus to a Patient During an Invasive Dental Procedure. Arch Dermatol
126: 1553-1555
[Abstract]
Raffanti, S., Svenningsson, A., Resnick, L.
(1990). Determination of HIV-1 Status of Discarded Sharps: Polymerase Chain Reaction Using Minute Quantities of Blood. JAMA
264: 2501-2501
[Abstract]
Henderson, D. K., Fahey, B. J., Willy, M., Schmitt, J. M., Carey, K., Koziol, D. E., Lane, H. C., Fedio, J., Saah, A. J.
(1990). Risk for Occupational Transmission of Human Immunodeficiency Virus Type 1 (HIV-1) Associated with Clinical Exposures: A Prospective Evaluation. ANN INTERN MED
113: 740-746
[Abstract]
Leisure, M. K., Moore, D. M., Schwartzman, J. D., Hayden, G. F., Donowitz, L. G.
(1990). Changing the Needle When Inoculating Blood Cultures: A No-Benefit and High-Risk Procedure. JAMA
264: 2111-2112
[Abstract]
HATEM, D. S., HUROWITZ, J. C., GREENE, H. L., SULLIVAN, J. L.
(1990). Seroprevalence of Human Immunodeficiency Virus in a State Psychiatric Institution. Arch Intern Med
150: 2209-2209
[Abstract]
(1990). Possible Transmission of Human Immunodeficiency Virus to a Patient During an Invasive Dental Procedure. JAMA
264: 1092-1093
Mishu, B., Schaffner, W., Horan, J. M., Wood, L. H., Hutcheson, R. H., McNabb, P. C.
(1990). A Surgeon With AIDS: Lack of Evidence of Transmission to Patients. JAMA
264: 467-470
[Abstract]
Henry, K., Campbell, S., Jackson, B., Balfour, H. Jr, Rhame, F., Sannerud, K., Sninsky, J.
(1990). Long-term Follow-up of Health Care Workers With Work-Site Exposure to Human Immunodeficiency Virus. JAMA
263: 1765-1766
[Abstract]
Glassock, R. J., Cohen, A. H., Danovitch, G., Parsa, K. P.
(1990). Human Immunodeficiency Virus (HIV) Infection and the Kidney. ANN INTERN MED
112: 35-49
[Abstract]
The Emergency Cardiac Care Committee of the Americ,
(1989). Risk of Infection During CPR Training and Rescue: Supplemental Guidelines. JAMA
262: 2714-2715
[Abstract]
Cummins, R. O.
(1989). Infection Control Guidelines for CPR Providers. JAMA
262: 2732-2733
[Abstract]
Lowenfels, A. B., Wormser, G. P., Jain, R.
(1989). Frequency of Puncture Injuries in Surgeons and Estimated Risk of HIV Infection. Arch Surg
124: 1284-1286
[Abstract]
Joseph, S. C.
(1989). Premarital AIDS Testing: Public Policy Abandoned at the Altar. JAMA
261: 3456-3456
[Abstract]
(1988). RISK OF HIV TRANSMISSION TO HEALTH WORKERS REMAINS LOW. JWatch General
1988: 1-1
[Full Text]