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Needlestick injury is among the most common types of
accidental exposureresulting in the documented transmission of
hepatitis B and C virus for hospital personnel. Health care
workers in emergency department are know to be at high risk of
exposure to needle and blood body fluid accidents. However, the
prevalenceand predisposing factors of these injuries are unknown
in Taiwan. The purpose of this survey was to understand the
experience of needlestick injury & exposure tobody fluid in
health care worker and estimate risk hepatitis B and hepatitis
Cthrouth the way. Therefore, we began to survey the prevalence
of needlestickinjuries & exposure to body fluid in emergency
department among health careworkers, and the hepatitis B &
hepatitis C carrier seroprevalence in emergencydepartment
patients. A quedtionnaire survey of 372 health care workers in
14 hospitals, including medical centers, district hospitals,
local and local teaching hospital in Taiwan wasconducted. The
prevalence of ever having needlestick of sharp injuries at
workwas as high as 91.9% in this group. Concerning the most
recent episode ofneedle/sharp injury, approximately 55.3% of the
episodes were caused by ordinaryneedles, and most frequently duo
to recapping(21.3%). Approximately 80.5% ofthe people who were
ever stuck stated that they did not report the most recentevent
to their employers or the hodpital administration. The reported
frequencies ofinjuries caused by needles and other sharps were
1.43 and 1.54/person/year,respectively. The frequencies of
exposure to blood and other body fluids were0.98/person/year to
non-intact skin, 0.28/person/year to the eyes, 0.13/person/
yearto mucosa membrane of nose, and 0.16/person/year to mucosa
membrane of mouth. To assess exposure or infectious risk about
hepatitis B and hepatitis C afterneedlestick injury, we began to
survey hepatitis B and hepatitis C carrierseroprevalence in
emergency department. We collected 872 serum samples ispatients
older than 6 years and who require to phlebotomy. Anonymous
study ofthese blood samples include testing HBsAg, HBeAg, and
anti-HCV by enzyme-linked immuno-sorbent assay(ELISA). One
hundred thirty-one of 872(15%) werepositive for HBsAg and among
131 HBsAg positive 20(16.1%) were HBeAgpositive. Hepatitis B
seroprevalence was highest among patients aged 30 to 40 years,
males, and low urbanization. Theses were statistically
significant between heaptitisB and above variables. Hepatitis C
seroprevalence was 12.6%(110 samples), and highest above 50
years, males, and low urbanization. The relation
betweenhepatitis C and age was statistically significant. After
this survey, we referredneedestick injury among health care
workers in emergency department and many references, then we
estimated that infectious risk of hepatitis B and hepatitis
Cthrough contaminated needlestick injury was 0.001-0.008 and
0.003-0.004, and life-time risk was 0.03-0.25 and 0.10-0.13. The
exposure risk of hepatitis B and hepatitis C through blood and
body fluid from patience was 0.06 and 0.05. It wasconcluded
that, needlestick and sharps injuries in the health care workers
inemergency department were high, with potential hazards of
transmitting infectiousdisease, such as hepatitis B or C.
Precaution, education, and protective equipmentwill be warranted
to reduce the needle and sharps injuries in health care workers
inTaiwan.
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