Biosafety Issues in Focus in AIHce Conference

For the first time, U.S. physicians' rates of suffering needlesticks and sharps injuries exceeded nurses' rates during 2017, an International Safety Center presenter said during a "Biosafety Issues in IH" session at the AIHce EXP 2019 conference.

MINNEAPOLIS -- A "Biosafety Issues in IH" session May 21 at the AIHce EXP 2019 conference identified several important issues facing health care workers and also pathology and mortuary workers.

For the first time, U.S. physicians' rates of suffering needlesticks and sharps injuries exceeded nurses' rates during 2017, Amber Mitchell, DrPH, MPH, of the International Safety Center, said during the session as she shared summary surveillance data from EPINet -- the Exposure Prevention Information Network surveillance system, a free resource that allows health care facilities to track occupational sharps injuries and blood and body fluid incidents. The number of needlestick injuries in operating rooms exceeded the number that occurred in patient examination rooms during 2017, she explained, citing increasing pressure on physicians to see more patients and the fact that more suturing is now done in operating rooms than in the past.

Both the sharps injury rate and the needlesticks rate increased from 2014 to 2017, she said. According to the data, only 31.4 percent of the workers who sustained a sharps injury in 2017 reported that they were using a sharp with a safety device when they were injured, and most of those who were using such a sharp reported they had not activated the safety device at the time, Mitchell said.

She reported that blood and body fluid exposures also are rising, and more than 50 percent of those exposures are to the workers' eyes. Only 3 percent of the health care workers who had an eye exposure said they were wearing any type of eye protection at all, she said.

Another presenter in the session, Aurora Le, MPH, CSP, an adjunct professor at the Indiana University School of Public Health, shared results from a survey of medical examiner and coroner personnel in larger jurisdictions on how they handle highly infectious remains. Pathology and mortuary workers are at elevated risk of occupational exposures, but they often are overlooked for training, resources, and education and may lack knowledge about modes of transmission, Le explained. The survey respondents reported their facilities had inadequate biosafety structures in place, there is a lack of appropriate training and continuing education for their staffs, and there are critical shortages of forensic pathologists, she said.

In the email survey conducted from Dec. 5, 2017 to Feb. 6, 2018, 52 percent of responding medical examiners said they wear N95 respirators during routine autopsies -- and this rose only to 68 percent who wear them for suspected or confirmed highly infectious remains. Powered air-purifying respirator use rose only by 30 percent for confirmed cases, and faceshield use increased from 59 percent to only 76 percent, Le said. One factor some of them cited is being very busy because of the opioids crisis, she added.

Le recommended implementing an all-hazards approach to protect medical examiner and coroner personnel; increasing coordination among public health, local and state health departments, funeral homes, crematories, and waste handling companies; and standardizing policies, education, and training guidelines. "There is obviously room for improvement in standard operating procedures and standard operating guidelines," she said.

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