Neglecting injuries from needles while attending to patients exposes 73% of doctors to blood transmitted diseases, according to a recent study conducted by AIIMS, New Delhi.

The study lists inexperienced doctors- those below 25 years of age in the high risk category. But resident doctors in Maharashtra said that there’s only minimal awareness about needle stick injuries. Also, there’s excessive workload in emergency wards and carelessness in vaccinations, they added.

Researchers call for an “immediate action plan”

The researchers stressed on the need for awareness and said that an immediate action plan was needed to avoid exposure to Hepatitis B, Hepatitis C and HIV among health care workers who serve in government-run facilities.

According to Dr Sarman Singh, professor and head of clinical microbiology and molecular medicine at the department of laboratory medicine of AIIMS, 476 health care workers were part of the study which focused on self-reported injuries between January 2011 and December 2013.

The study found that the lion-share of those affected were doctors(351, 73.7%). Out of them, resident doctors were the highest in number(321, 91.4%). Interns followed (26, 7.4%) and faculty members came behind them(4,1.1%). Interestingly enough, just 91(19.1%) nurses reported injuries. 15(3.2%) of the workers were hospital waste disposal staff who weren’t directly involved in patient care or surgical procedures.

“We realized that the prevalence is definitely more in resident doctors, who are inexperienced in handling the needle in operation theatres or emergency rooms. But again, the numbers are much more in reality as the participants were only those who voluntarily reported the injuries to the hospital,” said Singh. “Occupational exposures are common and it is believed that 40–75% of these injuries are not reported.”

Risk of infections lowest for HIV and highest for HBV

Quoting data from The Centers for Disease Control and Prevention(CDC), Singh and his colleagues said that the risk of infections due to needle stick injuries range as low as 0.2 to 0.5 percent for HIV to as high as 3 to 10% for HCV and 40% for HBV. Among the workers, 12(2.5%) weren’t vaccinated against HBV. And among the vaccinated 24(5%) had completed three doses of the vaccine in an year. Also, 19(3.9%) were vaccinated more than 10 years back, according to the study.

It was also noted that a large number of resident doctors don’t adhere to their yearly vaccination schedules, thereby putting their lives at risk of infection. As Dr Sagar Mundada, former president of Maharashtra Association of Resident Doctors(central) said, “In the first year of our internship after completing MBBS, we are counselled and directed by our senior doctors to take the first three doses of the HBV vaccine within six months. Most of the time, doctors tend to miss the doses, exposing themselves to the risk of HBV that is more likely to transmit through open wounds and cuts.”

Of the 24 respondents who were found to be exposed to HBV positive sources, eight of them were either non-responders to HBV vaccination or didn’t receive the vaccination.

According to Singh, “Overall, the exposure had taken place from 32 sources but further tests revealed 12 new sources that can carry highly potent viral infections.”

Resident doctors opined that there exists little monitoring on the part of the higher officials or senior doctors to check if the resident doctors were following the vaccination schedule. Apparently, it’s not uncommon for resident doctors to miss the dose, thereby lowering their immunity levels against the blood transmitted diseases.

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