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Health care workers (HCW) who handle blood and body fluids are at increased risk of infection with HBV, HCV and HIV – those most at risk include phlebotomists [link widoczny dla zalogowanych], nurses, clinical laboratory workers, and physicians. Exposure is most commonly associated with needle-stick injury or percutaneous injury resulting from other sharp instruments (i.e.
There are a number of different infectious agents that can be transmitted through blood and body fluids containing blood including the human immunodeficiency virus (HIV), hepatitis B (HBV) and C (HCV) viruses, Treponema pallidum, malarial plasmodia, Trypanosoma cruzi and others. The three most common blood-borne infections in North America are HBV [link widoczny dla zalogowanych], followed by HCV, then HIV.
blood, serum, plasma and all biologic fluids visibly contaminated with bloodtissuespleural, amniotic, pericardial, peritoneal, synovial and cerebrospinal fluids (CSF)cervical/vaginal secretions or semen (HCV)saliva contamination in a bite wound
Blood is the single most important source of HIV, HBV, and other BBPs in the occupational setting; therefore, transmission is most likely to occur in workers involved in rescue or patient care activities [link widoczny dla zalogowanych], or during other interactions where workers are directly exposed to infected blood. Occupational transmission of HIV, HBV and HCV in health care and public service settings is most commonly associated with injuries involving needles or other sharp instruments. Most HCW BBP exposures occur due to percutaneous sharps injury.
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A number of factors affect the risk of transmission and infection following exposure:
sexual transmission through the mucous membranes of the genital tract,splashes to the mucous membranes of the eyes (conjunctiva), nasal passages or mouth,contamination or exposure of broken or damaged skin (broken, abraded, chapped, cuts, wounds, scratches, breaks around nail-beds, eczema, psoriasis, dermatitis, etc.)percutaneous (across the skin barrier) transmission with a contaminated sharp (sharing of intravenous drug paraphernalia, sharps injury with a contaminated device)
The specific body fluids capable of transmitting BBPs include:
Significant exposure involves a route of entry into the body:
Type of fluid exposure – blood poses a greater risk than saliva, for exampleVolume of fluid – a hollow bore needle such as one that is used for venipuncture contains more blood on average than a suture needle or lancetProbability of exposure – dependent on type of risk behaviour and work performedSpecific pathogen involved – on average, HBV infection is associated with greater numbers of viral particles in the patient’s blood and tissues at any one time than HCV or HIVRoute of exposure – percutaneous exposure results in greater risk of infection than exposure through mucous membranes or non-intact skinDisease progression – viral particles may be found in much greater numbers in patients whose disease has progressedVirus concentration in fluid or tissue (viral load)
A blood-borne pathogen, as the term suggests, is a disease or infection-producing agent that can be acquired through exposure to blood and other body fluids containing blood. BBPs are transmitted from one individual to another when blood or body fluids from the infected individual enter the body of a previously uninfected individual.
Infection occurs when the pathogen contained in the body fluid multiplies and causes disease. Exposure does not necessarily result in transmission, and transmission does not necessarily result in infection.