Bloodborne pathogen exposure risks among South African surgeons

Background: The operating room is a high-risk setting for occupational sharps injuries and bloodborne pathogen exposure. In Africa, where prevalence of bloodborne pathogens is often high and resources are often low, the risks are especially high for surgeons. This study systematically documents risk factors among South African surgeons regarding bloodborne pathogen transmission during surgery. Methods: A retrospective survey was conducted among surgeons attending the ASSA biennial meeting. The survey results reflect patterns of risk and availability and use of safety practices, garments and devices. Results: Of 96 surgeons participating in the survey, 70% reported at least one percutaneous injury during the previous year, with the average rate of percutaneous injury 2.75 per year. Suture needles were the most common source of injury (84%). More than half reported being splashed by blood or body fluids, with an annual average of 3.5, most often to the eyes. Sixty-nine percent reported complete HBV vaccination, and HIV Post-Exposure Prophylaxis (PEP) was readily available. Eyes were not sufficiently protected. Slightly more than half reported using hands-free passing, and more than one-third reported using blunt suture needles. Comparing surgeons who used a combination of hands-free passing and blunt sutures and those who did not revealed markedly different rates of injury. Conclusions: Risks of blood exposure among South African surgeons are high. Wider adoption of safe techniques, devices and personal protective equipment could reduce the risks. Recommendations for injury prevention and safe practice that can protect the health and lives of the surgical team are offered