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Occupational Exposure to Blood and Body Fluids among Nursing and Dental Students at Internship Year in
Assiut City
Amira A. El- Houfey, Soad A. Sharkawey and Asmaa K. Hassan
Community Health Nursing Department, Faculty of Nursing, Assiut University
amiraelhoufey@yahoo.com
Abstract: Exposure to blood-borne pathogens poses a serious occupational threat to health care workers including
nursing and dental students; it causes substantial illness and it is unavoidable part of daily patient care. This study
aims to assess the occupational exposure to blood and body fluids (BBF) among undergraduate nursing and dental
students at internship year in Assiut city. A cross sectional research design was used on 140 nursing students and
150 dental students using a convenient sample technique. The study was conducted at Assiut University Hospitals
and Al Azhar University Hospital in Assiut city. A questionnaire sheet for collection of data contains the following
main parts: socio-demographic data, history and frequency of occupational exposure to (BBF), information about
the occupational exposure to BBF and infection control measures. The main findings of this study were: the mean
age was 21.8 years for nursing and 22.9 for dental students. 88.6%, 51.3% respectively of nursing and dental
students were exposed to needle stick injuries (NSI) and BBF. All dental and nursing students did not report the
exposure incidents and the main causes of not reporting: they don not think anything could be done by (72.1%, 55.3%
respectively) among nursing and dental students. A high percentage of the dental and nursing students reported use
of gloves during the exposure. 93.3% among dental and 65.7% of nursing students were not vaccinated against
hepatitis B. About one third (30.0%, 32.0% respectively) of nursing and dental student had good score of knowledge
about and only (2.9%, 15.3% respectively) had poor score of knowledge about occupational diseases and infection
control measures. Based on the results of the study it can be concluded that the majority of studied students were
exposed to NSI and BBF. The majority of studied students did not report the exposure to BBF. The majority of them
were not vaccinated against hepatitis B. One third of nursing and dental student had good score of knowledge. This
study recommend that mandatory continuing education and supervision involves all undergraduate dental and
nursing students at internship year must contain a specific component on the occupational exposure to BBF.
Hepatitis B vaccine must be given obligatory to all studied sample.
[Amira A. El- Houfey, Soad A. Sharkawey and Asmaa K. Hassan. Occupational Exposure to Blood and Body
Fluids among Nursing and Dental Students at Internship Year in Assiut City. J Am Sci 2013;9(5): 466-475].
(ISSN: 1545-1003). http://www.americanscience.org.
Key Words: Occupational exposure; Blood and body fluids (BBF); Needle stick injuries (NSI); Infection Control,
Undergraduate Nursing and Dental Students
workers ranged from 2% to 40 % (Werner and Grady,
2009).
Body substances such as feces, urine and wound
drainage
contain
potentially
infectious
microorganisms. For this reason, health care workers
are at a risk for exposure to microorganisms in
hospitals (Potter et al., 2011).
Exposure to blood-borne pathogens poses a
serious occupational threat to health care workers.
Safer needle devices for performing procedures and
universal infection control precautions will not
completely eliminate the risk, and prophylactic
treatment will remain an important component of
prevention efforts (Gerberding and Wood, 2008).
Most exposure to infectious agents in the dental
setup is accidental and can be avoided by using safe
work practices and following infection control
guidelines. However, some exposure is not
preventable; immunization and appropriate post
1. Introduction:
Occupational exposure is defined as reasonably
anticipated skin, eye, mucous membrane, or
parenteral contact with blood or other potentially
infectious materials that can result from the
performance of an employee's duties (Centers for
Disease Control and Prevention, 2009).
The risk for occupationally acquired infections
is an unavoidable part of daily patient care; it causes
substantial illness and occasional deaths among
health care workers (Sepkowitz, 2011).
Health care workers (HCW) including nursing
and dental students engaged in direct patient care are
at considerable risk of acquiring hepatitis B (HB), C
viruses and human immune virus (HIV) at their place
of work through the exposure to contaminated blood
and body fluids (BBF) while executing their routine
of patient care (Gustavo et al., 2006). The risk of the
transmission of HB for non immune health care
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3. Results:
Table (1) shows the distribution of studied
undergraduate nursing and dental students at
internship year, regarding their socio-demographic
characteristics. It was found that nearly the majority
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Table (1): Distribution of the studied sample regarding their socio-demographic characteristics
Socio-demographic characteristics
Nursing students
(n= 140)
No.
%
Dental students
(n= 150)
No.
%
116
82.9
24
17.1
21.84 0.88
48
32.0
102
68.0
22.98 0.87
0.000*
117
23
83.6
16.4
150
0
100.0
0.0
0.000*
56
84
40.0
60.0
44
106
29.3
70.7
.0..056
33
15
92
23.6
10.7
65.7
0
10
140
0.0
6.7
93.3
0.000*
P-value
Age (years):
20 <23
23 25
Mean SD
Experience/ month:
< 6 month
6- 12 month
Conferences attendance :
Yes
No
Hepatitis B vaccination status:
Full vaccination
Incomplete vaccination
Not vaccinated
0.000*
Table (2): Distribution of the studied sample regarding occupational exposure to BBF
Nursing students
(n= 140)
No.
%
Variables
Occurrence of exposure:
Not exposed
NSI
Exposed to BBF
Both NSI and BBF
#Causes:
NSI
Dental students
(n= 150)
No.
%
6
10
0
124
4.3
7.1
0.0
88.6
15
29
29
77
10.0
19.3
19.3
51.3
P-value
0.000*
118
84.3
96
64.0
0.000*
92
65.7
66
44.0
0.000*
Sharp instruments
48
26
90
6
5
78
34.3
18.6
64.3
4.3
3.6
55.7
84
11
8
4
42
74
56.0
7.3
5.3
2.7
28.0
49.3
0.000*
26
73
47
11
30
19.4
54.5
35.1
8.2
22.4
41
51
39
0
25
38.7
48.1
36.8
0.0
23.6
0.001*
0.327
0.783
0.007*
0.827
3
57
46
3
35
2.4
46.0
37.1
2.4
28.2
7
17
31
0
59
6.6
16.0
29.2
0.0
55.7
0.220
0.000*
0.208
0.303
0.000*
Scalpel
I.V cannula introducer
Winged steel needle butterfly
Anesthesia needle
Coughing or sneezing from patients
#Measures taken post exposure to NSI:
Squeezing
Antiseptic solution
Wash with soup and water
Dressing
Nothing
# Measures taken post exposure to BBF:
Squeezing
Antiseptic solution
Wash with soup and water
Dressing
Nothing
0.004*
0.000*
0.665
0.000*
0.277
Variables
NSI
Nursing students Dental students
(n= 140)
(n= 150)
No.
No.
103
31
76.9
23.1
77
29
72.6
27.4
2.2
13
12.3
P-value
0.453
0.000*
None
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2 5 times
6 10 times
> 10 times
Parts of the body exposed:
Hand
Face
Face and hand
Thumb finger
Index finger
43
79
9
32.1
59.0
6.7
70
11
12
66.0
10.4
11.3
50
11
9
19
14
48.5
10.7
8.8
18.4
13.6
23
6
10
17
21
29.9
7.8
13.0
22.1
27.3
0.051
Table (4): The history of exposure to BBF among the studied sample
BBF
Nursing students
(n= 140)
Variables
Dental students
(n= 150)
No.
No.
94
30
75.8
24.2
66
40
62.3
37.7
13
58
36
3
14
10.5
46.8
29.0
2.4
11.3
24
32
33
9
8
22.6
30.2
31.1
8.5
7.5
48
17
21
3
5
51.1
18.1
22.3
3.2
5.3
9
30
24
3
0
13.6
45.5
36.4
4.5
0.0
P-value
0.026*
0.007*
0.000*
Table (5): Distribution of the studied sample regarding reporting the incident of occupational exposure
Nursing students
(n= 140)
No.
%
Variables
The rate of reporting:
No
#Reasons for not reporting:
Do not think anything could be done
Do not know the reporting procedure
Think the patient was no risk for blood borne viruses
Do not want to know the results
Do not know the importance of reporting
Worried about the potential impact on my career
Too busy
Fear that became ill
Little or no perception about the complication of exposure
Dissatisfaction with waiting times
Forgotten
P-value
140
100.0
150
100.0
101
75
27
25
55
72.1
53.6
19.3
17.9
39.3
83
65
39
34
50
55.3
43.3
26.0
22.7
33.3
0.003*
0.081
0.173
0.309
0.292
66
40
57
47.1
28.6
40.7
29
27
36
19.3
18.0
24.0
0.000*
0.033*
0.002*
28
27
20.0
19.3
25
42
16.7
28.0
0.463
0.082
47
39.8
28
21.1
0.001*
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Dental students
(n= 150)
No.
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Table (6): Distribution of the studied sample regarding the application of infection control measures during the
exposure
P-value
Dental students
(n= 150)
%
No.
Nursing students
(n= 140)
%
No.
Items
0.000*
0.000*
90.4
122
70.9
95
63.7
86
29.1
39
0.000*
41.5
56
1.5
Wear gown
0.000*
13.3
18
1.5
Wear goggle
80
Poor
Satisfactory
Good
67.1
70
52.7
60
50
% 40
32
30
30
15.3
20
2.9
10
0
Nursing students
Dental students
Figure (1): Total score of knowledge about occupational diseases and infection control measures
Table (7): Relation between total score of knowledge and occupational exposure to NSI and BBF
Poor
Satisfactory
NSI
Yes
(n= 240)
No. %
23
9.6
134 55.8
No
(n= 50)
No. %
4
8.0
39
78.0
BBF
Yes
(n= 230)
No. %
15
6.5
136 59.1
No
(n= 60)
No. %
12
20.0
37
61.7
Good
83
79
11
P-value
0.010*
Level of knowledge
34.6
14.0
34.3
18.3
0.001*
Table (8): Relation between conference attendance and their level of knowledge
Conference attendance
Level of knowledge
No (n= 190)
Poor
Satisfactory
No.
8
59
%
8.0
59.0
No.
19
114
%
10.0
60.0
Good
33
33.0
57
30.0
P-value
0.786
4. Discussion:
Health care workers including dental and
nursing undergraduate students are at risk of
occupational exposure to a variety of blood-borne
pathogens caused by needle stick, sharp injuries and
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Conclusion
Based on the results of the study, it can be
concluded that: The majority of studied students were
exposed to NSI and BBF. While more than three
quarters of the studied sample had a history of
exposure to NSI in the previous week. The majority
of studied students did not report the exposure to
BBF. The minority of them uses goggle during the
exposure. Moreover, it was observed that the
majority of them were not vaccinated against
hepatitis B. One third of nursing and dental student
had good score of knowledge and the minority had
poor score of knowledge about occupational diseases
and infection control measures.
Recommendations:
Based on the results of this study we recommended
that:
1. Mandatory continuing education and supervision
involves all undergraduate dental and nursing
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