HIVAIDS in China by Zunyou Wu & Yu Wang & Roger Detels & Marc Bulterys & Jennifer M. McGoogan

Author:Zunyou Wu & Yu Wang & Roger Detels & Marc Bulterys & Jennifer M. McGoogan
Language: eng
Format: epub
ISBN: 9789811385186
Publisher: Springer Singapore

16.2 Occupationally Exposed Workers

Here, we define HCW as any employee in a healthcare setting. In China, healthcare settings are categorized based on their main functions, such as centers for disease control and prevention (CDC) sites, hospitals, blood banks, maternal and child health (MCH) clinics, and border quarantine facilities. Occupationally exposed HCW are defined as those who are potentially exposed to infectious materials such as blood, specific bodily fluids (e.g., semen, vaginal fluid), and medical supplies, equipment, or environmental surfaces contaminated with these fluids, during the routine course of work (Chinese Center for Disease Control and Prevention 2009). These workers may be exposed to HIV through percutaneous injury, such as through a needlestick or sharps cut, or contact with the mucus membranes of an infected person.

HCW working in hospitals, including physicians, nurses, and nursing assistants, are considered health providers. Among all HCW, health providers are most at risk for occupational exposure to HIV infection. However, studies on occupational exposure in hospitals have indicated that nurses are at the highest risk of occupational exposure to blood-borne pathogens overall (Wang et al. 2010; Li et al. 2003). Nurses are at especially high risk because they have the most direct contact with patients and their blood and bodily fluids, including frequent procedures involving needles (e.g., injections, IV insertions) and responsibility to dispose of infected and contaminated materials. In addition, nursing staff members are heavily involved in all procedures in obstetrics and gynecology and surgery departments, where most exposure events occur (Li et al. 2003).

HCW working in CDC sites are primarily laboratory technicians or other laboratory personnel, who perform testing and/or experiments with potentially high-risk specimens (see Chap. 5 for more information). Although laboratory workers are rarely in direct contact with PLWH, the risk of exposure to an HIV-infected specimen is high. Examples of occupational exposure in the laboratory include nonintact skin contact, needlestick injury, or mucous membrane exposure.

HCW working in other healthcare facilities that perform HIV testing and research, such as blood banks, MCH clinics, border quarantine facilities, and research institutions, also are at risk of occupational exposure, but the risk is not as high as in hospitals and CDC sites.

Besides HCW, public security officers (e.g., police, penitentiary officers, and detoxification center personnel) are also at risk of occupational exposure to HIV. Public security officers often have direct and frequent contact with members of key populations, such as people who inject drugs (PWID), and the levels of occupational exposure are even higher than that of laboratory workers (Qiang et al. 2006).

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