Occupational blood exposure among unlicensed home care workers and home care registered nurses: Are they protected?

• Published in: American journal of industrial medicine Vol. 52; no. 7; pp. 563 - 570
• Main Authors: Lipscomb, J., Sokas, R., McPhaul, K., Scharf, B., Barker, P., Trinkoff, A., Storr, C.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.07.2009; Wiley-Liss
• Subjects: Accidents, Occupational - prevention & control; Accidents, Occupational - statistics & numerical data; Adult; Biological and medical sciences; Blood; blood and body fluid contact; Blood-Borne Pathogens; Body Fluids; Community Health Nursing - statistics & numerical data; Female; Health participants; Health Surveys; home care; Home Care Services, Hospital-Based - statistics & numerical data; Home Health Aides - statistics & numerical data; Humans; Male; Medical sciences; Middle Aged; Needlestick Injuries - epidemiology; Needlestick Injuries - prevention & control; needlesticks; Occupational Exposure - prevention & control; Occupational Exposure - statistics & numerical data; occupational health and safety; prevention; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Safety Management; United States; United States Occupational Safety and Health Administration; Workload - statistics & numerical data; United States; North America; America; Accidental blood exposure; Human; Biological fluid; Health staff; Occupational exposure; occupational health and safety; Blood; Care; Prevention; Work safety; blood and body fluid contact; home care; Register; At home; Syringe; needlesticks; Body contact; Worker; Comparative study; Occupational medicine; Nurse
• ISSN: 0271-3586; 1097-0274
• DOI: 10.1002/ajim.20701

Background Little is known about the risk of blood exposure among personnel providing care to individual patients residing at home. The objective of this study was to document and compare blood exposure risks among unlicensed home care personal care assistants (PCAs) and home care registered nurses (RNs). Methods PCAs self‐completed surveys regarding blood and body fluid (BBF) contact in group settings (n = 980), while RNs completed mailed surveys (n = 794). Results PCAs experience BBF contact in the course of providing care for home‐based clients at a rate approximately 1/3 the rate experienced by RNs providing home care (8.1 and 26.7 per 100 full time equivalent (FTE), respectively), and the majority of PCA contact episodes did not involve direct sharps handling. However, for PCAs who performed work activities such as handling sharps and changing wound dressings, activities much more frequently performed by RNs, PCAs were at increased risk of injury when compared with RNs (OR = 7.4 vs. 1.4) and (OR = 6.3 vs. 2.5), respectively. Conclusion Both PCAs and RNs reported exposures to sharps, blood, and body fluids in the home setting at rates that warrant additional training, prevention, and protection. PCAs appear to be at increased risk of injury when performing nursing‐related activities for which they are inexperienced and/or lack training. Further efforts are needed to protect home care workers from blood exposure, namely by assuring coverage and enforcement of the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogen Standard [Occupational Safety and Health Administration. 1993. Frequently Asked Questions Concerning the Bloodborne Pathogens Standard. Available at: http://www. osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS &p_id=21010#Scope. Accessed May 30, 2008]. Am. J. Ind. Med. 52:563–570, 2009. © 2009 Wiley‐Liss, Inc.