Page 373 - Encyclopedia of Nursing Research

340 n NuRSING OCCuPATIONAL INJuRy AND STReSS

facilities had the highest incidence rate (8.7 illness that they cause. There have been 57
cases per 100 full-time workers) with nearly documented cases of occupational HIv trans-
N 200,000 injury cases, followed by hospitals mission among health care personnel, as
with an incidence rate of 7.5, and the highest reported by the Centers for Disease Control
number of injury cases (259,000) among the and Prevention, through December 2006
four subsectors (BLS, 2005a). (Centers for Disease Control and Prevention,
The incidence of nonfatal occupational 2007). Based on the estimated number of per-
illnesses for this sector was 39.9 cases per cutaneous injuries per year and the average
10,000 full-time workers, compared to 26.7 transmission rate, Sepkowitz and eisenberg
and 19.6 cases in the private and service- (2005) suggested that 50–150 transmissions
providing industries, respectively (BLS, of HCv would be expected each year. Thus,
2006a). Hospitals had the highest incidence prevention of transmission in health care
rate (66.2 cases per 10,000 full-time work- workers depends on prevention of sharps
ers) and number of reported cases (22,900), injuries and other blood and body fluid expo-
and nursing and residential care facilities sures. Although occupational transmission
accounted for the second highest incidence of blood-borne virus infection is a relatively
rate (40.3 cases per 10,000 full-time workers; rare event, unfortunately, sharp injuries
BLS, 2005b). continue to occur too frequently. Because
Nurses provide numerous health care hospital-based personnel only account for
services in a variety of work environ- about half of all health care personnel, the
ments that often are potentially hazardous. total number of percutaneous injuries in this
Depending on the nature of the work pre- population may be considerably higher; only
formed, the type of hazard will vary. For limited data are available to support an esti-
example, a nurse anesthetist will have greater mate that includes nonhospital-based per-
exposure to anesthetic waste gases, whereas sonnel. Health care workers must also face
an oncology nurse may be faced with antineo- unknown exposures, as they are routinely on
plastic drug exposure. Nurses are exposed the front line in caring for those with emerg-
to numerous hazards including biological, ing infectious diseases, that is, severe acute
chemical, enviromechanical, physical, and respiratory syndrome, avian influenza, mul-
psychosocial hazards. exposure routes occur tidrug-resistant pathogens, pandemic influ-
through inhalation, ingestion, or direct or enza, or the emerging threat of bioterrorism,
indirect contact, and the type and degree of such as anthrax and smallpox.
exposure will depend on the work setting. Chemical exposure from medications
A significant exposure route for biologi- such as antineoplastic agents and other sub-
cal agents such as blood-borne pathogens is stances, including disinfectants, sterilants,
via needlestick injuries, with an estimated latex, and anesthetics, poses significant
385,000 percutaneous injuries annually by threats (International Agency for Research
hospital health care workers. Nurses may be on Cancer, 2004; NIOSH, 2004a; Rogers,
exposed to more than 20 pathogens, of which 2003). Drugs are classified as hazardous if
the most commonly transmitted are hepatitis animal or human studies indicate that expo-
B virus, hepatitis C virus (HCv), and human sures to them have a potential for causing
immunodeficiency virus (HIv; Wagner cancer, developmental or reproductive toxic-
et al., 2004). Sharps injuries and blood-borne ity, or other organ system damage. Most haz-
pathogens remain an important issue in the ardous drugs are those used to treat cancer,
health care sector. HIv, hepatitis B virus, and but they also include other types of drugs
HCv are blood-borne pathogens of special such as antiviral agents. Workers may be
concern because of their potential for occu- exposed when they create aerosols, generate
pational transmission and the severity of dust, clean up spills, or touch contaminated