Lifetime risk of occupational viral infection
Clinical bottom line
A way of calculating individual cumulative risks for surgeons (or other healthcare workers) shows a significant lifetime risk of infection even at low background prevalence rates.
Reference
J-L Caillot et al. The occupational viral risk run by French surgeons: a
disturbing perspective. AIDS 2000 14: 2061-2062.
Method
This study looked at the individual cumulative risk of occupational viral contamination run by surgeons in France. It used the following equation:
ICR = 1 - [1-(seroprevalence of virus x seroconversion rate)] raised to the power of number of skin injuries per year x number of years of practice
Results
- Seroprevalence of hepatitis C and HIV have been estimated as 1.2% and 0.16%.
- Seroconversion rate has been estimated as 3% for hepatitis C and 0.5% for HIV.
- Incidence of skin injury is about 0.8 punctures per 100 hours of operating time.
- Mean surgical activity is 750 hours of operating time each year (average of about 3 hours a working day), over a 35 year career.
With a working lifetime estimate of 210 skin punctures, the individual cumulative risks are:
| Virus |
Individual cumulative risk (%) |
|---|---|
| Hepatitis C |
6.9 |
| HIV |
0.15 |
Comment
These figures suggest that one French surgeon in 14 might expect to be hepatitis C contaminated during his or her career, and one in 630 might be infected with HIV. The figure for HIV is similar to estimates for US surgeons.
It is the figures for hepatitis C that are worrying. Some populations, like drug addicts and prisoners, have high prevalence rates. This dramatically increases the chance of a surgeon being infected then become so high that within a short time they move from if to when.