nature.com

Magnitude and determinants of occupational exposure to blood and body fluids among physicians in a teaching hospital in …

Abstract

Occupational exposure to blood and body fluids (BBF) poses a significant risk for transmission of blood-borne pathogens among healthcare workers, especially in low-income countries. Physicians are at higher risk due to their direct involvement in patient care. The aim of this study was to investigate the prevalence and factors associated with occupational exposure to blood and body fluid exposure among physicians in a teaching hospital in northern Ethiopia. An institutional cross-sectional study was conducted at Ayder Comprehensive Specialized Hospital from January 1–March 31, 2020. A total of 255 physicians were selected by simple randomization. Data were collected using a structured self-reported questionnaire. Descriptive statistics were used to summarize the data. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with blood and body fluid exposure. Of the 255 participants, 188 (73.7%) were male, and the mean age was 28.21 years (SD ± 4.08). The prevalence of occupational exposure to blood and body fluid in the last three months was 94 (36.9%), and lifetime exposure was 210 (82.4%). Exposure was most common among residents (52.1%) and interns (35.1%). The highest exposure rates occurred in the departments of obstetrics and gynecology (30.8%) and general surgery (24.5%). Working more than 8 h per day (AOR = 4.87, 95% CI 2.46–9.63), lack of infection prevention training (AOR = 5.36, 95% CI 1.83–15.72) and inconsistent use of gloves (AOR = 3.08, 95% CI 1.69–5.61) were significantly associated with BBF exposure. Occupational exposure to blood and body fluid exposure is high among physicians, especially among residents and interns. Factors such as long working hours, lack of infection prevention training and inconsistent use of personal protective equipment contribute to this risk. Measures to provide training, ensure the availability and consistent use of personal protective equipment and manage workload are essential to reduce occupational exposure.

Introduction

Occupational exposure to blood and body fluids (BBF) among healthcare workers is a significant public health problem worldwide, as it poses a risk for the transmission of blood-borne pathogens such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV)1,2. According to the World Health Organization (WHO), millions of healthcare workers are occupationally exposed to BBF every year, leading to significant morbidity and mortality worldwide3.

Healthcare workers in low- and middle-income countries bear a disproportionate burden of occupational exposures due to factors such as the high prevalence of blood-borne infections, inadequate safety measures and limited resources for training and protective equipment4,5. Physicians and other healthcare professionals involved in direct patient care and invasive procedures are particularly at risk of occupational exposure to BBF6.

In Ethiopia, the prevalence of blood-borne infections remains high and occupational exposure of health care workers is a significant problem7. Studies conducted in different regions of Ethiopia reported prevalence rates of occupational infections among health care workers ranging from 31–57%8,9,10. However, most of these studies focused on nurses and other health professionals. There is little data looking specifically at physicians, particularly in teaching hospitals where workloads are high and the risk of exposure may be greater.

Teaching hospitals are an important part of the healthcare system. They provide advanced medical care and serve as training centers for future healthcare professionals. The combination of high patient volume, complex medical cases, and the involvement of less experienced physicians such as residents and interns may contribute to an increased risk of occupational exposure in these facilities11,12. Understanding the extent of BBF exposure of physicians in teaching hospitals is critical to developing targeted measures to protect healthcare workers and prevent the transmission of bloodborne infections.

The aim of this study was to assess the prevalence of occupational exposure to BBF and identify the associated factors among physicians working at Ayder Comprehensive Specialized Hospital (ACSH), a large teaching hospital in northern Ethiopia. By identifying the risk factors and circumstances associated with BBF exposure, this study aims to provide strategies to reduce occupational risks among physicians and improve the overall safety of patients and medical staff.

Methods

Study design, setting, and period

An institutional cross-sectional study was conducted from January 1 to March 31, 2020, at Ayder Comprehensive Specialized Hospital (ACSH) in Mekelle city, Tigray Region, northern Ethiopia. ACSH is a teaching and referral hospital affiliated with Mekelle University, serving a catchment population of over nine million people. Although vaccination campaigns, particularly for the three-dose hepatitis B vaccine, are organized from time to time, the hospital does not offer a routine staff vaccination program at enrollment. It also does not conduct anti-hepatitis B virus titer tests owing to logistical limitations. Notably, data collection coincided with the early phase of the global COVID-19 pandemic, which may have affected both PPE availability and infection prevention practices at ACSH.

Study population

The study population consisted of all physicians working at ACSH during the study period, including interns, residents, general practitioners, and specialists. Physicians who were on leave during the study period or had less than three months of work experience at the hospital were excluded.

Sample size and sampling technique

The sample size was calculated using a single population proportion formula, taking into account a prevalence (p) of 56.3% from a previous study8, a confidence level of 95 and a margin of error of 5%. Taking into account a non-response rate of 10, the final sample size was 261. A stratified sampling technique was used to select departments and total sample size was distributed to each department based on the proportion of physicians in each department. Once a proportional sample was allocated to each department, physicians were selected using a simple random sampling method from a list provided by the hospital administration.

Data collection

Data were collected using a structured, self-administered questionnaire adapted from a literature review. The questionnaire included sections on sociodemographic characteristics, history of BBF exposure, use of personal protective equipment (PPE), infection prevention training and details of occupational exposures. Participants were recruited from January 1, 2020–March 31, 2020.

Six data collectors were trained in data collection procedures and the questionnaire was pre-tested on 5% of the sample in a nearby hospital to ensure clarity and reliability. The data collectors distributed the questionnaires to the selected physicians and collected them after completion.

Variables

In this study, the dependent variables were the three-month and lifetime occupational exposures to blood and body fluids. The independent variables consisted of age, sex, job category, department, years of experience, working hours, personal protective equipment (PPE) use, training on infection prevention, and vaccination status. More variables were also captured such as specific department in which each participant worked (e.g., Obstetrics/Gynecology, Surgery, Internal Medicine) and documented the precise type and site of any exposure to blood or body fluids (e.g., needlestick, splash to skin, splash to mucous membranes). This allowed for a more detailed analysis of how exposure risks varied by clinical setting and the anatomical site of exposure.

Operational definitions

Occupational Exposure to Blood and Body Fluids: In this study, occupational exposure to blood and body fluids is any incidents where healthcare workers come into direct contact with a patient’s blood or other potentially infectious body fluids through percutaneous injuries (e.g., needlesticks or cuts), contact with mucous membranes (e.g., eyes, nose, mouth), or contact with non-intact skin.

Blood and body fluids (BBFs): BBFs in this study are any patient-derived fluids that either contain visible blood or are regarded as potentially infectious (such as amniotic fluid, pus, ascitic fluid, cerebrospinal fluid, semen, vaginal secretions, and saliva).

Needlestick injury: A needlestick injury is defined as any incident in which a healthcare worker’s skin is pierced by a needle or similar sharp object (such as a syringe, blade, or broken glass) that has been in contact with blood or other body fluids. For the purposes of this study, this includes any pricking sensation or penetration of the skin by a non-sterile sharp object.

Intern: In this study, an intern is a final-year (senior) medical student who, under direct supervision, provides healthcare services in designated hospitals.

Physicians: Physicians are defined here as senior specialists/subspecialists (including surgeons, gynecologists, and other specialists), residents, and interns involved in patient care.

Postexposure prophylaxis (PEP): PEP refers to the antiretroviral medication regimen initiated within 72 h after a confirmed or suspected occupational exposure to blood or body fluids, with the goal of preventing infection (e.g., HIV).

Universal precautions: Universal Precautions are the set of infection control practices in which all human blood and other potentially infectious materials are treated as if they are known to be infectious (e.g., with HIV or hepatitis viruses), regardless of the patient’s perceived or stated infection status.

Consistent use of PPE: Always use appropriate PPE (e.g. gloves, masks) when required during patient care or procedures.

University hospital: For this study, a university hospital is any hospital affiliated with a university, functioning as both a treatment center for patients and a training facility for medical students and other healthcare professionals.

Data analysis

The data were entered into SPSS version 23 for analysis. Descriptive statistics were used to summarize the data. Bivariate logistic regression was performed to identify candidate variables (p-value < 0.25) for multivariate analysis13. Multivariate logistic regression was performed to identify factors independently associated with BBF exposure. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and variables with a p-value < 0.05 were considered statistically significant.

Ethical considerations

Ethical approval

was obtained from the Institutional Review Board of Mekelle University, College of Health Sciences (ERC1739/2020). The study was conducted in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained from all participants. Confidentiality was maintained throughout the study.

Results

A total of 261 questionnaires were distributed to physicians at Ayder Comprehensive Specialized Hospital. Of these, 255 were completed and returned, which corresponds to a response rate of 97.7%.

Socio-demographic characteristics

Of the 255 participating physicians, 73.7% (n = 188) were male and 26.3% (n = 67) were female. The average age of the respondents was 28.21 years (SD ± 4.08), ranging from 23 to 48 years. The majority of participants (56.5%, n = 144) were between 25 and 30 years old, followed by those under 25 (20.4%, n = 52). Only a small proportion (1.6%, n = 4) were older than 40.

In terms of professional categories, residents formed the largest group (45.9%, n = 117), followed by interns (35.7%, n = 91) and specialists (18.4%, n = 47). Most physicians had two years or less experience (57.3%, n = 146), while 25.5% (n = 65) had between three and five years and 17.3% (n = 44) had more than five years of experience (Table 1).

Table 1 Socio-demographic characteristics of participants (N = 255), ayder comprehensive specialized hospital, Ethiopia, 2020.

Full size table

Distribution of participants by department

The participants were distributed across different departments, with most of them coming from general surgery (19.2%, n = 49), internal medicine (18.8%, n = 48), obstetrics and gynecology (18.0%, n = 46), and pediatrics (16.9%, n = 43). Other departments were dentistry (6.7%, n = 17), radiology (6.3%, n = 16), orthopedics (3.9%, n = 10), ENT (3.1%, n = 8) and pathology (2.7%, n = 7) (Fig. 1).

Fig. 1

figure 1

Distribution of participants per department (N = 255), Ayder Comprehensive Specialized Hospital, Ethiopia, 2020.

Full size image

Prevalence of occupational exposure to blood and body fluids (BBF)

The prevalence of occupational exposure to BBF within the last three months was 36.9% (n = 94). Lifetime exposure was reported by a substantial majority of physicians, 82.4% (n = 210).

Of those exposed in the last three months, 57.4% (n = 54) had a single exposure, 38.3% (n = 36) had two to four exposures and 4.3% (n = 4) reported five or more exposures.

Exposure by department

Occupational exposures varied considerably between departments. Most exposures occurred in the Department of Obstetrics and Gynecology with 30.8% (n = 29) of exposures, followed by General Surgery (24.5%, n = 23), Internal Medicine (12.8%, n = 12) and Pediatrics (9.6%, n = 9). Exposures in other departments included dentistry, radiology, orthopedics, ENT and pathology (Fig. 2).

Fig. 2

figure 2

Frequency of exposure rate by department among physicians in ACSH, Northern Ethiopia, 2020 (n = 94).

Full size image

Types and circumstances of occupational exposure

Most BBF exposures were due to splashes (54.3%, n = 51), followed by needlestick injuries and splashes (24.5%, n = 23) and needlestick injuries alone (21.3%, n = 20). Of the 74 participants who experienced splashes, 67.6% (n = 50) came into contact with the skin, 20.3% (n = 15) with the mucous membranes and 12.2% (n = 9) with both the skin and the mucous membranes. Of the needlestick injuries, 91.2% (n = 52) occurred on the upper extremities (forearms and hands), while 8.8% (n = 5) involved the lower extremities (legs and feet).

The most common anatomical sites of BBF exposure were the upper extremities (79.2%, n = 76), followed by mucous membranes and eyes (25.5%, n = 25) and the face (18%, n = 46). Less frequent were the legs (8.5%, n = 8) and splashes in the neck and face (5.3%, n = 5).

Participants reported various activities at the time of exposure. The most common activities included performing procedures such as biopsies, wound care and intravenous injections (30.8%, n = 29), setting up IV lines (39.4%, n = 37), managing emergencies (20.2%, n = 19) and performing elective procedures (18.8%, n = 17). The disposal or recapping and blood sampling were each reported by 9.6% (n = 9) of the participants. Exposures occurred predominantly in the operating room (37.5%, n = 36), followed by the emergency room (29.7%, n = 27), the maternity ward (24.0%, n = 23), regular outpatient clinics (10.6%, n = 6) and the intensive care unit (5.3%, n = 5) (Table 2).

Table 2 Participants’ responses on the type and site of occupational body fluid exposures among physicians (n = 94), ayder comprehensive specialized hospital, Ethiopia, 2020.

Full size table

Personal protective equipment (PPE) use and training

A substantial majority of physicians (92.3%, n = 241) stated that they used personal protective equipment (PPE). However, the consistent use of specific PPE items was strikingly low. Only 34.5% (n = 88) consistently used gloves, 7.8% (n = 20) consistently used face masks, 3.9% (n = 10) consistently used aprons and only 7.5% (n = 19) consistently used eye protection.

In terms of training, only 14.9% (n = 38) of physicians had attended an infection prevention course, while the vast majority (85.1%, n = 217) had received no such training. The vaccination rate against hepatitis B was relatively high: 86.3% (n = 220) of the physicians stated that they had been vaccinated.

Factors associated with occupational exposure

The study of working hours revealed that a significant proportion of exposures occurred among physicians with longer working hours. Specifically, 87.2% (n = 82) of the 94 physicians exposed in the past three months worked more than 8 h per day, compared with only 12.8% (n = 12) who worked 8 h or less per day.

Occupational category was also an important factor, with residents and interns having a higher exposure rate compared to specialists. Of the exposed physicians, 52.1% (n = 49) were residents, 35.1% (n = 33) were interns and 12.8% (n = 12) were specialists.

A lack of infection prevention training was strongly associated with increased exposure rates. Of the exposed physicians, 95.7% (n = 90) had received no infection prevention training, while only 4.3% (n = 4) had received such training. In addition, inconsistent glove use was significantly associated with a higher exposure rate: 36.2% (n = 34) of exposed physicians reported rarely or never using gloves consistently, compared with 63.8% (n = 60) who reported always or often using gloves.

Determinant factors of BBF exposure

Bivariate analysis identified several factors that were significantly (p < 0.25) associated with BBF exposure in the past three months, including age, job category, department, surgical discipline, infection prevention training, consistent use of PPE, PPE shortages, and average hours worked per day.

In the subsequent multivariate logistic regression analysis, job category, department, surgical discipline, lack of lifelong infection prevention training, and inconsistent use of PPE (especially gloves and aprons) remained significantly associated with occupational BBF exposure. Interns (AOR = 1.66, 95% CI 1.10–2.03) and residents (AOR = 2.65, 95% CI 1.12–6.28) were significantly more likely to be exposed to BBF compared to senior physicians. Physicians working in the obstetrics and gynecology department (AOR = 3.34, 95% CI 1.33–8.42) and in the general surgery department (AOR = 2.65, 95% CI 0.27–14.78) were also at higher risk. In surgery, the probability of BBF exposure was twice as high (AOR = 2.46, 95% CI 1.44–4.16).

In addition, physicians who worked more than 8 h per day had a significantly higher risk of exposure (AOR = 6.16, 95% CI 12.62–14.43), and those who were not trained in infection prevention had an increased risk (AOR = 5.36, 95% CI 1.83–15.72). A lack of personal protective equipment was associated with a higher risk of exposure (AOR = 4.97, 95% CI 2.15–16.45). In addition, physicians who rarely or never used gloves were more likely to be exposed (AOR = 3.08, 95% CI 1.69–5.61), as was inconsistent use of aprons (AOR = 3.87, 95% CI 2.08–7.18) (Table 3).

Table 3 Multivariate logistic regression analysis of factors associated with BBF among participants in ACSH, Northern Ethiopia, 2020 (n = 94). Significant values are in bold.

Full size table

Post-exposure management

Reporting of exposures was exceptionally low, with only 3.2% (n = 3) of exposed physicians reporting them to hospital authorities. The vast majority, 96.8% (n = 91), did not report their exposure. The main reasons for not reporting included lack of time (33%, n = 31), not knowing how or whether to report (32%, n = 30), perceiving a low risk of infection (22%, n = 21) and not considering it important to report (9%, n = 8). In addition, one physician (1%) expressed concerns about confidentiality.

After exposure, the majority of physicians (91.5%, n = 86) reported washing the exposed area with soap and water. However, only 20.2% (n = 19) underwent laboratory testing, and only 11.7% (n = 11) initiated HIV post-exposure prophylaxis (PEP). Prophylaxis against hepatitis B was administered to only 3.2% (n = 3) of physicians (Table 4).

Table 4 Participants response on post-exposure management in ACSH, Northern Ethiopia, 2020 (n = 94).

Full size table

Discussion

This cross-sectional study investigated the extent of occupational exposure to BBF among physicians in the ACSH and identified associated factors. The results showed a high prevalence of occupational exposure, with 36.9% of physicians reporting exposure in the past three months and 82.4% reporting lifetime exposure. The high prevalence underscores the significant occupational risks physicians face in this setting, particularly among resident and intern physicians. A relevant consideration is that data collection overlapped with the early global COVID-19 pandemic, which may have influenced personal protective equipment (PPE) availability and infection prevention practices.

The prevalence of recent exposure (36.9%) in our study is consistent with the findings of other studies conducted in Ethiopia and similar low-resource settings. For example, a study among health care workers in Gondar, Ethiopia, found a prevalence of 32.8%14, while another study in Addis Ababa found a prevalence of 39.4%15. These findings underscore the persistent risk of occupational exposure among HCWs in Ethiopia.

Residents and interns were more likely to be exposed than specialists. This could be due to their relative inexperience, their greater involvement in invasive procedures and possibly inadequate training in infection prevention15. Similar findings have been reported in studies from other countries where residents and trainees had higher exposure rates16,17. The increased exposure of residents and trainees emphasizes the need for targeted training and monitoring of less experienced physicians to reduce the risk of exposure.

Working more than 8 h per day was significantly associated with higher exposure to BBF. Long working hours can lead to fatigue, reduced alertness and increased likelihood of errors, thus increasing the risk of occupational accidents18. Studies have shown that excessive workload and extended shifts are significant predictors of needlestick injuries and other occupational exposures in healthcare workers19. The introduction of measures to regulate working hours and manage workload could help to reduce this risk.

Lack of infection prevention training was another important factor associated with BBF exposure. Training on standard precautions and infection prevention measures is crucial to ensure that healthcare workers have the necessary knowledge and skills to protect themselves and their patients6. Studies have shown that healthcare workers who receive regular training in infection control are less likely to be occupationally exposed5. It is therefore important to offer regular and comprehensive training programs.

Inconsistent use of personal protective equipment, especially gloves, was associated with a higher risk of exposure. Proper use of PPE is a fundamental part of standard precautions to prevent occupational exposure to infectious material20. Barriers to consistent use of PPE may include inadequate supply, discomfort or lack of awareness of the importance of PPE21. Ensuring the availability of PPE and promoting its consistent use through education and institutional measures are crucial steps to reduce exposure risks.

Most exposures occurred in high-risk departments such as obstetrics and gynecology and general surgery. In these departments, procedures are performed where the likelihood of exposure to blood and body fluids is higher, such as surgical procedures and deliveries22. Tailored interventions focused on these high-risk areas, including specialized training and improved safety protocols, could be beneficial.

It is concerning that a significant proportion of exposed physicians did not report the incidents to hospital authorities and only a small proportion initiated post-exposure prophylaxis. Underreporting of occupational exposures is a common problem and can hinder timely medical assessment and intervention, which can increase the risk of infection transmission23. Factors contributing to underreporting include lack of knowledge of reporting procedures, perceived stigma, or underestimation of risk24. Establishing a supportive reporting system and fostering a culture that encourages reporting without fear of negative consequences are essential.

Limitations

This study has several limitations. The use of self-report may lead to recall bias and underreporting, especially for sensitive topics such as occupational exposure. The cross-sectional design limits the ability to establish causal relationships. In addition, the study was conducted in a single teaching hospital, which may limit the generalizability of the results.

Conclusion

Occupational exposure to BBF is high among physicians at ACSH, especially among resident physicians and interns. Factors such as long working hours, lack of infection prevention training and inconsistent use of PPE contribute to this risk. The results of this study emphasize the need for comprehensive strategies to reduce occupational exposure of physicians. Measures should include regular infection prevention and control training, ensuring consistent availability and use of PPE, managing workload to avoid fatigue and establishing effective reporting and post-exposure management systems.

Further research is needed to investigate the barriers to reporting occupational exposures and adherence to post-exposure prophylaxis protocols. Longitudinal studies could provide insight into the effectiveness of interventions over time. Extending the studies to multiple healthcare facilities would improve the generalizability of the results.

Data availability

All relevant data are within the paper. The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

ACSH:

Ayder Comprehensive Specialized Hospital

AOR:

Adjusted odds ratio

BBF:

Blood and body fluids

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

HCW:

Healthcare worker

HIV:

Human immunodeficiency virus

PEP:

Post-exposure prophylaxis

PPE:

Personal protective equipment

SPSS:

Statistical Package for the Social Sciences

References

World Health Organization. Health workers: Health worker occupational health (2016). Retrieved from https://www.who.int/occupational_health/topics/hcworkers/en/

Tarigan, L. H., Cifuentes, M., Quinn, M. & Kriebel, D. Prevention of needlestick injuries in healthcare facilities: A meta-analysis. Infect. Control Hosp. Epidemiol. 36 (7), 823–829 (2015).

PubMedMATHGoogle Scholar

World Health Organization. Global Hepatitis Report 2017 (WHO, 2017).

Ndejjo, R. et al. Occupational health hazards among healthcare workers in Kampala, Uganda. J. Environ. Public Health 2015, 913741 (2015).

PubMedPubMed CentralGoogle Scholar

Kebede, A. et al. Standard precautions practice among health care workers in public health facilities of Mekelle special zone, Northern Ethiopia. J. Community Med. Health Educ. 8 (1), 593 (2018).

MathSciNetMATHGoogle Scholar

Motaarefi, H. et al. Factors associated with needlestick injuries in health care occupations: A systematic review. J. Clin. Diagn. Res. 10 (8), IE01–IE04 (2016).

PubMedPubMed CentralGoogle Scholar

Mulat, A. et al. Prevalence of needlestick and sharps injuries among healthcare workers in Ethiopia: A systematic review and meta-analysis. Environ. Health Prev. Med. 20 (6), 413–423 (2015).

MATHGoogle Scholar

Gessessew, A. Occupational exposure of health workers to blood and body fluids in six hospitals of Tigray region: Magnitude and management. Ethiop. Med. J. 47 (3), 213–219 (2009).

PubMedGoogle Scholar

Bekele, T. et al. Factors associated with occupational needlestick and sharps injuries among hospital healthcare workers in Bale zone, Southeast Ethiopia. PLoS One 10 (10), e0140382 (2015).

Gebremariam, M. et al. Prevalence of needlestick and sharps injuries and associated factors among healthcare workers in Ethiopia: Systematic review and meta-analysis. Environ. Health Prev. Med. 25 (1), 29 (2020).

MATHGoogle Scholar

Wubie, T. et al. Occupational exposure to blood and body fluids among health care workers in Mekelle zone, North Ethiopia. Saf. Health Work 10 (1), 100–106 (2019).

Google Scholar

Zeleke, A. et al. Needlestick injuries and associated factors among healthcare workers in addis Ababa, Ethiopia. Ethiop. Med. J. 54 (2), 61–67 (2016).

Google Scholar

Bendel, R. B. & Afifi, A. A. Comparison of stopping rules in forward Stepwise regression. J. Am. Stat. Assoc. 72, 46–53 (1977).

MATHGoogle Scholar

Bisetegn, T. A. et al. Prevalence and associated factors of occupational exposure to blood and body fluids among health care workers at the university of Gondar comprehensive specialized hospital, Northwest Ethiopia. BMC Res. Notes 14 (1), 5 (2021).

Google Scholar

de Castro, A. B. et al. Occupational health and safety issues among nurses in the Philippines. AAOHN J. 65 (11), 21–29 (2017).

MATHGoogle Scholar

Zhang, M. et al. Occupational exposure to blood and body fluids among health care workers in a general hospital. China Am. J. Ind. Med. 61 (2), 163–169 (2018).

ADSMATHGoogle Scholar

Sarvestani, A. S. et al. Knowledge, attitude and practice towards needlestick injury among health care workers in a tertiary care hospital in Sharjah, UAE. Asian J. Med. Sci. 7 (6), 50–55 (2016).

MATHGoogle Scholar

Farsi, D. et al. The relationship between working hours and occupational injuries among emergency medicine residents. J. Emerg. Med. 58 (1), 90–95 (2020).

MATHGoogle Scholar

Williams, C. et al. Occupational exposures to blood and body fluids among health care workers in three public hospitals in Botswana: A cross-sectional study. Pan Afr. Med. J. 27, 157 (2017).

MATHGoogle Scholar

Kaur, R. et al. Needlestick injuries in nursing staff: A preventable but neglected epidemic. Int. J. Res. Med. Sci. 6 (4), 1361–1365 (2018).

MATHGoogle Scholar

Ebrahimi, H. & Khosravi, A. Needlestick injuries among nurses. J. Res. Health Sci. 17 (2), e00385 (2017).

Google Scholar

Nsubuga, F. M. & Jaakkola, M. S. Needle stick injuries among nurses in sub-Saharan Africa. Trop. Med. Int. Health 10 (8), 773–781 (2005).

PubMedGoogle Scholar

de Perio, M. A. et al. Needlestick injuries and other occupational exposures to blood and body fluids among home health care nurses and aides. Am. J. Public Health 109 (4), 598–600 (2019).

Google Scholar

Williams, C. et al. Occupational blood exposure and HIV post-exposure prophylaxis in healthcare workers in Addis Ababa, Ethiopia. J. Hosp. Infect. 83 (4), 304–307 (2013).

MATHGoogle Scholar

Download references

Acknowledgements

We thank the physicians who participated in the study and the administration of Ayder Comprehensive Specialized Hospital for their support.

Funding

HW received a grant from the MU-NMBU with grant award No: PG/MSc/CHS/MU-NMBU/44/2012. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Mekelle University, Tigray, Ethiopia

Hayelom Weldetekle, Hale Teka & Hagos Gidey

Department of General Surgery, Alamata General Hospital, Tigray, Ethiopia

Assefa Sharew

Department of Radiology, School of Medicine, College of Health Sciences, Mekelle University, Tigray, Ethiopia

Mebrihit Gebremeskel

Department of Internal Medicine, School of Medicine, College of Health Sciences, Aksum University, Tigray, Ethiopia

Ruta Mehari Tafere

Department of Anaesthesiology, Critical Care, and Pain Medicine, School of Medicine, College of Health Sciences, Mekelle University, Tigray, Ethiopia

Hailesllassie Berhe

Authors

Hayelom Weldetekle

View author publications