Clin Colon Rectal Surg 2019; 32(06): 435-441
DOI: 10.1055/s-0039-1693010
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Workplace Exposures

Janet T. Lee
1   Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
,
Wolfgang B. Gaertner
1   Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
› Author Affiliations
Further Information

Publication History

Publication Date:
22 August 2019 (online)

Abstract

Workplace exposure in colorectal surgery is unique compared with other surgical specialties and generally underreported. Although the most common device-associated exposure in surgery is suture needle injury, colorectal surgeons are increasingly exposed to gastrointestinal-related infectious agents, radiation, and other hazards in multiple different clinical settings. Highlighting the unique workplace exposures in colorectal surgery may help increase awareness, improve education, and identify possible targets for early intervention in order to minimize these risks.

 
  • References

  • 1 Panlilio AL, Orelien JG, Srivastava PU, Jagger J, Cohn RD, Cardo DM. ; NaSH Surveillance Group; EPINet Data Sharing Network. Estimate of the annual number of percutaneous injuries among hospital-based healthcare workers in the United States, 1997-1998. Infect Control Hosp Epidemiol 2004; 25 (07) 556-562
  • 2 Grimmond T, Good L. Exposure Survey of Trends in Occupational Practice (EXPO-S.T.O.P.) 2015: a national survey of sharps injuries and mucocutaneous blood exposures among health care workers in US hospitals. Am J Infect Control 2017; 45 (11) 1218-1223
  • 3 Myers DJ, Lipscomb HJ, Epling C. , et al. Surgical procedure characteristics and risk of sharps-related blood and body fluid exposure. Infect Control Hosp Epidemiol 2016; 37 (01) 80-87
  • 4 Hasak JM, Novak CB, Patterson JMM, Mackinnon SE. Prevalence of needlestick injuries, attitude changes, and prevention practices over 12 years in an urban academic hospital surgery department. Ann Surg 2018; 267 (02) 291-296
  • 5 Choi LY, Torres R, Syed S. , et al. Sharps and needlestick injuries among medical students, surgical residents, faculty, and operating room staff at a single academic institution. J Surg Educ 2017; 74 (01) 131-136
  • 6 Kevitt F, Hayes B. Sharps injuries in a teaching hospital: changes over a decade. Occup Med (Lond) 2015; 65 (02) 135-138
  • 7 Davies CG, Khan MN, Ghauri ASK, Ranaboldo CJ. Blood and body fluid splashes during surgery--the need for eye protection and masks. Ann R Coll Surg Engl 2007; 89 (08) 770-772
  • 8 Werner BG, Grady GF. Accidental hepatitis-B-surface-antigen-positive inoculations. Use of e antigen to estimate infectivity. Ann Intern Med 1982; 97 (03) 367-369
  • 9 Egro FM, Nwaiwu CA, Smith S, Harper JD, Spiess AM. Seroconversion rates among health care workers exposed to hepatitis C virus-contaminated body fluids: the University of Pittsburgh 13-year experience. Am J Infect Control 2017; 45 (09) 1001-1005
  • 10 Bell DM. Occupational risk of human immunodeficiency virus infection in healthcare workers: an overview. Am J Med 1997; 102 (5B): 9-15
  • 11 Ippolito G, Puro V, De Carli G. The risk of occupational human immunodeficiency virus infection in health care workers. Italian Multicenter Study. The Italian Study Group on Occupational Risk of HIV infection. Arch Intern Med 1993; 153 (12) 1451-1458
  • 12 Nwaiwu CA, Egro FM, Smith S, Harper JD, Spiess AM. Seroconversion rate among health care workers exposed to HIV-contaminated body fluids: the University of Pittsburgh 13-year experience. Am J Infect Control 2017; 45 (08) 896-900 U.S.
  • 13 U.S. Public Health Service. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR Recomm Rep 2001; 50 (RR-11): 1-52
  • 14 Centers for Disease Control and Prevention. CDC guidance foe evaluating health-care personnel for hepatitis B protection and for administering postexposure management. MMWR Recomm Rep 2013; 62: 1-19
  • 15 Centers for Disease Control. Information for healthcare personnel potentially exposed to Hepatitis C virus (HCV). Available at https://www.cdc.gov/hepatitis/pdfs/testing-followup-exposed-hc-personnel.pdf . Accessed January 30, 2018
  • 16 Kuhar DT, Henderson DK, Struble KA. , et al; US Public Health Service Working Group. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol 2013; 34 (09) 875-892
  • 17 Lunding S, Katzenstein TL, Kronborg G. , et al. The Danish PEP Registry: experience with the use of post-exposure prophylaxis following blood exposure to HIV from 1999-2012. Infect Dis (Lond) 2016; 48 (03) 195-200
  • 18 Mannocci A, De Carli G, Di Bari V. , et al. How much do needlestick injuries cost? A systematic review of the economic evaluations of needlestick and sharps injuries among healthcare personnel. Infect Control Hosp Epidemiol 2016; 37 (06) 635-646
  • 19 Tanner J, Parkinson H. Double gloving to reduce surgical cross-infection. Cochrane Database Syst Rev 2006; (03) CD003087
  • 20 Mischke C, Verbeek JH, Saarto A, Lavoie MC, Pahwa M, Ijaz S. Gloves, extra gloves or special types of gloves for preventing percutaneous exposure injuries in healthcare personnel. Cochrane Database Syst Rev 2014; (03) CD009573
  • 21 Brearley S, Buist LJ. Blood splashes: an underestimated hazard to surgeons. BMJ 1989; 299 (6711): 1315
  • 22 Roberge RJ. Face shields for infection control: a review. J Occup Environ Hyg 2016; 13 (04) 235-242
  • 23 Mansour III AA, Even JL, Phillips S, Halpern JL. Eye protection in orthopaedic surgery. An in vitro study of various forms of eye protection and their effectiveness. J Bone Joint Surg Am 2009; 91 (05) 1050-1054
  • 24 Loveridge JM, Gozzard C, Bannister GC. The effectiveness of a visor as a surgical barrier: an inverted position is better. J Hosp Infect 2006; 62 (02) 251-253
  • 25 Occupational Safety and Health Administration (OSHA). Bloodborne Pathogens standard. Available at https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051">https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051 . Accessed January 31, 2018
  • 26 American College of Surgeons (ACS) Committee on Perioperative Care. Revised statement on sharps safety. Bull Am Coll Surg 2016; 101 (10) 53-55
  • 27 Mohandas KM, Gopalakrishnan G. Mucocutaneous exposure to body fluids during digestive endoscopy: the need for universal precautions. Indian J Gastroenterol 1999; 18 (03) 109-111
  • 28 Benter T, Klühs L, Teichgräber UK, Riechert F, Ludwig WD, Dörken B. Need for safety goggles for endoscopy. Endoscopy 2003; 35 (09) 803
  • 29 Tomita Y, Mihashi S, Nagata K. , et al. Mutagenicity of smoke condensates induced by CO2-laser irradiation and electrocauterization. Mutat Res 1981; 89 (02) 145-149
  • 30 U.S. Department of Health and Human Services, National Institute for Occupational Safety and Health. Health Hazard Evaluation Report. HETA 85-126-1932, 1988 . Available at https://www.cdc.gov/niosh/hhe/reports/pdfs/85-126-1932.pdf . Accessed on February 12, 2018
  • 31 Brüske-Hohlfeld I, Preissler G, Jauch KW. , et al. Surgical smoke and ultrafine particles. J Occup Med Toxicol 2008; 3: 31
  • 32 Champault G, Taffinder N, Ziol M, Riskalla H, Catheline JM. Cells are present in the smoke created during laparoscopic surgery. Br J Surg 1997; 84 (07) 993-995
  • 33 Baggish MS, Poiesz BJ, Joret D, Williamson P, Refai A. Presence of human immunodeficiency virus DNA in laser smoke. Lasers Surg Med 1991; 11 (03) 197-203
  • 34 Ferenczy A, Bergeron C, Richart RM. Human papillomavirus DNA in CO2 laser-generated plume of smoke and its consequences to the surgeon. Obstet Gynecol 1990; 75 (01) 114-118
  • 35 Ziegler BL, Thomas CA, Meier T, Müller R, Fliedner TM, Weber L. Generation of infectious retrovirus aerosol through medical laser irradiation. Lasers Surg Med 1998; 22 (01) 37-41
  • 36 Lewin JM, Brauer JA, Ostad A. Surgical smoke and the dermatologist. J Am Acad Dermatol 2011; 65 (03) 636-641
  • 37 Ferenczy A, Bergeron C, Richart RM. Carbon dioxide laser energy disperses human papillomavirus deoxyribonucleic acid onto treatment fields. Am J Obstet Gynecol 1990; 163 (4 Pt 1): 1271-1274
  • 38 McFarland LV, Mulligan ME, Kwok RY, Stamm WE. Nosocomial acquisition of Clostridium difficile infection. N Engl J Med 1989; 320 (04) 204-210
  • 39 Landelle C, Verachten M, Legrand P, Girou E, Barbut F, Brun-Buisson C. Contamination of healthcare workers' hands with Clostridium difficile spores after caring for patients with C. difficile infection. Infect Control Hosp Epidemiol 2014; 35 (01) 10-15
  • 40 Amis Jr ES, Butler PF, Applegate KE. , et al; American College of Radiology. American College of Radiology white paper on radiation dose in medicine. J Am Coll Radiol 2007; 4 (05) 272-284
  • 41 Pedrosa MC, Farraye FA, Shergill AK. , et al; ASGE Technology Committee. Minimizing occupational hazards in endoscopy: personal protective equipment, radiation safety, and ergonomics. Gastrointest Endosc 2010; 72 (02) 227-235