الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The healthcare workforce, 35 million people worldwide, represents 12% of the working population. The occupational health of this significant group has long been neglected both organizationally and by governments. The misconception exists that the healthcare industry is “clean” and without hazard, when in fact the chemical and blood-borne exposures encountered can be career and life-ending.(1)
Workplace safety is a very important aspect of occupational health practice.(11) The Centers for Disease Control and Prevention (CDC) define an “exposure” that might place HCWs at risk for bloodborne pathogens infection; as a percutaneous injury (e.g., needlestick or cut with a sharp object) or contact of mucous membrane or nonintact skin (e.g., exposed skin that is chapped, abraded, or afflicted with dermatitis) with blood, tissue, or other bodily fluids that are potentially infectious.(20,21,28)
Occupational exposure to bloodborne pathogens from SIs and/or BBF exposure is a serious problem in healthcare due to the high frequency and severity of the infections that can occur.(8) CDC estimates that each year 385,000 needlesticks and other sharps-related injuries are sustained by hospital-based healthcare personnel; an average of 1,000 sharps injuries per day.(9,10) The WHO state that among the 35 million HCWs worldwide, about 3 million receive percutaneous exposures to bloodborne pathogens each year; 2 million of those to HBV, 0.9 million to HCV and 170 000 to HIV.(12) The estimated risks of transmission of infection from an infected patient to the health worker following a needle-stick injury are to be: hepatitis B – 3–10% (up to 30%); hepatitis C – 0.8–3%; HIV – 0.3%.(13) An assessment done by the WHO Eastern Mediterranean Regional Office shows an average of 4 needlestick injuries per year per HCW.(14)
The operating room continues to rank as one of the highest-risk hospital settings for percutaneous injury and for blood and body fluid exposure.(17) Of the estimated 384,000 needle-stick injuries occurring in hospitals each year, 23% occur in surgical settings.(19) The surgical environment is unique among health care settings in that it is blood intensive, requires extensive manipulation of sharp instruments, often with compromised visual cues, and involves highly orchestrated interactions among members of the surgical team.(22) Moreover, about 40% of patients undergoing surgery have a potentially transmissible, blood-borne illness, which puts a substantial proportion of operating room staff (nurses, surgeons, surgical assistants) who experience a SI during surgery at risk of serious illness.(18)These special circumstances place surgical personnel at higher risk of percutaneous injury and blood exposure than most other health care professionals.(22)
In Egypt, particularly in Alexandria, safety in operating rooms was not adequately studied and few efforts have been undertaken to raise awareness about needlesticks and sharps injuries among HCWs and hospital managers. Limited knowledge about the transmission of blood borne diseases in health care facilities and unsafe practices are common. Additionally, there is an inadequate postexposure management. This study was conducted in order to assess injection and sharps safety measures adopted in the operating rooms at the Alexandria Main University Hospital for safe injection and sharp use, assess sterilization measures, identify factors contributing to needlestick and sharps injuries, blood and body fluid exposure and the post exposure management, assess knowledge and practices of HCWs in the operating rooms with regard to injection safety and assess injection and sharps safety management policy adopted in the studied operating rooms.
A descriptive cross-sectional approach was selected for this study using an observational checklists of the operating rooms and injection practices conducted as well as an interview questionnaire with HCWs. All operating rooms (n=34) as well as sterilization rooms (n=8) at the Alexandria Main University Hospital were observed for safe injection and sterilization measures adopted. In addition, HCWs were observed for safe injection practices (n=62).(118) All HCWs including surgeons, anesthetists, nurses, ancillary workers, housekeepers attending the operating rooms during the field work period of the study (n=318) were interviewed using a self-structured predesigned questionnaire based on the World Health Organization revised injection safety assessment tool, CDC Survey of healthcare personnel on occupational exposure to blood and body fluids and the Exposure Prevention Information Network (EPINet) needlestick and sharp injury report, blood and body fluid exposure report as well as post exposure management report. (10,118,120)An assessment of injection and sharps safety management policy adopted in the operating rooms was done by interviewing the head of infection control unit and the studied HCWs.(118).