Blood and body fluid exposures in the French military

• Published in: Occupational medicine (Oxford) Vol. 62; no. 2; pp. 141 - 144
• Main Authors: Dia, A., Verret, C., Pommier de Santi, V., Tanti, M., Decam, C., Migliani, R., Deparis, X.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-03-2012
• Subjects: Biological and medical sciences; Blood-Borne Pathogens; Body Fluids - microbiology; Female; Firefighters; France; Health care; Health Personnel; HIV Infections - prevention & control; HIV Infections - transmission; Humans; Infectious Disease Transmission, Patient-to-Professional - prevention & control; Infectious Disease Transmission, Patient-to-Professional - statistics & numerical data; Male; Medical sciences; Military Personnel; Miscellaneous; Needlestick Injuries - epidemiology; Occupational Exposure - analysis; Occupational medicine; Personnel, Hospital; Post-Exposure Prophylaxis; Public health. Hygiene-occupational medicine; Risk Assessment; France; Europe; body fluid; non-hospital-based; occupational exposure; Blood; military personnel; Accidental blood exposure; Human; Biological fluid; Retroviridae; Military environment; Occupational exposure; Personnel; Lentivirus; Virus; Human immunodeficiency virus; Occupational medicine; Military
• ISSN: 0962-7480; 1471-8405
• DOI: 10.1093/occmed/kqr179

Background
Occupational exposure to blood and body fluids (BBFs) is a hazard of many occupations, particularly hospital-based health care providers. However, non-hospital-based health care workers (HCWs) and other personnel not providing health care are also at risk.
Aims
To present the results of surveillance of accidental exposure to BBFs among non-hospital-based French military personnel between 2007 and 2009, comparing different occupational categories.
Methods
The study population included all French military personnel subjected to occupational BBF exposure in a non-hospital setting. BBF exposure was defined as any percutaneous (needlestick injury, scalpel cut, etc.) or mucocutaneous (splash to mucosa, eyes or non-intact skin) exposure to blood, a biological fluid contaminated with blood or a fluid known to transmit blood-borne pathogens.
Results
Between 1 January 2007 and 31 December 2009, 704 occupational BBF exposures were reported in non-hospital-based French military personnel. Annualized BBF exposure incidence rates were statistically different among health care workers in non-hospital settings, firefighters, 'gendarmes' and other military personnel, with respectively 38.7, 5.4, 0.8 and 0.1 exposures per 1000 persons per year. Among the 97 cases of HIV post-exposure prophylaxis (PEP) initiated, the source patient's HIV status was unknown in 78 cases (84%).
Conclusions
These results suggest that the appropriateness of HIV PEP initiation in the French military should be reviewed. Adapting French guidelines for managing BBF exposure, for non-hospital-based environments should be considered.