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Occupational Exposure to Blood: Search for a Relation Between Personality and Behavior

Published online by Cambridge University Press:  02 January 2015

Christian Rabaud ,
Agnès Zanea ,
Jean Marie Mur ,
Marie Françoise Blech ,
Didier Dazy ,
Thierry May  and
Francis Guillemin
Christian Rabaud*
Affiliation:
Cellule Régionale de Hygiène de Lorraine, CHU de Nancy, Hôpitaux de Brabois, Faculté de Médecine de Nancy, Nancy, France
Agnès Zanea
Affiliation:
Service de Médecine du Travail, CHU de Nancy, Hôpitaux de Brabois, Faculté de Médecine de Nancy, Nancy, France
Jean Marie Mur
Affiliation:
INSERM Unité 420, Faculté de Médecine de Nancy, Nancy, France
Marie Françoise Blech
Affiliation:
Cellule Régionale de Hygiène de Lorraine, CHU de Nancy, Hôpitaux de Brabois, Faculté de Médecine de Nancy, Nancy, France
Didier Dazy
Affiliation:
INSERM Unité 420, Faculté de Médecine de Nancy, Nancy, France
Thierry May
Affiliation:
Service de Maladies Infectieuses et Tropicales, CHU de Nancy, Hôpitaux de Brabois, Faculté de Médecine de Nancy, Nancy, France
Francis Guillemin
Affiliation:
Service Epidémiologie et Evaluation Clinique, CHU de Nancy, Hôpital Marin; Faculté de Médecine de Nancy, Nancy, France
*
Service de Maladies Infectieuses et Tropicales, CHU de Nancy—Hôpitaux de Brabois, Allée du Morvan, 54511 Vandoeuvre les Nancy Cedex, France
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Abstract

Objective:

To describe the behavior of French nurses after occupational exposure to blood (OEB); to study the reasons for not reporting an OEB to the occupational medicine service or the hospital authorities, and to explore the links between personality traits and both the risk of having an OEB and the likelihood of reporting it.

Design:

A descriptive and correlational study using a cross-sectional survey for data collection.

Setting:

Six nursing schools (four initial training institutes and two specialty training schools, one for surgical nurses and one for nurse anesthetists) and six hospitals in Lorraine.

Participants:

942 nurses and 459 nursing students were approached, and 964 (69%) replied to the questionnaire.

Methods:

The participants received an anonymous two-part questionnaire. The first part explored the knowledge of the risk and Standard Precautions and collected details of the history of OEB. Reporting of OEB to the occupational medicine service or the hospital authorities and the nature of serological monitoring after OEB also were explored. The second part was composed of the Zuckerman sensation-seeking scale, exploring four areas: disinhibition, danger- and adventure-seeking, seeking new experiences, and susceptibility to boredom.

Results:

947 nurses were vaccinated against hepatitis B, but only 528 (56%) had checked that they were effectively immunized. Only 166 respondents (17%) stated they routinely used gloves during all procedures in which they were exposed to blood. There were 505 recorded OEB during the study period (0.24 per person per year). The most frequently reported OEB were those involving hollow needles (57%). Approximately one half (48.5%) of all OEB were reported. “Good local antisepsis immediately after the accident” was the reason most often given to justify nonreporting. Only 57% of OEB victims sought to determine the serological status of the source patient for human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus immediately after accident. Only 40% and 31% of OEB victims checked their own HIV and HCV serostatus 3 and 6 months after OEB, respectively. Few staff adopted safer-sex measures after OEB, and some continued to donate blood in subsequent months. Logistic regression identified two variables significantly and independently linked to the risk of having at least one OEB in the 27 months preceding the date on which the questionnaire was completed: having a permanent position and having a higher degree of disinhibition. Taking into account the number of OEB during this period (Poisson regression), four variables were significantly and independently linked to the risk of having a larger number of OEB: having a permanent position; having a higher degree of disinhibition; being more susceptible to boredom; and having less nursing experience. In logistic regression, three variables emerged as being significantly and independently linked to reporting all OEB: younger age; having had at least one percutaneous injury (excluding splashes); and having lower susceptibility to boredom.

Conclusion:

Nursing personnel continue to ignore or be unaware of many factors surrounding OEB, meaning that information and counseling must continue unabated. Knowledge of the risk, of the benefit of respecting Standard Precautions, and of the importance of notification and serological follow-up is still inadequate. Finally, certain personality traits, such as a high level of disinhibition and susceptibility to boredom, appear to be linked to the risk of OEB. Subjects strongly susceptible to boredom are less likely to report such accidents.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 21 , Issue 9 , September 2000 , pp. 564 - 574
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2000

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References

1. Direction Générale de la Santé. Note de la DGS. Note d'information DGS/DH/DRT n°666 du 28/10/1996 sur la conduite à tenir pour la prophylaxie anti-VIH après accidents exposant au sang. Bulletin Epidemiologique Hebdomadaire 1996;49:213–216.Google Scholar
2. Direction Générale de la Santé. Principales dispositions de la circulaire DGS/DH/DRT/DSS n°98/228 du 09/04/1998. Bulletin Epidemiologique Hebdomadaire 1998;30:130–131.Google Scholar
3. Cardo, DM, Culver, DH, Ciesielski, C, Srivastava, PV, Marcus, R, Abiteboul, D, et al. A case-control study of HIV seroconversion in health care workers after percutaneous exposure. N Engl J Med 1997;337:1485–1490.Google Scholar
4. Rabaud, C, Lepori, ML, Vignaud, MC, Martin, C, May, T, Canton, P. Les accidents avec exposition au sang (AES) au CHU de Nancy: enquête sur le comportement du personnel vis à vis du risque de contamination VIH. Med Mal Infect 1996;26:327–331.CrossRefGoogle Scholar
5. Carton, S, Jouvent, R, Widlöcher, D. Cross-cultural validity of the sensation seeking scale: development of a French abbreviated form. Eur Psychiatry 1992;7:225–234.CrossRefGoogle Scholar
6. Zuckerman, M, Kolin, EA, Price, L, Zoobe, I. Development of a sensation-seeking scale. J Consult Clin Psychol 1964;28:477–482.CrossRefGoogle Scholar
7. Zuckerman, M. Dimensions of sensation seeking. J Consult Clin Psychol 1971;36:45–52.CrossRefGoogle Scholar
8. Carton, S, Lacour, C, Jouvent, R, Widlöcher, D. Le concept de recherche de sensations: traduction et validation de l'échelle de Zuckerman. Psychiatr Psycobiol 1990;5:39–44.Google Scholar
9. Zuckerman, M, Eysenck, S, Eysenck, HJ. Sensation seeking in England and America: cross cultural, age and sex comparisons. J Consult Clin Psychol 1978;46:139–149.Google Scholar
10. Hadler, SC, Margolis, HS. Hepatitis B immunization: vaccine types, efficacy and indications for immunization. Curr Clin Top Infect Dis 1992;12:282–308.Google Scholar
11. Alimonos, K, Nafziger, AN, Murray, J, Bertino, JS Jr. Prediction of response to hepatitis B vaccine in health care workers: whose titers of antibody to hepatitis B surface antigen should be determined after a three-dose series, and what are the implications in terms of cost-effectiveness? Clin Infect Dis 1998;26:566–571.Google Scholar
12. Mitsui, T, Iwano, K, Suzuki, S, Yamazaki, C, Masuko, K, Tsuda, F, et al. Combined hepatitis B immune globulin and vaccine for postexposure prophylaxis of accidental hepatitis B virus infection in hemodialysis staff members: comparison with immune globulin without vaccine in historical controls. Hepatology 1989;10:324–327.CrossRefGoogle ScholarPubMed
13. Bolyard, EA, Tablan, OC, Williams, WW, Pearson, ML, Shapiro, CN, Deitchman, SD, et al. Guidelines for infection control in healthcare personnel, 1998. Infect Control Hosp Epidemiol 1998;19:407–463.Google Scholar
14. Palmovic, D, Crnjakovi-Palmovic, J. Prevention of hepatitis B virus (HBV) infection in health-care workers after accidental exposure: a comparison of two prophylactic schedules. Infection 1993;21:42–45.CrossRefGoogle ScholarPubMed
15. Centers for Disease Control and Prevention. Immunization of health care workers: recommendation of Advisory Committee of Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR 1997;46(RR-18):1–42.Google Scholar
16. Direction Générale de la Santé. Circulaire DGS/DH relative à la prévention de la transmission du virus de l'immunodéficience humaine chez les personnels de santé. Bulletin Epidemiologique Hebdomadaire 1989;34:137–139.Google Scholar
17. Direction Générale de la Santé. Circulaire sur la prévention de la transmission d'agents infectieux véhiculés par le sang ou les liquides biologiques lors des soins (Circulaire DGS/DH n°98/249 du 20 Avril 98). Bulletin Epidemiologique Hebdomadaire 1998;25:107–111.Google Scholar
18. Nelsing, S, Nielsen, LT, Nielsen, JO. Occupational exposure to blood among personnel employed in a department of infectious disease, 2: accidental mechanisms and protective devices. Ugeskr Laeger 1993;155:3367–3370.Google Scholar
19. Burke, S, Madan, I. Contamination incidents among doctors and midwives: reasons for non-reporting and knowledge of risks. Occup Med 1997;47:357–360.CrossRefGoogle ScholarPubMed
20. Abiteboul, D, Antona, D, Descamps, JM, Bouvet, E et le GERES. Procédures à risque d'exposition au sang pour le personnel infirmier. Surveillance et évolution de 1990 à 1992 dans 10 hôpitaux. Bulletin Epidemiologique Hebdomadaire 1993;43:195–196.Google Scholar
21. Abiteboul, D, Antona, D, Azoulay, S, Louet, M, Marandi, J, Pelletier, A et al. Analyses des expositions accidentelles au sang à l'Assistance Publique—Hôpitaux de Paris. Bulletin Epidemiologique Hebdomadaire 1991;50:217–219.Google Scholar
22. Denis, MA, Poyard, G, Saury, A, Cadiot, M, Forissier, MF, Lery, L, et al. La sous déclaration des accidents d'exposition au sang dans un CHU. Med Mal Infect 1993;54:242–248.Google Scholar
23. Hamory, BH. Underreporting of needlestick injuries in a university hospital. Am J Infect Control 1983;11:174–177.Google Scholar
24. Haiduven, DJ, Simpkins, SM, Phillips, ES, Stevens, DA. A survey of percutaneous/mucocutaneous injury reporting in a public teaching hospital. J Hosp Infect 1999;41:151–154.Google Scholar
25. Waterman, J, Jankowski, R, Madan, I. Under-reporting of needlestick injuries by medical students. J Hosp Infect 1994;26:149–153.Google Scholar
26. Kirkpatrick, BL, Ricketts, VE, Reeves, DS, MacGowan, AP. Needlestick injuries among medical students. J Hosp Infect 1993;23:315–317.CrossRefGoogle ScholarPubMed
27. Alter, MJ, Margolis, HS, Krawczynski, K, Judson, FN, Mares, A, Alexander, WJ, et al. The natural history of community-acquired hepatitis C in the United States. N Engl J Med 1992;327:1899–1905.Google Scholar
28. Ridzon, R, Gallagher, K, Cielsielski, C, Ginsberg, MB, Roberston, BJ, Luo, CC, et al. Simultaneous transmission of HIV and HCV from a needlestick injury. N Engl J Med 1997;336:919–922.Google Scholar