Non-hospital occupational blood exposure accidents: A nine-year retrospective analysis of post-exposure HIV, hepatitis B and C risk management in the Netherlands.

Occupational blood exposure accidents (OBEAs) pose significant risks to healthcare workers, potentially exposing them to hepatitis B (HBV), hepatitis C (HCV), and HIV. While most research focuses on hospital settings, this study assessed OBEA management in non-hospital contexts. Although our data predate the COVID pandemic, findings remain highly relevant, especially for healthcare professionals working outside hospital settings. A retrospective analysis of OBEA registry data (2006-2014) was conducted in a southern Dutch region. Data included demographics, profession, workplace, injury type, source status (HBV, HCV, HIV), risk assessment, post-exposure measures, and lab results. Chi-square and t-tests were applied. In total, 975 OBEA were reported. Among nurses, medical assistants, students, and housekeeping staff, subcutaneous needles (51-67%) and lancets (25%) were common exposure sources. Police officers mainly reported biting (26%), scratching, or spitting (70%). HBV vaccination coverage ranged from 18% (housekeeping) to over 90% (nurses, police). Post-exposure measures were taken in 52% of cases. High-risk exposures (43%) mainly affected ambulance staff, sterilization workers, police, and dentists. Sources were tested in 85% of high-risk cases: 1.4% were HBV positive, 2% HCV positive, and 1.1% HIV positive. No seroconversions occurred. Results stress the need for better HBV vaccination coverage, targeted prevention, and prompt OBEA reporting outside hospital settings.