Emergency Radiology

, Volume 1, Issue 2, pp 89–92

Bloodborne pathogens: Occupational risk and infection control in radiology

Part 1: Risk of bloodborne pathogen transmission in radiology
  • Margaret E. Hansen
Original Article


Transmission of bloodborne pathogens, such as the human immunodeficiency virus, can occur in the healthcare setting, either from patient to healthcare worker or vice versa. The risk of such transmission, however, is quite low. No other cases of physician to patient transmission have been confirmed, and HIV infection due to occupational exposure has been documented in only 39 healthcare workers to date. Other pathogens, particularly hepatitis B virus, pose a greater threat. Procedures in which there may be exposure to various body fluids pose a risk to healthcare workers, including those in radiology. Compliance with current infection control regulations should reduce this risk.

Key Words

Occupational diseases Radiology Accidents, occupational Needlestick injuries HIV 


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  1. 1.
    Centers for Disease Control. Update: transmission of HIV infection during an invasive dental procedure—Florida. MMWR Morb Mortal Wkly Rep 1991;40:21–7.Google Scholar
  2. 2.
    Ciesielski C, Marianos D, Ou C-Y, et al. Transmission of human immunodeficiency virus in a dental practice. Ann Intern Med 1992;116:798–805.PubMedGoogle Scholar
  3. 3.
    Breo DL. The dental AIDS cases—murder or an unsolvable mystery? JAMA 1993;270:2732–4.PubMedCrossRefGoogle Scholar
  4. 4.
    Lewis DL, Boe RK. Cross-infection risks associated with current procedures for using high-speed dental handpieces. J Clin Microbiol 1992;30:401–6.PubMedGoogle Scholar
  5. 5.
    Sacks JJ. AIDS in a surgeon [letter]. New Engl J Med 1985;313:1017–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Mishu B, Schaffner W, Horan JM, Wood LH, Hutcheson RH, McNabb PC. A surgeon with AIDS: lack of evidence of transmission to patients. JAMA 1990;264:467–70.PubMedCrossRefGoogle Scholar
  7. 7.
    Danila RN, MacDonald KL, Rhame FS, et al. A look-back investigation of patients of an HIV-infected physician: public health implications. New Engl J Med 1991;325:1406–11.PubMedCrossRefGoogle Scholar
  8. 8.
    Centers for Disease Control. Update: investigations of patients who have been treated by HIV-infected health-care workers. MMWR Morb Mortal Wkly Rep 1992;41:44–6.Google Scholar
  9. 9.
    Centers for Disease Control. Update: investigations of patients who have been treated by HIV-infected health-care workers—U.S. MMWR Morb Mortal Wkly Rep 1993;42:329–31, 337.Google Scholar
  10. 10.
    Mishu B, Schaffner W. HIV-infected surgeons and dentists: looking back and looking forward [editorial]. JAMA 1993;269:1843–4.PubMedCrossRefGoogle Scholar
  11. 11.
    Centers for Disease Control. Update: human immunodeficiency virus infections in health-care workers exposed to blood of infected patients. MMWR Morb Mortal Wkly Rep 1987;36:285–9.Google Scholar
  12. 12.
    Klein RS, Phelan JA, Freeman K, et al. Low occupational risk of human immunodeficiency virus infection among dental professionals. New Engl J Med 1988;318:86–90.PubMedCrossRefGoogle Scholar
  13. 13.
    Marcus R, and the CDC Cooperative Needlestick Surveillance Group. Surveillance of healthcare workers exposed to blood from patients infected with the human immunodeficiency virus. New Engl J Med 1988;319:1118–23.PubMedCrossRefGoogle Scholar
  14. 14.
    Henderson DK, Fahey BJ, Willy M, et al. Risk for occupational transmission of human immunodeficiency virus type 1 (HIV-1) associated with clinical exposures: a prospective evaluation. Ann Intern Med 1990;113:740–6.PubMedGoogle Scholar
  15. 15.
    Beekmann SE, Fahey BJ, Gerberding JL, Henderson DK. Risky business: using necessarily imprecise casualty counts to estimate occupational risks for HIV-1 infection. Infect Control Hosp Epidemiol 1990;11:371–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Department of Labor. Occupational exposure to bloodborne pathogens; final rule. Fed Register 12/6/91;64175–64182 (29 CFR Part 1910.1030).Google Scholar
  17. 17.
    Centers for Disease Control. Recommendations for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures. MMWR Morb Mortal Wkly Rep 1991;40(RR8):109.Google Scholar
  18. 18.
    Gerbert B. AIDS and infection control in dental practice: dentists’ attitudes, knowledge, and behavior. J Am Dent Assoc 1987;114:311–4.PubMedGoogle Scholar
  19. 19.
    Kelen GD, DiGiovanna T, Bisson L, Kalainov D, Sivertson KT, Quinn TC. Human immunodeficiency virus infection in emergency department patients: epidemiology, clinical presentations, and risk to healthcare workers—the Johns Hopkins experience. JAMA 1989;262:516–22.PubMedCrossRefGoogle Scholar
  20. 20.
    Hammond JS, Eckes JM, Gomez GA, Cunningham DN. HIV, trauma, and infection control: universal precautions are universally ignored. J Trauma 1990;30:555–61.PubMedCrossRefGoogle Scholar
  21. 21.
    Courington KR, Patterson SL, Howard RJ. Universal precautions are not universally followed. Arch Surg 1991;126:93–6.PubMedGoogle Scholar
  22. 22.
    Troya SH, Jackson MM, Lovrich-Kerr M, McPherson CD. A survey of nurses’; knowledge, opinions, and reported uses of the body substance isolation system. Am J Infect Control 1991;19:268–76.PubMedCrossRefGoogle Scholar
  23. 23.
    Kaczmarek RG, Moore RM Jr, McCrohan J, et al. Glove use by health care workers: results of a tristate investigation. Am J Infect Control 1991;19:228–32.PubMedCrossRefGoogle Scholar
  24. 24.
    Gorse GJ, Messner RL. Infection control practices in gastrointestinal endoscopy in the United States: a national survey. Infect Control Hosp Epidemiol 1991;12:289–96.PubMedGoogle Scholar
  25. 25.
    Hansen ME, Miller GL III, Redman HC, McIntire DD. HIV and interventional radiology: a national survey of physician attitudes and behaviors. J Vasc Intervent Radiol 1993;4:229–36.Google Scholar
  26. 26.
    Edmond M, Khakoo R, McTaggart B, Solomon R. Effect of bedside needle disposal units on needle recapping frequency and needlestick injury. Infect Control Hosp Epidemiol 1988;9:114–6.PubMedGoogle Scholar
  27. 27.
    Jagger J, Hunt EH, Brand-Elnaggar J, Pearson RD. Rates of needlestick injury caused by various devices in a university hospital. New Engl J Med 1988;319:284–8.PubMedCrossRefGoogle Scholar
  28. 28.
    Becker MH, Janz NK, Band J, Bartley J, Snyder MB, Gaynes RP. Noncompliance with universal precautions policy: why do physicians and nurses recap needles? Am J Infect Control 1990;18:232–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Centers for Disease Control. HIV prevalence estimates and AIDS case projections for the U.S.: report based upon a workshop. MMWR Morb Mortal Wkly Rep 1990;39(RR-16):1–31.Google Scholar
  30. 30.
    Baker JL, Kelen GD, Sivertson KT, Quinn TC. Unsuspected human immunodeficiency virus in critically ill emergency patients. JAMA 1987;257:2609–11.PubMedCrossRefGoogle Scholar
  31. 31.
    Janssen RS, St Louis ME, Satten GA, et al. HIV infection among patients in US acute care hospitals: strategies for counseling and testing of hospital patients. New Engl J Med 1992;327:445–52.PubMedCrossRefGoogle Scholar
  32. 32.
    Department of Labor. Occupational exposure to bloodborne pathogens; final rule. Fed Register 12/6/91;56:64004–64182 (29 CFR Part 1910.1030).Google Scholar
  33. 33.
    Alter MJ. Hepatitis C: a sleeping giant? Am J Med 1991;91(Suppl 3B):112S-115S.PubMedCrossRefGoogle Scholar
  34. 34.
    Polywka S, Laufs R. Hepatitis C virus antibodies among different groups at risk and patients with suspected non-A, non-B hepatitis. Infection 1991;19:81–4.PubMedCrossRefGoogle Scholar
  35. 35.
    Centers for Disease Control. Recommendations for prevention of HIV transmission in health-care settings. MMWR Morb Mortal Wkly Rep 1987;36(2S):3S-18S.Google Scholar
  36. 36.
    American College of Radiology. OSHA details application of bloodborne pathogen standard. ACR Bulletin 1992;48(8):3.Google Scholar
  37. 37.
    Centers for Disease Control. HIV-AIDS Surveillance Rep 1993;5(3):13.Google Scholar
  38. 38.
    Hansen ME, Miller GL III, Redman HC, McIntire DD. Needle-stick injuries and blood contacts during invasive radiologic procedures: frequency and risk factors. AJR Am J Roentgenol 1993;160:1119–22.PubMedGoogle Scholar
  39. 39.
    Gerberding JL, Littell C, Tarkington A, Brown A, Schecter WP. Risk of exposure of surgical personnel to patients’ blood during surgery at San Francisco General Hospital. New Engl J Med 1990;322:1788–93.PubMedCrossRefGoogle Scholar
  40. 40.
    Lowenfels AB, Wormser GP. Frequency of puncture injuries in surgeons and estimated risk of HIV infection. Arch Surg 1989;124:1284–6.PubMedGoogle Scholar
  41. 41.
    Popejoy SL, Fry DE. Blood contact and exposure in the operating room. Surg Gynecol Obstet 1991;172:480–3.PubMedGoogle Scholar
  42. 42.
    Panlilio AL, Foy DR, Edwards JR, et al. Blood contacts during surgical procedures. JAMA 1991;265:1533–7.PubMedCrossRefGoogle Scholar
  43. 43.
    Hussain SA, Latif ABA, Choudhary AAAA. Risk to surgeons: a survey of accidental injuries during operations. Br J Surg 1988;75:314–6.PubMedCrossRefGoogle Scholar
  44. 44.
    Quebbeman EJ, Telford GL, Hubbard S, et al. Risk of blood contamination and injury to operating room personnel. Ann Surg 1991;214:614–20.PubMedCrossRefGoogle Scholar
  45. 45.
    Gerbert B, Maguire BT, Hulley SB, Coates TJ. Physicians and acquired immunodeficiency syndrome: what patients think about human immunodeficiency virus in medical practice. JAMA 1989;262:1969–72.PubMedCrossRefGoogle Scholar
  46. 46.
    Bachner P. The epidemiology of fear: scientific, social, and political responses to the occupational risk of blood-borne infection. Arch Pathol Lab Med 1990;114:319–23.PubMedGoogle Scholar
  47. 47.
    Slovic P. Perception of risk. Science 1987;236:280–5.PubMedCrossRefGoogle Scholar
  48. 48.
    Tokars JI, Bell DM, Culver DH, et al. Percutaneous injuries during surgical procedures. JAMA 1992;267:2899–2904.PubMedCrossRefGoogle Scholar
  49. 49.
    White MC, Lynch P. Blood contact and exposures among operating room personnel: a multicenter study. Am J Infect Control 1993;21:243–8.PubMedCrossRefGoogle Scholar
  50. 50.
    Lowenfels AB, Wormser G. Risk of transmission of HIV from surgeon to patient [letter]. New Engl J Med 1991;325:888–9.PubMedCrossRefGoogle Scholar
  51. 51.
    Bell DM, Martone WJ, Culver DH, et al. Risk of endemic HIV and hepatitis B virus (HBV) transmission to patients during invasive procedures [abstract]. Abstracts from the VII International Conference on AIDS. Vol 1:16–21. Rome, Italy: Instituto Superiore de Sanita, 1991:37.Google Scholar

Copyright information

© the American Society of Emergency Radiology 1994

Authors and Affiliations

  • Margaret E. Hansen
    • 1
  1. 1.Department of Radiology, Special Procedures SectionUniversity of Texas Southwestern Medical CenterDallas

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