Doctors and paramedical staff in Delhi’s hospitals are at great risk. And they have only themselves to blame because of their inept handling of biomedical waste, throwing safety precautions to the wind.
Their daily exposure to infected blood and body fluids, compounded by the lack of universal precautions in handling them, makes them vulnerable to infections such as HIV and Hepatitis A, B and C.
Two major city hospitals have come up with the startling fact that a majority of doctors, along with nurses and cleaning staff, are exposed to HIV and other deadly infections. This was revealed in a retrospective review of data, culled from three years of an ongoing surveillance of occupational exposure to HIV of healthcare workers.
“ We found that a majority of healthcare providers with occupational exposure were doctors, followed by nurses.
Improper adherence to universal precautions, improper handling and disposal of biomedical waste — especially sharp objects — were responsible for most of the occupational exposures,” Dr Anju Seth, professor at the department of paediatrics, Lady Hardinge Medical College, said.
The surveillance data collected from doctors of the department of paediatrics at Kalawati Saran Children’s Hospital, Sucheta Kriplani Hospital and Lady Hardinge Medical College revealed 103 healthcare professionals reported occupational exposure to blood and body fluids between 2007 and 2010.
While it is not known if anyone who was part of the study was affected, there have been cases of diseases being passed on from patients to doctors because of lack of safety precautions.
For example in 2006, Chandigarh’s Postgraduate Institute of Medical Education and Research reported two cases of possible occupationally acquired HIV infection.
And in 2009, when swine flu attacked Delhi, a dozen doctors in government hospitals such as Ram Manohar Lohia and Safdarjung contracted the disease.
In the study, those exposed to the infections comprised 72 doctors, 20 nursing personnel and 11 cleaning staff. “ The most common circumstance of exposure was clinical procedures.
The other circumstances were sweeping and handling used sharps, recapping and surgery.
The HIV status of the blood and body fluid was positive in at least seven per cent cases, unknown in around 40 per cent case and negative in the rest,” Dr Varun Aggarwal of Lady Hardinge Medical College said.
The team that conducted the study included besides Aggarwal and Seth, Dr Jagdish Chandra, Dr Rohini Gupta, Dr Praveen Kumar and Dr Ashok Kumar Dutta. It was published in the current issue of the Indian Journal of Medical Research . The surveillance report said around 85.4 per cent of the exposure occurred in hospital wards, the emergency, the operating room and the labour room of the hospital.
WHAT AILS THE SYSTEM
Heavily burdened residents and interns manning busy clinics
Non- availability of equipment and supplies in government hospitals. Even if supplies are available, they aren’t used properly by healthcare workers
Many healthcare workers aren’t properly trained
Even doctors are ignorant or reluctant to go in for adequate check- ups after needle stick injury
KEEP THEM AT BAY
These guidelines, often referred to as ‘ universal precautions’, should be consistently used for all patients
Healthcare workers should use appropriate barrier precautions to prevent skin and mucous- membrane exposure when contact with body fluids of any patient is anticipated
Hands and other skin surfaces should be washed immediately and thoroughly if contaminated with blood or other body fluids.
Hands should be washed immediately after gloves are removed
All healthcare workers should take precautions to prevent injuries caused by needles, scalpels, and other sharp instruments
Health workers suffering from a skin condition should refrain from direct patient care and handling patient- care equipment until the condition resolves
All healthcare workers who participate in invasive procedures must routinely use appropriate barrier precautions to prevent skin and mucous- membrane contact with body fluids of all patients. Gloves and surgical masks must be worn for all invasive procedures, along with protective eyewear, gowns or aprons
All specimens of blood and body fluids should be put in a well- constructed container with a secure lid to prevent leaking during transport. Care should be taken when collecting each specimen to avoid contaminating the outside of the container