Global prevalence of percutaneous injuries among healthcare workers: a systematic review and meta-analysis

BACKGROUND: Healthcare workers (HCWs) are at risk of occupational exposure to blood-borne pathogens through contact with human blood and other body fluids. This study was conducted to estimate the global and regional 1-year prevalence of percutaneous injuries (PCIs) among HCWs.

METHODS: We systematically searched EMBASE, PubMed, CINAHL and PsychInfo databases for studies published from January 2008 to January 2018 that reported the prevalence of PCIs among HCWs. A random-effects meta-analysis was conducted to estimate pooled prevalence of PCIs among HCWs.

RESULTS: Of the 5205 articles identified, 148 studies from 43 countries met the inclusion criteria. The pooled global 1-year prevalence estimate of PCIs was 36.4% [95% confidence interval (CI): 32.9-40.0]. There were substantial regional variations in the 1-year prevalence of PCIs, ranging from 7.7% (95% CI: 3.1-12.4) in South America to 43.2% (95% CI: 38.3-48.0) in Asia. The estimates for Africa and Europe were comparable with values of 34.5% (95% CI: 29.9-39.1) and 31.8% (95% CI: 25.0-38.5), respectively. The highest 1-year prevalence by job category was among surgeons, at 72.6% (95% CI: 58.0-87.2). The estimates for medical doctors (excluding surgeons), nurses (including midwives) and laboratory staff (including laboratory technicians) were 44.5% (95% CI: 37.5-51.5), 40.9% (95% CI: 35.2-46.7) and 32.4% (95% CI: 20.9-49.3), respectively. PCIs commonly occurred among HCWs working in hospital (41.8%, 95% CI: 37.6-46.0) than non-hospital (7.5%, 95% CI: 5.9-9.1) settings.

CONCLUSIONS: Our findings suggest high rates of PCIs among HCWs with direct patient care across many regions of the world. However, paucity of data from some countries was a major limitation.