Main Article Content
Specialist surgeons are at high risk of exposure to hepatitis viruses through occupational exposure to blood or body fluids. Protective measures against occupational exposure to the hepatitis B virus (HBV) and hepatitis C virus (HCV) must be taken in order to prevent infection in surgeons. We aimed to determine the needlestick injuries, and markers HBV and HCV in Iranian surgeons.
This study was cross-sectional research, performed in Baqyatallah, Shohada, Rasoul Akram, Sina, Taleghani, and Emam Hossein hospitals (all university hospitals) of Tehran, Iran. Overall 318 eligible surgeons were included. Anonymous questionnaires were used containing data about demographic characteristics, self-reported blood and needlestick contacts, occasional exposures, risk behaviors and vaccination. Also, the blood samples were taken and tested for hepatitis B surface antigen (HBsAg), antibody against Hepatitis B surface antigen (antiHBs) and HCV antibody (HCVAb). Fisher exact test and Kruskal Wallis test were used to analyze the data.
The mean age of the surgeons was 47.76 ± 8.95 years and 177 of them (55.66%) were male. The average number of needle–sticks was 28.28 ± 16.58 during the surgeons’ working life. Among them, 5 cases (1.59%) were positive for HBsAg and 2 cases (0.66%) were positive for HCVAb.
In spite of the high needlestick rate in Iranian surgeons, prevalence of hepatitis B and C is not very high among them. A high degree of vigilance and a careful surgical technique is the only means available to prevent the transmission of the viruses.
Center for Disease Control and Prevention. What is viral hepatitis? Atlanta : Center for Disease Control and Prevention;2020.
Westermann C, Peters C, Lisiak B, Lamberti M, Nienhaus A, Harling M. The prevalence of hepatitis C among healthcare workers: a systematic review and meta-analysis. Occup Environ Med 2015 ;72:880-8. doi: 10.1136/oemed-2015-102879.
Mohammadi Z, Keshtkar A, Eghtesad S, et al. Epidemiological profile of hepatitis B virus infection in Iran in the past 25 years; a systematic review and meta-analysis of general population studies. Middle East J Dig Dis 2016;8:5-18. doi: 10.15171/mejdd.2016.01.
Shakeri MT, Foghanian B, Nomani H, et al. The prevalence of hepatitis B virus infection in Mashhad, Iran: a population-based study. Iranian Red Crescent Med J 2013;15:245-8. doi: 10.5812/ircmj.8200.
Merat S, Rezvan H, Nouraie M, et al. Seroprevalence of hepatitis C virus: the first population-based study from Iran. Int J Infect Dis 2010;14:e113-e6. DOI: https://doi.org/10.1016/j.ijid.2009.11.032.
Park H, Jeong D, Nguyen P, et al. Economic and clinical burden of viral hepatitis in California: a populationbased study with longitudinal analysis. PLoS ONE 2018;13: e0196452. https://doi.org/10.1371/journal.pone.0196452
Kermani FR, Hosseini KM, Kafi-Abad SA, Mansournia MA, Sharifi Z, Maghsudlu M. Hepatitis C (HCV) viremic rate and its correlation to demographic factors among HCV confirmed Iranian blood donors. Arch Iran Med 2019;22:76-7.
Alavian SM. Hepatitis B virus infection in Iran: changing the epidemiology. Iranian J Clin Infecti Dis 2010;5:51-61.
Razavi-Shearer D, Gamkrelidze I, Nguyen MH, et al. for Polaris Observatory Collaborators. Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study. Lancet Gastroenterol Hepatol 2018;3:383-403. doi: 10.1016/S2468-1253(18)30056-6.
Nelson NP, Easterbrook PJ, McMahon BJ. Epidemiology of hepatitis B virus infection and impact of vaccination on disease. Clin Liver Dis 2016;20: 607–28. doi: 10.1016/j.cld.2016.06.006.
Al-Abhar N, Moghram GS, Al-Gunaid EA, Al Serouri A, Khader Y. Occupational exposure to needle stick injuries and hepatitis B vaccination coverage among clinical laboratory staff in Sana’a, Yemen: cross-sectional study. JMIR Public Health Surveill 2020;6:e15812. DOI: 10.2196/15812.
Raimondo G, Locarnini S, Pollicino T, et al. Update of the statements on biology and clinical impact of occult hepatitis B virus infection. J Hepatol 2019 ;71:397-408. DOI: https://doi.org/10.1016/j.jhep.2019.03.034.
Li M, Wang Z, Zhang L, Zheng H, Liu DW, Zhou MG. Burden of cirrhosis and other chronic liver diseases caused by specific etiologies in China, 1990–2016: findings from the Global Burden of Disease Study 2016. Biomed Environ Sci 2020; 33:1-10. doi: 10.3967/bes2020.001.
Naglik J, Fay GG. Prevention and management of occupational exposures. In: DePaola L, Grant L. eds. Infection control in the dental office. Cham (Swizerland): Springer;2020. https://doi.org/10.1007/978-3-030-30085-2_9.
Le MH, Yeo YH, Cheung R, Henry L, Lok AS, Nguyen MH. Chronic hepatitis B prevalence among foreign born and US born adults in the United States, 1999-2016. Hepatology 2020;71: 431-43. doi: 10.1002/hep.30831.
Mbaawuaga EM, Hembah-Hilekaan SK, Iroegbu CU, Ike AC. Hepatitis B virus and human immunodeficiency virus infections among health care workers in some health care centers in Benue State, Nigeria. Open J Med Microbiol 2019;9:48-62. DOI: 10.4236/ojmm.2019.92007.
Coppola N, De Pascalis S, Onorato L, Calò F, Sagnelli C, Sagnelli E. Hepatitis B virus and hepatitis C virus infection in healthcare workers. World J Hepatol 2016;8:273-81. doi: 10.4254/wjh.v8.i5.273.
Sadlier C, O’Rourke A, Carr A, Bergin C. Seroepidemiology of hepatitis A, hepatitis B and varicella virus in people living with HIV in Ireland. J Infect Public Health 2017 ;10:888-90. doi: 10.1016/j.jiph.2017.01.019.
Motaarefi H, Mahmoudi H, Mohammadi E, Hasanpour-Dehkordi A. Factors associated with needlestick injuries in health care occupations: a systematic review. J Clin Diagn Res 2016;10:IE01-4. doi: 10.7860/JCDR/2016/17973.8221.
Yang AD, Quinn CM, Hewitt DB, et al. National evaluation of needlestick events and reporting among surgical residents. J Am Coll Surg 2019; 229:609-20. doi: 10.1016/j.jamcollsurg.2019.09.001.
Ishak AS, Haque MS, Sadhra SS. Needlestick injuries among Malaysian healthcare workers. Occup Med (Lond) 2019;69:99-105. doi: 10.1093/occmed/kqy129.
Prester E, Diab-El Schahawi M, Lusignani LS, Paula H, Reilly JS. Blood-borne viruses: HIV, hepatitis B, and hepatitis C. Prester E, Diab-El Schahawi M, Reilly JS, eds. In: Basic microbiology and infection control for midwives. Cham (Switzerland): Springer Nature Switzerland AG; 2019. p.143-49.
Shakeri MT, Nomani H, Ghayour Mobarhan M, et al. The prevalence of hepatitis C virus in Mmashhad, Iran: a population-based study. Hepat Mon 2013;13:e7723. doi: 10.5812/hepatmon.7723.
Merat S, Rezvan H, Nouraie M, Jafari E, Abolghasemi H, Radmard AR, et al. Seroprevalence of hepatitis C virus: the first population-based study from Iran. Int J Infect Dis. 2010;14 Suppl 3:e113–6. doi: 10.1016/j.ijid.2009. 11.032.
Zamani F, Sohrabi M, Poustchi H, et al. Prevalence and risk factors of hepatitis C virus infection in Amol city, North of Iran: a population-based study 2008-2011. Hepat Mon 2013; 13: e13313. doi: 10.5812/hepatmon.13313.
Fisher WD. Hepatitis C and the surgeon. J Can Chir 2013;56:80-1. DOI: 10.1503/cjs.000912.