Ann R Coll Surg Engl 2007; 89: 276-280 276Hepatitis C viral transmission is an important issue in orthopaedic surgery since there are no known vaccines or effective prophylaxis. Orthopaedic surgeons are at risk of sharps injuries and, therefore, at risk of occupationally acquired viral transmission. Controversy exists as to whether hepatitis C infected surgeons should be transferred to lowrisk duties. 1The prevalence of hepatitis C infection is 0.07-1.4% in the general population, 2 although the prevalence of hepatitis C infection in a high-risk group, such as intravenous drug abusers, is much higher (44%).3 Studies have shown healthcare workers are at an increased risk of acquiring hepatitis C infection. 4 The average risk of hepatitis C seroconversion following sharps injury from a hepatitis C positive donor has been quoted as up to 10%.5 When 3411 orthopaedic surgeons attending a recent conference were anonymously tested for hepatitis C, 0.8% were found to be infected. This rose to 1.4% with increasing age of the surgeon. 6 The aims of our questionnaire study (Appendix 1) were to determine orthopaedic surgeons' perceptions and attitudes regarding the risks of hepatitis C viral infection as well as the precautions used against infection. It was hoped this paper would stimulate debate regarding the role of routine testing of patients and surgeons. Materials and MethodsAnonymous questionnaires were sent to all orthopaedic surgeons who were listed in the British Orthopaedic Association Handbook (2004) as members of the British Hip Society (BHS), British Trauma Society (BTS), British Association of Surgeons of the Knee (BASK) and British Society of Surgeons of the Hand (BSSH). The aim was to obtain a cross-section of sub-specialities in order to assess orthopaedic surgeons' perceptions as a whole. A total of 763 questionnaires were sent with 261 (34.2%) being returned within the designated period of 1 month. Twelve replies were from surgeons retired from practice, these being excluded from analysis. Therefore, 249 questionnaires were used in the analysis. ResultsThe mean age of respondents was 50.7 years (range, 32-71 years), although 5 gave no answer. The mean number of