Perceptions of Orthopaedic Surgeons Regarding Hepatitis C Viral Transmission: A Questionnaire Survey

Abstract

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

The Prevalence of Accidental needle Stick Injury and their reporting among healthcare Workers in orthopaedic Wards in General hospital Melaka, Malaysia

“…8 The mean exposure rate among the orthopaedic surgeons is 1.4 per year with only 33 % reporting the incident. The reason for not reporting was identified as a perceived low risk of the patient carrying the blood borne infections and possible stigmatization and loss of employment [9][10] .…”

Hepatitis C and the surgeon

“…In actual fact, the risk of transmission from an infected person is much greater for hepatitis C, which has been reported to be as high as 10% but is more likely about 2%, than for HIV, which is reported to be about 0.3%. 3 The consequences of infection are compounded by the fact that both the early and later stages of the infection can be relatively asymptomatic. Despite the dangers of hepatitis C exposure and infection, few recommendations have been put forward for events after surgeon exposure.…”

Surgeons’ Perception to Needle Stick Injuries and Transmission of Blood Borne Viral Infections

“…Majority of the surgeons attributed this to excessive paperwork, too time consuming a process of reporting, and that the risk of transmission of viruses is low since they have received vaccination against HBV in the past However, the risk of viral transmission for HCV and HIV is quite significant with an average seroconversion rate of 3% for HCV and 0.3% for HIV [4][5][6]. Wallis et al have documented in their study that the orthopedic consultants found this reporting system far too complex to report incidences of percutaneous exposure [7]. This was a small, retrospective study confined to only one tertiary care centre and we could not rule out some degree of recall bias to the study.…”