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A Survey of Occupational Blood Contact and HIV Infection Among Orthopedic Surgeons

Jerome I. Tokars, MD, MPH; Mary E. Chamberland, MD, MPH; Charles A. Schable, MS; David H. Culver, PhD; Marsha Jones; Penny S. McKibben; David M. Bell, MD; Daniel R. Benson, MD; Joseph M. Lane, MD; James V. Luck Jr, MD; Theodore I. Malinin, MD; Carl L. Nelson, MD; William J. Robb III, MD; Dale B. Glasser, MS, MPhil; Richard N. Peterson, JD, MHA
JAMA. 1992;268(4):489-494. doi:10.1001/jama.1992.03490040065027.
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Objective.  —To study the seroprevalence of human immunodeficiency virus (HIV) among orthopedic surgeons, and correlate the results with occupational and nonoccupational risk factors. Orthopedic surgeons are one of several groups of health care workers at risk for occupationally acquired HIV infection; however, few HIV seroprevalence studies in health care workers, and none in surgeons, have been performed to assist in estimating the extent of occupational risk.

Design.  —A voluntary, anonymous HIV serosurvey at an annual meeting. To assess the representativeness of participants, a mail survey of orthopedic surgeons was conducted 5 months prior to the annual meeting.

Setting.  —The 1991 annual meeting of the American Academy of Orthopaedic Surgeons held in Anaheim, Calif.

Participants.  —United States or Canadian orthopedic surgeons in training, in practice, or retired from practice who attended the annual meeting.

Main Outcome Measures.  —Participants' HIV serostatus and reporting of occupational and nonoccupational risk factors for HIV infection.

Results.  —Of 7147 eligible orthopedists at the annual meeting, 3420 (47.9%) participated. Compared with the 10411 orthopedic surgeons responding to the mail survey, serosurvey participants had at least as many opportunities for occupational contact with blood and with HIV-infected patients. Among participants, 87.4% reported a blood-skin contact and 39.2% reported a percutaneous blood contact in the previous month. Among 3267 participants without reported nonoccupational risk factors for HIV infection, none was positive for HIV antibody (0%; upper limit of the 95% confidence interval [CI] = 0.09%); among 108 participants with reported nonoccupational HIV risk factors, two were positive for HIV antibody (1.9%; upper limit of the 95% CI = 5.7%).

Conclusion.  —Although these findings may not be generalizable to all orthopedic surgeons, we found no evidence of HIV infection among serosurvey participants without nonoccupational risk factors. The high rates of self-reported blood contact underscore the importance of compliance with infection control precautions and of development of new techniques and equipment to minimize the risk of exposures to blood during surgical procedures.(JAMA. 1992;268:489-494)


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