100720 - Occupational blood and body Fluid exposure among hospital staff: epidemiological profile, mechanisms and psychological impact

Occupational blood and body fluid exposure (BBE) represents a major professional risk for healthcare workers (HCWs), exposing them to transmissible viral infections and significant psychological distress. This study aims to describe the sociodemographic, professional, and clinical characteristics of HCWs who sustained a BBE, as well as the post-exposure management protocols observed within a Tunisian university hospital.

A retrospective descriptive study was conducted at the Occupational Medicine Department of Sahloul University Hospital, including healthcare professionals who sought consultation following a BBE between 2022 and 2024. Data were analyzed using medical records and occupational accident registries. Variables studied included sociodemographic characteristics, professional context, circumstances of the accident, post-exposure management, and psychological impact evaluated using the PCL-5 (Post-Traumatic Checklist) score.

The study included 140 workers, of whom 72.9% were women, with a mean age of 30.8 years (± 5.4 years). More than half of the participants (52.9%) were under the age of 30. The majority worked in medical and surgical wards (73.6%). Physicians accounted for 78.6% of the cohort, followed by nurses (13.6%) and senior technicians (4.3%). Most accidents occurred in 2023 (41.4%) and during shift work (85.7%).The predominant mechanism of injury was needlestick injury with a used needle (84.3%), followed by mucosal splashes (9.3%) and cuts by sharp objects (6.4%). These BBEs most frequently occurred during routine bedside care (72.1%), followed by invasive surgical procedures (10%), and needle recapping (7.1%). All victims sought emergency department care for initial treatment and evaluation. Post-accident, 93.6% performed immediate washing with soap and water, and 22.1% applied an antiseptic. Regarding source patients, serology was known and negative for HIV in 70%, HCV in 68.6%, and HBV in 62.1% of cases. Among the victims, 75% were immunized against HBV, while 25% were not. The most frequent post-exposure management was biological surveillance (35%), followed by an HBV vaccine booster (18.6%); only one case required HIV post-exposure prophylaxis (0.7%). No accidents resulted in initial sick leave. However, 5% of victims reported psychological repercussions, and 3.6% presented with confirmed Post-Traumatic Stress Disorder according to the PCL-5 scale (mean score: 0.99± 3, 08). The most frequently observed criteria were intrusive re-experiencing symptoms (1.3± 3.4) and negative alterations in cognition and mood (0.9 ±2.6).

BBEs remain frequent among young healthcare professionals, occurring primarily during routine care via percutaneous exposure. Despite good compliance with first-aid measures and mostly satisfactory vaccination coverage, post-exposure follow-up remains insufficient, and the psychological impact is underestimated. Strengthening preventive training, promoting a workplace safety culture, and providing psychological support are essential to reducing the incidence and consequences of these accidents.