Estimates of the Risk of Endemic Transmission of Hepatitis B Virus and Human Immunodeficiency Virus to Patients by the Percutaneous Route During Invasive Surgical and Dental Procedures (Draft)

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body; 3) I tinoz punctUr
instrument, resi.41ting.n bleed4
body cav ity; 4) contact QP a
f rom a MCW' Is exudativ..,e dermnat
contact wit,,h t ]e blcd of a HCW
inadeqite sterilzation or dis
in irvasi-vp >:duss
Tn 6pr~ ~:t~ve utdiis,;thep
o b at e tric;,,- prc'!cedures during wj
surgi e~, xTerien:ed a per
5.4%The proport."oh
in wirl ~~ rt may haVe bee
unknown. -. *Aa rmore A-eqent 'pr*
conducted ni 4 h sp -a Is, prei4
more percut ar~sous1injwries occiw
during 96 '6.9%';of 13 2 Opert
surgery, qvrecolcqgy, orthoipe.4
The mean rate of, injuy i u l45t
-^atient -b1cod fot a si-1 gre n
(r*-ange anq athe',speci i
the A sapojCcausi
open wcr,1.r,, resuItiflg Ti
~ater 4 me ~cw'n a a
range amocT s z), -ta.s 4
Were -:I Qse'd by ztu ee
wres, and one e'ach wa
S t ai e ctun, ' 2 a retr c
S a wel
P.nic t bc -n:.m=unize 9
C f 1ECW& h Vaye. -
A Xpr 6 tey % f h
V 3 ifcton;
-LonSS.C f 1i BV t'M "infect
a. been r "- ortxe,.,.iz.several e
s4,jtuatftons, Sinco th e int: od ct.
I n t~e el11970s, Zl

6$ theICWsa skin with-a sharp
4~o a Patient's open woundo
*open wound with'exudate,OU or skin lesions 7~,nother patient) 'throug
- of -reusable devices, used,
0 M aof surgical or
Icb,-at least one 'Member c~f the.
'n, OUs'injury ranged.from.3
'tteesurgical proce.u 7!
ieposed'to the HCW b,: t1Q4 is
~e~iveCDC observationa.l ~i4
L at indicate that,", or;0I
4i!4 a:,=ng zsurgical perso,
a~4rs on tegm~
=Oe nd them I; srgeon-prooedux~
~~4,ad" 6)aTh bervers tot* a
'ti~'y recont cte1 the patjetL
iilpercut'neusexposure, of 'the
i"$. (32%k) fL the 88 obsarvod
Iq, iurg: cal 'spec'ialt ies. 8-57% V
O these2a injuries, 21 7%
(11) wrecaused by surgidal
settingsl
'ad kcu oxa is~fr WaW s
to five fold higher vj
ah gceneral Population
IveS Serol'o'gic evidence of
~f06%are HBV carrir

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