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)

~Sm~a ~ wiVesfo ~e~t3.Wor r s(~ ral. surgeons,
d e ni~ derntil hygienists) a4;.C- *pared by the; laCk of
prcspev St,.idi4Aes of th fre x'0Y. pruaes n ris
these wcr and th epe r en t ~4 h4njuries which result in::Pneusinuresin
po~~i' ~co r ota Pat i ent, worker's blood. ILacin
S1 st vd e So it is diiciult tYiza t e the risk to a patient
f. nde r C' cn5 a invas~ve procoe~s,, an HIV-infected dental,
wcorksr. A ~ a data per't l.,,it,'y 4,,- a,indireot estimate4 If a
strP, f-ormsappro~imately 3 0%,ocQ4dut' prye having
r t e rti2.4 "exposure to bipod" of 4 Vstie4nt (calculated f rom
-i r fcyv reser+,ted by itha Amerc~d~n4 Dental Association at
rcu11a t n a 1Safety anO Hetalt,,4 staion hearings, 1989) nd
h a 12 T' erUtaneous nrjurl~eu, * ro (based on a retrospective
q'eto4aresre,t1e, a fprcutaneous inuy a.~
17 ~ i e 4 s0.4 per 100 rc4 Asuriflg that the per6en f
i~ Th~h te ~h j trecntacts the patient:~
s~ urgeons (32V) ite risk of HIV transmis n
S -CIut arP 0U S 0XP U~ to;-HIV-i~ftected blood is.0.31% the
~ bo~, re r kbv ten er roeur s 000t
r, S r703- 000Orf 2/23157. heeore. t
pruacd, thpoent. -t to bloper perfouredis1 by004e~
n t s-t3 - A r 1 1. 14 b0',eativ~ted (Table 2).
r ~ ~ n-alal f act0~o this 'horeti cal patient PO,low -ev~e AD ~rfoe t is possibleathat thlo"
~'~~c- rin4fection in$h~sn o~~mii untecteAby
'frtensi tad, with.43V durLig invasive
IF? ermcd b t~ ositive sur~ea.,s and dntit zo
>'can a.L b ~t~ed sn a different approachb e
v-rthe T ~o e *1 nce in, these occupational grop Tb.
3\ ~rmc 24~C~0 r~ors in the U-S., 0 6% are sistimated t e
- of these, 20% are est,rated to be positv o
hepaiti B ~;i~.gn (DCunpulised ata) Th ~4'HI

est.1na t ed i n asimilar"mane th o h*Z
0.32 prob "bii I WO
0;.02 or. 0....