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A new European Union (EU) Directive has been introduced to prevent needlestick injuries and transmission of blood-borne pathogens, including hepatitis B virus (HBV), to healthcare workers (HCWs). It proposes an integrated approach establishing policies in risk assessment and prevention, training, information, awareness raising, and monitoring.
Methods
A cross-sectional survey among 25 EU Member States (MS) on current policies regarding post-exposure management of needlestick injuries for HBV and HBsAg-positive HCWs
Results
Answers were received from 17 MS, representing 89% of the population and 90% of HCWs in the EU-25. For post-exposure management, national or international guidelines were followed by 16 MS. For HCWs not vaccinated against HBV, 15 MS recommended hepatitis B immunoglobulin (HBIg) administration and vaccination. For vaccinated HCWs without known post-vaccination serology, serology (mostly combined with other measures) was recommended in 10 MS. For fully vaccinated HCWs with anti-HBs >= 10 mIU/ml, no additional measures were recommended in 10 MS. For non-responders, 7 MS recommended HBIg and HBV vaccination; 6 MS recommended vaccination only. For management of HBsAg-positive HCWs national guidelines were available in 8 MS. In 12 MS restrictions to perform duties applied; in 8 MS exposure-prone procedures (EPPs) were explicitly mentioned. HBV DNA testing was available in 16 MS, but only 4 had defined a limit above which restrictions would apply. Only 8 MS answered the question on implications for the HCWs’ career: in 6 MS no EPPs would be allowed; in 2 MS no EPPs would be allowed until cleared below a given limit (1000 copies/ml)
Discussion
These results, representing the large majority of EU MS, show the variable way EU legislation is translated into practice in different MS. More consultation between key actors from MS at EU level could optimise the way this matter is dealt with. This can contribute to further reducing HBV transmission to HCWs