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Abstract

Introduction: Healthcare workers (HCWs) face numerous workplace injuries, including blood and body fluid exposure (BBFE), which can impact their physical and mental health. The epidemiology of reported BBFE among HCWs in Vancouver Coastal Health was examined, along with prescribed post-exposure prophylaxis (PEP), completeness of follow-up, and coding for prevention. Methods: All data were derived from the Workplace Health Information Tracking and Evaluation (WHITEtm), where BBFEs are recorded, either following receipt of laboratory results or upon a staff member calling the Provincial Workplace Health Service. Poisson regression modeling with generalized estimating equations was used to estimate the relative risk of reported BBFE across various occupations from 2013 to 2023, stratified by pre/post- COVID-19 period. Workflows were verified with the operational personnel involved. Results: A total of 3,859 blood tests related to BBFE were recorded (17.9/1,000 PY); 1,020 reports were coded as BBFE, and 2,394 BBFE reports were identified through manual matching. Additionally, 291 BBFE reports had no associated blood tests. Medical residents consistently had the highest incidence rates in both pre/post- COVID-19 periods, followed by Registered Nurses. This was also reflected in the regression results, which showed that Residents had a significantly higher risk of reported BBFE in both periods compared to Registered Nurses. Other job groups had significantly lower risk. Older HCWs had significantly lower risks compared to those under 30. Follow-up proportions were low, even among BBFE cases exposed to infected sources and/or prescribed PEP. These findings may reflect either incomplete documentation or incomplete follow-up. No seroconversions were reported among BBFE cases that were followed up. Of reported exposures, 5.2% (n = 192) were prescribed PEP. Most had percutaneous injuries (85.4%), mainly from needlesticks (82.9%). Exposures leading to PEP occurred primarily during surgical procedures (38%) and injection-related activities (32.3%). Over half (58.1%) of injection-related exposures occurred during disposal or while preparing equipment for disposal. Conclusion: The findings suggest opportunities to strengthen primary and secondary prevention of BBFE. Standardized coding of BBFE reports and tailored trainings can help guide prevention efforts. A more structured approach to post-exposure management could help improve continuity of care and support effective occupational health surveillance.