Surgical Procedure Characteristics and Risk of Sharps-Related Blood and Body Fluid Exposure.


OBJECTIVE To use a unique multicomponent administrative data set assembled at a large academic teaching hospital to examine the risk of percutaneous blood and body fluid (BBF) exposures occurring in operating rooms. DESIGN A 10-year retrospective cohort design. SETTING A single large academic teaching hospital. PARTICIPANTS All surgical procedures (n=333,073) performed in 2001-2010 as well as 2,113 reported BBF exposures were analyzed. METHODS Crude exposure rates were calculated; Poisson regression was used to analyze risk factors and account for procedure duration. BBF exposures involving suture needles were examined separately from those involving other device types to examine possible differences in risk factors. RESULTS The overall rate of reported BBF exposures was 6.3 per 1,000 surgical procedures (2.9 per 1,000 surgical hours). BBF exposure rates increased with estimated patient blood loss (17.7 exposures per 1,000 procedures with 501-1,000 cc blood loss and 26.4 exposures per 1,000 procedures with >1,000 cc blood loss), number of personnel working in the surgical field during the procedure (34.4 exposures per 1,000 procedures having ≥15 personnel ever in the field), and procedure duration (14.3 exposures per 1,000 procedures lasting 4 to <6 hours, 27.1 exposures per 1,000 procedures lasting ≥6 hours). Regression results showed associations were generally stronger for suture needle-related exposures. CONCLUSIONS Results largely support other studies found in the literature. However, additional research should investigate differences in risk factors for BBF exposures associated with suture needles and those associated with all other device types. Infect. Control Hosp. Epidemiol. 2015;37(1):80-87.





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Publication Info

Myers, Douglas J, Hester J Lipscomb, Carol Epling, Debra Hunt, William Richardson, Lynn Smith-Lovin and John M Dement (2016). Surgical Procedure Characteristics and Risk of Sharps-Related Blood and Body Fluid Exposure. Infect Control Hosp Epidemiol, 37(1). pp. 80–87. 10.1017/ice.2015.233 Retrieved from

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Hester Johnstone Lipscomb

Professor Emeritus in Family Medicine and Community Health

Research Interests
Broad research interests:
Health Disparities
Injury Epidemiology
Occupational Epidemiology
Intervention evaluation - use of conceptual frameworks, latency of effect

More specific current interests:
Occupational injuries and disorders of construction workers.
Injuries associated with pneumatic nail guns
Safety policy 

Musculoskeletal disorders (MSDs) of occupational origin, as well as the effect of MSDs on the ability to work; special interest in back disorders.

Classification of MSDs, episodes of care; problems with use of ICD9 codes for classification of MSDs related to epidemiologic research. Integration of latency into epidemiologic models assessing work related musculoskeletal disorders.

Occupational violence 

Work-related falls.

Vulnerable work populations.


Carol Ann Epling

Assistant Professor in Family Medicine and Community Health

William James Richardson

Professor of Orthopaedic Surgery
  1. Current research includes investigation of biomechanical aspects of cervical injury with head impact. This involves cadaveric work with high-speed photography and load cells to ascertain the mechanism for spinal fractures.

    2. An animal model is being used to evaluate the biomechanics of cervical laminectomy versus laminoplasty compared to the normal spine. A portion of the animals are developing myelopathy secondary to instability after the surgical procedure and this is being evaluated with MRI scanning as well as mechanical and radiographic testing.

    3. Studies are being performed to develop an impedance pedicle probe to aid safe insertion of pedicular instrumentation in the lumbar spine. Ongoing studies are being performed to define the optimal frequency for the probe to yield the most sensitive and specific device. Hopefully this will lead to development of a device for human use. Studies will compare impedance probe to currently used EMG techniques to see if combing them will lead to greater sensitivity and specificity.

    4. Studies are being completed on testing particular pull-out strength and doing a multi-varied analysis looking at size of the pedicle and bone density by two different techniques.

    5. Current work is ongoing to develop an outcomes instrument and database to be used in the outpatient setting for patients with spinal complaints, both cervical and lumbar. The device will be used to evaluate clinical effectiveness for a variety of treatments for spinal conditions and to look at patient satisfaction issues.

Lynn Smith-Lovin

Robert L. Wilson Professor Distinguished of Sociology

I study emotion, identity, and action. I’m interested in the basic question of how identities affect social interaction. I use experimental, observational, survey and simulation methods to describe how identities, actions and emotions are interrelated. The experiments I do usually involve creating social situations where unusual things happen to people, then seeing how they respond behaviorally or emotionally. I observe small task group interactions to see how identities influence conversational behavior. My survey work often focuses on gender and other social positions that influence the groups and networks in which people are imbedded. My simulations studies involve affect control theory, a mathematical model of how identities, actions and emotions affect one another. Now, I’m putting affect control theory together with McPherson’s ecological theory of affiliation to show how social systems, identities, and emotional experience are connected.


John McCray Dement

Professor Emeritus in Family Medicine and Community Health

Research interest focus on occupational and environmental epidemiology including exposure assessments for epidemiological studies. Exposure assessments involve the development of new and innovative exposure assessment methods and application of these methods to cohort and case-control studies of exposed populations. Research topics include occupational lung diseases and occupational and environmental carcinogens such as asbestos fibers, man-made fibers, and benzene. Epidemiological studies involve the development of quantitative risk estimates for occupational diseases among cohorts of workers exposed to substances such as asbestos. Other ongoing occupational lung disease studies include assessments of exposures and lung diseases among construction workers at Department of Energy nuclear facilities. The objective of this research is to identify possible occupational and personal factors related to the risk of lung diseases such as asbestosis, silicosis, and COPD.

Construction industry health and safety research is another area of research focus. This research includes development of epidemiological surveillance methods for work related diseases and injuries using existing data sources such as medical claims and worker compensation data. Work related musculoskeletal diseases among carpenters are currently being studied in collaboration with the United Brotherhood of Carpenters.

Other ongoing research includes the development and implementation occupational safety and health surveillance systems for health care workers. The objective of this research is to develop, implement, and evaluate a model surveillance program which can be implemented in other health care settings. This project involves both population-based and case-based surveillance strategies. Surveillance and prevention programs for workplace violence experienced by health care workers is a research interest,

Prevention and management of diabetes and cardiovascular diseases among workers participating in multi-employer health funds is a current area of research interest.

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