Blood and body fluid exposure and reporting behaviors among healthcare workers: a decade-long comparative study at a tertiary medical center.

Abstract

Background: Occupational exposure to blood and body fluids (BBFE) remains a significant risk for healthcare workers (HCWs), yet underreporting persists despite the implementation of institutional policies. This study aimed to compare BBFE prevalence, reporting practices, and HCWs' knowledge, perceptions, attitudes, and behaviors, and identify predictors of BBFE and failure to report incidents over a ten-year period at a tertiary medical center.

Methods: Two cross-sectional surveys were conducted at the American University of Beirut Medical Center (AUBMC) in 2013-2014 and 2023-2024. In 2013-2014, all participants completed paper-based questionnaires, whereas in 2023-2024, medical students, residents, and nurses completed online surveys, and housekeeping/laundry staff completed paper-based surveys. Descriptive comparisons and logistic regression were performed to assess BBFE prevalence, reporting behaviors, and predictors of exposure and reporting using logistic regression.

Results: A total of 299 HCWs participated (157 in 2013-2014; 142 in 2023-2024). Overall, 31.3% reported experiencing a BBFE, with housekeeping/laundry staff (48.6%) and nurses (44.6%) showing the highest prevalence (p < 0.001). The overall reporting rate was 82.6%, exceeding regional and global estimates. Lower attitude/behavior scores independently predicted BBFE occurrence (aOR = 0.665, p = 0.013), while lower perception scores predicted failure to report (aOR = 0.206, p < 0.001). No significant differences were observed in BBFE or reporting rates between cohorts, though knowledge and perception scores were higher in the 2023-2024 cohort.

Conclusion: Despite modest improvements in awareness and perception, BBFE remains a persistent occupational hazard across professional categories. High reporting rates reflect institutional progress, yet behavioral and cultural barriers to full compliance persist. Sustained efforts targeting safety culture, reporting accessibility, and psychosocial barriers are needed to achieve lasting reductions in occupational exposure.