OCCUPATIONAL BLOOD AND BODY FLUID EXPOSURE AMONG HEALTHCARE WORKERS IN HOSPITAL, DENTAL, LABORATORY, AND PREHOSPITAL EMS SETTINGS: PREVALENCE, RISK FACTORS, AND EFFECTIVENESS OF PREVENTION STRATEGIES; A SYSTEMATIC REVIEW AND META-ANALYSIS

ABSTRACT

Background: Occupational exposure to blood and body fluids (BBF) via needlestick/sharps injuries (NSIs) and mucocutaneous splashes remains a persistent safety problem across hospitals, dental clinics, laboratories, and prehospital emergency medical services (EMS), with substantial underreporting and preventable causes. Methods: A PRISMA-aligned systematic review was drafted using studies retrievable from PubMed-indexed sources and open-access full texts, plus Cochrane evidence for prevention strategies. Databases planned: PubMed, Scopus, Web of Science Core Collection, and Cochrane Library. Eligible study designs included original observational studies in hospital, dental, laboratory, and EMS settings reporting BBF/NSI/splash prevalence and determinants and prevention practices. A random-effects meta-analysis was performed on the subset reporting a comparable 12-month NSI outcome. Results: Ten original studies were included (2018 to 2025) in Saudi Arabia, UAE, India, China, Yemen, South Africa, the Netherlands, and the USA. Reported one-year NSI prevalence in hospital-based samples ranged from 19.7% to 31%. The pooled random-effects estimate for 12-month NSI prevalence across three hospital-based studies was 24.0% (95% CI 18.4–30.8), with substantial heterogeneity (I² 76%). Underreporting was frequent (53.8% not reporting the last event in one Saudi study). Dental BEAs were commonly linked to anaesthetic needles and instrument clean-up, and dentists reported less often than non-dentists. In EMS, memorable BBF exposure during career could be high, with NSI and eye splashes prominent. Cochrane evidence suggests education and some protective strategies reduce injuries, but certainty is generally low to very low. Conclusion: BBF/NSI/splash exposures remain common across settings, driven by workflow factors, unsafe practices, and gaps in reporting culture. Prevention should integrate engineering controls, targeted training, PPE/eye protection, reporting facilitation, and vaccination access.

Keywords: Needlestick injury; sharps injury; mucocutaneous splash; blood and body fluid exposure; healthcare workers; dental; laboratory; emergency medical services; underreporting; prevention; safety-engineered devices; post-exposure prophylaxis.