Hazards to the orthopaedic trauma surgeon: occupational exposure to HIV and viral hepatitis (a review article).

The risk of transmission of blood-borne pathogens is directly related to the prevalence of the infectious disease in the physician's patient population, the infectivity after a single exposure, and the frequency and nature of exposure. After reading this material the reader should understand the guidelines for risk prevention of human immunodeficiency virus (HIV), hepatitis B virus, and hepatitis C virus transmission as published by the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) and be better able to evaluate and choose personal protective devices for use while caring for patients. To date there have been no documented cases of HIV seroconversion from solid-bore needle puncture or aerosolized transmission from an HIV-positive patient to a physician in the operating room. However, the authors and the Orthopaedic Trauma Association urge all physicians who have sustained an occupational seroconversion to communicate with the CDC so that prevention guidelines and health-care worker protection can be improved. Regardless, all physicians performing invasive procedures must reevaluate their techniques to determine what procedures can be modified or new instruments developed to reduce the risk of exposure.