Biological Hazards of Being in the Medical Field

This is the first part in a multi-part series of hazards within the medical field.

A healthcare worker (HCW) is anyone who works in a healthcare or social care setting, including healthcare students on clinical placement, frontline healthcare workers, and other healthcare workers not in direct patient contact.

HCWs deliver care and services to the sick directly as doctors and nurses or indirectly as assistants, technicians, aides, or medical waste handlers. Many studies focus on patients' well-being and quality of care, but little attention has focused on the well-being of HCWs. 

Galen, the Greek physician (130-200 AD), once said, “The physician will hardly be thought very careful of the health of his patients if he neglects his own.” 

HCWs undertake their jobs in different workplaces in the hospital and are, therefore, potentially exposed to many sources of infection, including biological, chemical, and ergonomic hazards and hazardous drugs and radiation. 

Laboratory workers are exposed to biological hazards while collecting or processing biological materials, while physicians and nurses are especially exposed when they perform surgical or invasive procedures, treat wounds, or take body fluid samples. 

The following article breaks down the various biological hazards in the medical field. 

Bloodborne Risks

HCWs must treat body fluids from all patients as if they were infectious, whether or not they confirm an infection. This practice is called standard precautions and includes hand hygiene, use of personal protective equipment (PPE), safe injection practices, safe handling of potentially contaminated equipment or surfaces, and respiratory hygiene. 

Regardless, the most common bloodborne risks working as an HCW are Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency Virus (HIV) infections. 

The World Health Organization (WHO) estimated that HCWs experience approximately 16,000 HCV infections, 66,000 HBV infections, and 1,000 HIV infections every year globally from needlestick injuries (NSIs).

Latex

Natural latex rubber (NLR) gloves NLR gloves are the latex product most commonly used in the healthcare industry. Although they prevent exposure to bloodborne pathogens, some healthcare workers, patients, and visitors may be allergic to NLR and need to be protected.

The allergic response to NLR generally is a reaction to the protein in NLR and/or the chemicals used in the manufacturing process. NLR contains more than 200 identified allergens.

Other common medical devices that may contain NLR are blood pressure cuffs, bulb syringes, catheters, dental coffer dams, elastic bandages, electrode pads, endotracheal tubes and airways, enema syringes, ventriculoperitoneal shunts, finger cots, IV-access injection ports, manual resuscitators, Penrose surgical drains, pulse oxymeters, stethoscope tubing, stretcher mattresses, tourniquets, and vascular stockings. N

Medical Waste

The term “medical waste” refers to a subset of wastes generated at healthcare facilities, such as hospitals, physicians' offices, dental practices, blood banks, medical research facilities, and laboratories. 

Generally, medical waste is healthcare waste contaminated by blood, body fluids, or other potentially infectious materials. 

Medical waste treatment typically involves four main goals: inactivate or destroy infectious pathogens or microbes, destroy sharps, render waste unrecognizable for ethical and confidentiality considerations, and reduce the volume of waste.

Burning medical waste emits pollutants such as dioxins, furans, hydrochloric acid, sulfur dioxide, nitrogen oxides, lead, mercury, and cadmium. But these contaminants pose a significant threat to hospital workers, residents of the surrounding communities, and the environment. 

MRSA

Staphylococcus aureus (S. aureus) or “staph” is a pathogen found on human skin, in the nose, armpit, groin, and other areas. While these germs don’t always cause harm, they can make you sick under the right circumstances.

S. aureus strains, resistant to most antimicrobials, are increasingly prevalent in the hospital environment. Methicillin-resistant Staphylococcus aureus (MRSA) causes one type of staph infection that can be difficult to treat due to its antibiotic resistance.

MRSA is responsible for increased mortality in hospital inpatients and preventing nosocomial infections is a priority area in various high-prevalence settings. 

MRSA colonization takes place in 4.6% of HCWs, especially those with poor infection control practices, those with chronic skin diseases, and those working in countries where MRSA is highly endemic. About 5.1% of HCWs are symptomatic,

Tuberculosis and Other Airborne Diseases

Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB can attack any part of the body, such as the kidney, spine, and brain.

TB is transmitted through airborne particles called droplet nuclei, formed when individuals with pulmonary or laryngeal TB cough, sneeze, shout or sing.

The annual rate of tuberculosis infection in healthcare workers varies from 0.1% to 2% in unexposed hospital personnel compared to 1 to 10% among highly exposed HCWs. Administrative areas, outpatient and inpatient medical services, inpatient infectious services, surgical services, and laboratory services vary according to the risk. 

Overall, the well-being and safety of HCWs must be acknowledged and changed at both the administrative and institutional levels.