Frequency and social cognitive determinants of Biosafety Level 2 laboratory workers' hand hygiene behaviors.

摘要

Laboratory workers engaged in Biosafety Level 2 (BSL-2) research are at increased risk of being infected with disease-causing microorganisms when compared to the general public and when compared to clinical laboratory workers. The cause of most laboratory-acquired infections is unknown, but evidence suggests that hand transmission may be the single most important route of exposure at BSL-2. Paradoxically, little research has been done to determine the nature of laboratory workers' hand hygiene behaviors, including the frequency of hand washing (HW) and hand-to-face contact (HFC). Furthermore, little is known about the factors that most heavily influence workers' participation in these behaviors. The purpose of this study was to (1) determine the frequency of BSL-2 laboratory workers' compliance with established hand hygiene practices, and (2) to determine the social, environmental, and intrapersonal factors that most strongly predict workers' hand hygiene behaviors.Overall, compliance with HW was 10.3%. Study personnel observed 336 opportunities for HW in 12 labs without a single instance of the behavior. HW compliance ranged from 3 -- 85% in the remaining 9 labs. A significant negative relationship was found between observed HW and the rate of foot traffic through BSL-2 labs (r = -.45, P .05). HFC occurred among 72% of subjects, and the overall rate was 3.4 contacts per hour.This study suggests that many BSL-2 lab infections may be attributed to poor hand hygiene practices. When warranted by a risk assessment, alcohol-based hand sanitizers should be offered in conjunction with soap and water hand washing, especially in high traffic labs. Interventions to decrease HFC should include management support, coworker modeling, written or verbal feedback, and education.Laboratory workers (n = 93) from 21 BSL-2 research labs at a large university in the U.S. served as subjects in this cross-sectional study. In phase 1, laboratory workers' hand hygiene behaviors were measured during 118 hours of direct observation. In phase 2, participants completed a questionnaire measuring beliefs and perceptions of factors related to hand hygiene based on social cognitive theory. Indications for HW were (1) before exiting the lab, and (2) before entering a "clean" area within a BSL-2.