Exposures of Health Care Workers to HIV (Human Immunodeficiency Virus) Factors Affecting Occupational Risks in San Francisco, Boston, and New York

摘要

The report examined the experience with acquired immunodeficiency syndrome (AIDS) in San Francisco, New York and Boston, and illuminated various factors and trends which affect exposure of a range of health care workers to HIV. Health care planning was the first factor considered. In San Francisco the system was a highly decentralized delivery of needed services, relying heavily on outpatient care. Treatment in Boston and New York was often hospital bound. A disproportionate burden of AIDS care in New York fell on the public hospitals. Where patients were cared for was largely a determination of current reimbursement structures. Factors affecting the exposure of health care workers of human immunodeficiency virus (HIV) including the proportion of patients by age and disease stage, modes of transmission, distribution of care tasks, and changes in diagnostic and treatment procedures. Both procedural and technological innovations have been introduced to reduce the risk of infection by reducing the contact of the health care workers with the body fluids of the patient. The possible changes in occupational exposures include changes in procedures, infectivity of substances to which personnel are exposed, distribution of care among health care workers, personnel shortages, changing patient demographics, and treatment setting.