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Exposures of health care workers to HIV. Factors affecting occupational risks in San Francisco, Boston, and New York.

Twersky-F; Whitbeck-C; Hattis-D
Center for Technology, Policy and Industrial Development, Massachusetts Institute of Technology, Cambridge, Massachusetts, 1989 Jun; :1-92
This report examined the experience with acquired immune deficiency 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 this report. 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 to human immunodeficiency virus (HIV) were discussed, 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 worker with the body fluids of the patient. An important role in the worker's own assessment of his or her risk has been personal fear of AIDS transmission. The possible changes in occupational exposures to HIV were discussed. Factors expected to influence occupational exposure included 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. A series of interviews with personnel involved with different phases of health care were appended.
NIOSH-Cooperative-Agreement; Cooperative-Agreement-U60-CCU-100929; Health-care-personnel; Infectious-diseases; Viral-infections; Disease-transmission; Risk-factors; AIDS-virus; Body-fluids; Acquired-immune-deficiency-syndrome; Nursing; Medical-personnel
Publication Date
Document Type
Final Cooperative Agreement Report
Funding Type
Cooperative Agreement
Fiscal Year
NTIS Accession No.
NTIS Price
Identifying No.
NIOSH Division
Source Name
Center for Technology, Policy and Industrial Development, Massachusetts Institute of Technology, Cambridge, Massachusetts, 92 pages, 12 references
Performing Organization
Massachusetts Institute of Technology