Health hazard evaluation report: HETA-2000-0341-2839, Dallas Institute of Acupuncture and Oriental Medicine, Dallas, Texas.
In June 2000, the National Institute for Occupational Safety and Health (NIOSH) received a request from management personnel at the Dallas Institute of Acupuncture and Oriental Medicine (DIAOM) to evaluate the potential for occupational exposures to bloodborne pathogens (BBPs; e.g., the human immunodeficiency virus [HIV], Hepatitis B virus [HBV] and Hepatitis C virus [HCV]) from procedures performed at DIAOM. In response to this request, NIOSH investigators conducted a site visit in October 2000. During this visit, we met with management and employee representatives to discuss clinic policies and procedures; performed a visual inspection of the clinic procedure rooms and offices; and observed acupuncture, moxibustion, and cupping procedures. Although there have been reports of acupuncture procedures resulting in patients becoming infected with HIV, HBV, and HCV, these incidents were, in most cases, related to exposure to improperly sterilized reusable needles. With the current standard practice of using single-use, sterile acupuncture needles, this risk is greatly decreased. However, there is still a potential risk to the acupuncture practitioner for BBP exposures from needles freshly removed from a patient's skin. Furthermore, the cupping procedure used at DIAOM extracts several milliliters of blood and the cupping jars, gauze, and gloves used by the practitioner can be contaminated with blood from this procedure, posing another potential risk for infection with BBPs. In addition, we noted that sharps containers and gloves were located beyond easy reach of the practitioner during treatments and an ozone generator was occasionally used in the clinic for odor control. We offer several recommendations for decreasing the risk of occupational exposures to the employees at DIAOM. NIOSH investigators found that acupuncture and cupping procedures can expose employees to BBPs. All exposures to blood should be evaluated by a physician. Ozone generators and latex gloves used at the DIAOM have the potential to cause illness in susceptible employees. Exposure to ozone and latex should be minimized.