Maria Ganczak, Peter Barss: Nosocomial HIV Infection: Epidemiology and Prevention -A Global Perspective Nosocomial HIV Infection: Epidemiology and Prevention -A Global Perspective

Abstract Because, globally, HIV is transmitted mainly by sexual practices and intravenous drug use and because of a long asymptomatic period, healthcare-associated HIV transmission receives little attention even though an estimated 5.4% of global HIV infections result from contaminated injections alone. It is an important personal issue for healthcare workers, especially those who work with unsafe equipment or have insufficient training. They may acquire HIV occupationally or find themselves before courts, facing severe penalties for causing HIV infections. Prevention of blood-borne nosocomial infections such as HIV differs from traditional infection control measures such as hand washing and isolation and requires a multidisciplinary approach. Since there has not been a review of healthcare-associated HIV contrasting circumstances in poor and rich regions of the world, the aim of this article is to review and compare the epidemiology of HIV in healthcare facilities in such settings, followed by a consideration of general approaches to prevention, specific countermeasures, and a synthesis of approaches used in infection control, injury prevention, and occupational safety. These actions concentrated on identifying research on specific modes of healthcare-associated HIV transmission and on methods of prevention. Searches included studies in English and Russian cited in PubMed and citations in Google Scholar in any language. MeSH keywords such as nosocomial, hospital-acquired, iatrogenic, healthcare associated, occupationally acquired infection and HIV were used together with mode of transmission, such as "HIV and hemodialysis". References of relevant articles were also reviewed. The evidence indicates that while occasional incidents of healthcare-related HIV infection in high-income countries continue to be reported, the situation in many low-income countries is alarming, with transmission ranging from frequent to endemic. Viral transmission in health facilities occurs by unexpected and unusual as well as more frequent modes. HIV can be transmitted to patients and to donors of blood products by specific vehicles and vectors during blood transfusion, plasma donation, and artificial insemination, by improperly sterilized sharps, by medical equipment during activities such as dialysis and organ transplantation, and by healthcare workers infected by occupational exposure to hazards such as blood-contaminated sharps. Personal, equipment, and environmental factors predispose to acquisition of nosocomial HIV and all are pertinent for prevention. For infection and injury control, poverty is often an underlying determinant. While sophisticated new tests offer improved HIV detection, increasingly higher marginal costs limit their feasibility in many settings. Modest investment in safer equipment and appropriate integrated training in infection control, injury prevention, and occupational safety should provide greater benefit. (AIDS Rev. 2008;10:-61) Corresponding author: Peter Barss, [email protected]

Fear of HIV infection and impact of training on the attitudes of surgical and emergency nurses toward inpatient HIV testing

This study evaluates the association between the degree of fear of human immunodeficiency virus (HIV) infection and support for different HIV testing policies. A strong fear of acquiring HIV infection at work was widespread among a sample of 601 Polish surgical and emergency nurses. Most favored inappropriate HIV testing of all surgical patients and inpatients. Previous training about HIV and acquired immunodeficiency syndrome (AIDS) and experience caring for HIV‐positive patients had a significant impact on reducing support for testing of all inpatients but not for testing of surgical patients

Drownings and other water-related injuries in Canada. 1991 - 2000 10 years of research: Module 2: Ice & Cold Water

This research is dedicated to the 2,007 persons who died of cold immersion in Canada during 1991-2000. May the evidence of the circumstances of their deaths be a guide to safety for the many Canadians who venture forth on the ice or cold water for recreation, daily life, or work, and for professionals and decision makers with a duty to protect the vulnerable

What we have learned: 10 years of pertinent facts about: Drownings and other water-related injuries in Canada 1991-2000

According to data provided by Statistics Canada,drowning was the 4th most common cause of death by unintentional injury in Canada during 1991-2000, after highway deaths,falls and poisoning. Drowning was the leading cause of death for recreational and sporting activities. 5,900 individuals died and 3,289 were hospitalized for near drowning. Incalculable are the suffering and long-term personal losses of the nearly 10,000 family tragedies represented by these statistics. Furthermore, economic costs to Canadians of these deaths exceed 10 billion dollars. Yet many of these incidents are preventable

Drownings and other water-related injuries in Canada. 1991 - 2000, 10 years of research: Module 5: Fishing

This research is dedicated to the 889 persons who died during fishing in Canada between 1991 and 2000. May the evidence of the circumstances of their deaths be a guide to safety for Canadians who fish for recreation, subsistence, or work, and for professionals and decision makers with a duty to protect the vulnerable