Factors Associated with Occupational Exposure to Infectious Agents among Healthcare Workers in Georgia

Abstract

BACKGROUND. The prevalence of viral hepatitis B and C in Georgia is among the highest in the region. Healthcare workers are at risk of occupational exposure to blood-borne pathogens, but evidence on exposure patterns and associated factors in Georgia is limited. Since 2015, Georgia has launched a multi-year HCV elimination program, including treatment of infected individuals with modern Direct-Acting Antivirals (DAAs) and the implementation of prevention programs, such as infection control in healthcare facilities. OBJECTIVES. The objective of this study was to identify factors associated with occupational exposure to infectious agents among medical and dental healthcare workers in Georgia. METHODS. A multicentre cross-sectional survey was conducted from September 2019 to May 2020. The study participants were recruited from six participating multidisciplinary hospitals and dental care institutions in three large cities of Georgia (Batumi (Western Georgia), Rustavi (Eastern Georgia), and the capital city, Tbilisi). The primary outcome was occupational exposure to blood and body fluids (during the six months preceding completion of the questionnaire during the preceding six months. Modified Poisson regression with robust variance was used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals. The survey results of medical healthcare workers (HCWs) were compared with those of dental healthcare workers (DHCWs). RESULTS. A total of 442 healthcare workers were surveyed. Among them, 246/442 (55.7%) were HCWs from different departments and 196/442 (44.3%) were DHCWs. Of the 442 participants enrolled, 431 had complete data for hepatitis B knowledge and professional status. Medical healthcare workers had a higher prevalence of good knowledge of hepatitis B than dental healthcare workers (33.5% vs. 21.9%; PR=1.53, 95% CI: 1.11–2.11). Dental healthcare workers experienced occupational exposures more frequently than medical healthcare workers. The prevalence of needlestick injuries was significantly higher among dental healthcare workers (51.5% vs. 29.7%; PR=1.74, 95% CI: 1.37–2.20). Similarly, blood splashes were more common among dental healthcare workers (36.7% vs. 16.3%; PR=2.25, 95% CI: 1.60–3.16). Despite the higher frequency of occupational exposures, adherence to personal protective equipment was generally high. Glove use was more prevalent among dental healthcare workers (97.3% vs. 85.6%; PR=1.14, 95% CI: 1.07–1.20), and they were also more likely to report always wearing protective eyewear (46.9% vs. 27.4%; PR=1.71, 95% CI: 1.32–2.22). Hepatitis B vaccination coverage was significantly higher among dental healthcare workers than medical healthcare workers (74.9% vs. 58.4%; PR=1.28, 95% CI: 1.12–1.47). Vaccination coverage was also higher among younger participants, whereas no significant associations were observed with gender or attitudes toward treating patients with blood-borne infections. CONCLUSIONS. This study showed that occupational exposure remains common among healthcare workers, especially among dental healthcare workers. The findings highlight the need for better infection prevention training, wider hepatitis B vaccination coverage, improved reporting of occupational exposures, and stronger adherence to standard safety precautions. These results can support the development of educational programs and improve infection control practices in Georgia.