No exposure, correct?

[paranoidperson4]

I work in healthcare, and the other day I was sitting at my desk and noticed that there was something on my scrubs. I scratched it with my nail (trimmed nails but no visible cuts), and noticed it was dried blood from a patient I had seen earlier that day. I didn't see any of the blood actually get onto my nail but it may have been that I just quickly washed my hands.

Would this have been a possible exposure? Can you even get infected if blood was on the nail bed edge - like is there any exposure to your bloodstream that way?

Thank you.

[gnatcatcher]

paranoidperson4, this article describes nail anatomy in depth:
Since your nails have no visible cuts and the amount of blood is so small, the odds are extremely small that any HCV entered your blood stream and very high that your own immune system would get rid of a tiny amount. It was decades after I received tainted transfusions before I was diagnosed, and I know I occasionally used the wrong toothbrush by mistake during those decades on days when floss had cut my gums, yet spouse tested negative for hep C after I was diagnosed. The current thinking seems to be that it takes substantial exposure (such as transfusions) or a weak immune system to become chronic, and then even people like me who had it for many decades along with high viral loads and much liver damage are getting cured by the new crop of meds.

Gnatty

[CureSeeker]

You should have asked your employer or immediate supervisor.  If you work for a private doctor, he can help put your fears to rest, or see that you get an immediate and appropriate response to his perception of risk as he would be there to inspect the situation and maybe even know the patient's history.

In a facility environment, you would maybe be sent to Employees Health Services who would put your fears to rest or send you on down the pipeline to get immediate and appropriate treatment and follow up.

If you have washed the scrubs, I guess there is no way to really know, and since it wasn't immediately reported to anyone, it will be hard to prove a job related infection if one should prove to exist.

Do you know if the patient was infected with anything?

Did any microscopic blood penetrate any slight cuts in your nail bed?  Who knows?  We don't know.  It seems you didn't think much of it till later on. 

Your place of employment - whether a private doctor, or a large facility - should have procedures in place on how to deal with possible contaminations and spills by blood-borne pathogens.

Since you deal with blood/specimens, I am assuming you have been vaccinated for HBV.  There is no vaccine for HIV, but - right or wrong - I'm under the impression that HIV dies upon contact with air.  That just leaves HCV and about a dozen more blood-borne pathogens to worry about.

If you think there was no exposure - good!  If you are still worried about it in six months, get tested.  It's not like it was a needlestick/sharps incident but there is always a 0.01% chance.

In the future, report this kind of stuff immediately.  The worst that can happen is your employer laughs and tells you to get back to work after he has assessed the prospect of infection.

In some workplaces - especially private - you may fear reporting, which is truly a shame.  But, an incident that could be covered by Worker's Compensation, will be all on you if you don't immediately report.

Nurses and other healthcare workers probably have about the highest risk jobs on the planet when it come to dealing with any kind of infection.

Best wishes!

[Gaj]

Hi PP4,

Here is some information from CDC (Centre for Disease Control) about HCV in a health care setting.

Hepatitis C and Health Care Personnel

What is the risk for HCV infection from a needlestick exposure to HCV-contaminated blood?
After a needlestick or sharps exposure to HCV-positive blood, the risk of HCV infection is approximately 1.8% (range: 0%–10%).

Other than needlesticks, do other exposures, such as splashes to the eye, pose a risk to health care personnel for HCV transmission?
Although a few cases of HCV transmission via blood splash to the eye have been reported, the risk for such transmission is expected to be very low. Avoiding occupational exposure to blood is the primary way to prevent transmission of bloodborne illnesses among health care personnel. All health care personnel should adhere to Standard Precautions . Depending on the medical procedure involved, Standard Precautions may include the appropriate use of personal protective equipment (e.g., gloves, masks, and protective eyewear).

https://www.cdc.gov/hepatitis/hcv/hcvfaq.htm#f2


As they note the risk of infection from a needlestick injury from patients with known HCV infection is only 1.8% and for situations such as you experienced it would be many times less likely.

From your description of what happened I would think the possibility of infection was extremely low to almost non existent. Having said that, I do understand how something like this can affect someone's peace of mind so if you still have any concerns after reading the above CDC information then I would recommend that you discuss it further with a doctor who will be able to provide medical advice and also testing if you both still feel that is appropriate.

(Assuming you have a reasonable relationship with your employer, the incident should be reported so they have the opportunity to provide support and medical advice for you and any concerns you may have and it will also allow them to review procedures and training to avoid further incidents similar to this affecting you or your fellow employees. I would urge you to consider this option if at all possible.)