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Compliance With Universal Precautions Among Medical Students in a Tertiary Care Center in Thailand

TO THE EDITOR—Occupational exposure to bloodborne pathogens poses a serious threat to healthcare workers (HCWs). Transmission of at least 20 different pathogens by injuries due to sharp instruments and devices ("sharps") and needlesticks has been reported. HCWs in developing countries face an even higher risk because of the elevated prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV)." In addition, certain medical equipment used in developing countries, such as nonretracting finger-stick lancets and glass capillary tubes used to test for common tropical diseases, enhances the risk of transmission of bloodborne pathogens. At Thammasart University Hospital (Pratumthani, Thailand), needlestick and sharps injuries occurred at the rate of 47 incidents per 1,000 HCWs in the year 2004. Most incidents occurred in the operating rooms, the emergency room, the medical service, the obstetrics and gynecology service, and the surgical service. Because medical students in Thailand are allowed to perform all surgical and invasive procedures, albeit under supervision because of their inexperience, they account for 47% of all such incidents reported (unpublished data, A.A.). To develop better needlestick injury prevention programs, we surveyed medical students to determine their knowledge of bloodborne pathogen transmission, their level of compliance with universal precautions, and their use of personal protective equipment.