Management Practices and Risk of Occupational Blood Exposure in U.S. Paramedics: Non-Intact Skin Exposure

Purpose To estimate the risk of blood exposure to non-intact skin in U.S. paramedics; to estimate risk ratios for selected management practices. Methods A mail survey was conducted among a national sample of licensed paramedics in the United States in 2002–2003. Results The adjusted response rate was 55% ( N = 2,664). The overall 12-month risk of non-intact skin blood exposure was 8.7% (95% confidence interval: 6.4–11). As the number of types of personal protective equipment (PPE) always provided by the employer increased, risk decreased. Risk ratios and 95% confidence intervals for selected factors were: not being provided with appropriate PPE, 2.4 (1.6–3.3); job evaluation doesn't include following safety procedures, 1.8 (1.0–2.7); supervisor wouldn't speak to paramedic about not following Universal Precautions, 2.1 (0.9–3.2); both of the above supervisory behaviors, 2.3 (1.3–3.6). Conclusions Providing appropriate personal protective equipment is an effective means of preventing non-intact skin blood exposure and possible consequent bloodborne infection in paramedics. Future research should aim to identify factors limiting the provision of this equipment and to evaluate the advisability of interventions to increase provision. Supervisory behaviors that emphasize safe work practices may also be effective in preventing non-intact skin exposure in paramedics. Future research should develop interventions that apply general knowledge of management behaviors that promote worker safety to the work environment of paramedics.