University of Missouri - Saint Louis

The Graduate School

Announcement

An oral examination in defense of the dissertation for the degree

Doctor of Philosophy

Jeanne Elizabeth Zack
B.S.N. in Nursing, August 1995, Maryville University-St. Louis

Abstract

Police officers have increased risk of occupational exposures to bloodborne pathogens (BBP): HIV, hepatitis B, and hepatitis C. Police officers are at risk of acquiring these BBP because they come in contact with high risk populations such as intravenous drug users and persons who have risky sex. The purpose was two fold: (a) to describe the characteristics of occupational exposures to BBP among Saint Louis Metropolitan Police Department using data from the BJC Post Exposure Hotline data set (2000-2006); and (b) to survey in 2008 SLPD officers’ BBP exposure reporting practices to the BJC Post Exposure Hotline (2000-2006). The research design was descriptive. Sixty-two of 65 SLPD officers who called the BJC Post Exposure Hotline 2000-2006 had BBP exposures. Regarding exposure characteristics, blood was the predominately reported material (52%). Percutaneous (34%) and non-tact skin (31%) were the types of exposure predominately reported. Regarding device used during the exposure, other devices were predominately reported (19%). Thirty-seven percent of the BBP exposures were high risk or moderate risk using a CDC algorithm. A wide variety of source suspect risk factors were reported. Risk factors of the source suspect were unknown (16%), the source suspect claims disease (15%), and IV drug users (13%). The post exposure hotline nurse recommended post exposure prophylaxis (PEP) to 13 officers, most frequently for blood exposure (29%). Twelve officers agreed to take PEP. In the 12 officers who agreed to take PEP, the source suspect risk factors were confirmed HIV, suspected HIV, IV drug users, risky sex, and trauma. A total of 200 surveys were distributed with a 52% response rate. Fifty-nine of 103 (57%) reported having sustained a BBP exposure. Types of BBP exposures reported most were blood and/or body fluids to intact skin, blood and/or body fluids to non-intact skin, and human bite. Seventeen (29%) of the 59 officers reporting a BBP exposure reported their exposure to the BJC Post Exposure Hotline. The survey demonstrated that the hotline is under utilized. These data can help BJC Corporate Health Services and the SLPD to evaluate the BJC Post Exposure Hotline reporting program and to improve its utilization.

Defense of Dissertation Committee