Assessment of Occupational Radiation Exposure for Radiotherapy Healthcare Workers at Kenyatta National Hospital Using Thermoluminescence Dosimeter LiF:Mg,Ti

Kenyatta National Hospital (KNH) is the largest public referral hospital with a comprehensive cancer treatment facility in East and Central Africa. Occupational radiation monitoring is a significant technique for demonstrating compliance of radiation regulatory limits. The objective of the study was to carry out assessment of occupational radiation exposure among radiotherapy personnel at KNH using thermoluminescence dosimeter, TLD. KNH staff were monitored using dosimeter type TLD-100 made of LiF:Mg,Ti, on monthly basis. The reader system used for analysis was Harshaw 8800. The measurement established the average monthly accumulated occupational personnel dose for KNH to be 0.21 mSv and 0.29 mSv for Hp (10) and Hp (0.07) respectively. The accumulated dose results were within the maximum acceptable dose of 1.67 mSv/month and 41.6 mSv/month for Hp (10) and Hp (0.07) respectively. The investigation results were higher than the acceptable public limit of 0.08 mSv/month. Moreover, incidences were noted where the fetus dose limit 0.42 was also exceeded. Evaluation of statistical dose exposure among doctors, nurses and radiographers’ measurement results were within ±0.02 mSv. The study established the average KNH occupational radiation exposure levels for both Hp (10) and Hp (0.07) were within the ICRU recommendation, validating radiation protection safe practice. Data analysis of healthcare workers did not indicate exposure trend biased to any healthcare profession. Hence radiation risk cut across all professional categories. It is recommended that Radiation Monitoring program be reviewed to include non-clinical staff who access the facility. Radiation reporting should not be limited to one facility, but reflect cases where workers are involved in multiple multiple jobs.

Prevalence of Occupational Injury and Knowledge of Post-Exposure Prophylaxis Accessibility among Healthcare Workers in Mogadishu, Somalia

Introduction: Healthcare workers in Mogadishu, Somalia face significant occupational injury risks, particularly needle stick injuries, with 61.1% reporting incidents. This poses a serious threat to their health, leading to infections such as hepatitis B, hepatitis C, and HIV. Despite the high prevalence of injuries, awareness of Post-Exposure Prophylaxis (PEP) accessibility is relatively high, with 84.0% of respondents aware of it. However, there are gaps in knowledge and implementation, as evidenced by variations in availability of PEP. Improving workplace safety measures, providing comprehensive training on injury prevention and PEP protocols, and ensuring consistent availability of PEP in healthcare facilities are crucial steps to safeguard the well-being of healthcare workers in Mogadishu, Somalia. Methods: A cross-sectional study was conducted among hospital workers in Mogadishu, Somalia, focusing on professionals from various healthcare facilities. The study targeted nurses, doctors, laboratory personnel, and pharmacists. Purposive sampling was employed, resulting in a sample size of 383 calculated using Fisher’s sample size formula. Data were collected using coded questionnaires entered into Microsoft Excel 2019 and analyzed with SPSS software to generate frequencies and proportions, presented through frequency tables and pie figures. Results: The study in Mogadishu, Somalia, examined the prevalence of occupational injuries and knowledge of Post-Exposure Prophylaxis (PEP) accessibility among healthcare workers. Findings indicate a high prevalence of injuries, with 61.1% reporting incidents, predominantly needle stick injuries (60.6%). Despite the majority seeking prompt medical attention (72.0%), work-related illnesses affected 53.2% of respondents, notably work-related stress (59.5%). While most received training on injury and illness prevention (68.9%), gaps exist in PEP awareness, with 16.0% unaware of it. Nonetheless, 84.0% were aware, predominantly through health facilities (52.0%). Availability of PEP was reported by 71.3% in healthcare facilities, with variations in shift availability. The majority reported guidelines for PEP use (55.7%). Efforts are needed to bolster PEP awareness and ensure consistent availability in healthcare facilities to safeguard worker health. Conclusion: High prevalence of occupational injuries among healthcare workers, with needle stick injuries being the most common (60.6%). Despite this, 84.0% of respondents were aware of Post-Exposure Prophylaxis (PEP), primarily learning about it from health facilities (52.0%). While 71.3% reported the availability of PEP in their facility, 28.7% noted its unavailability. These results emphasize the need for improved education and accessibility of PEP to mitigate occupational injury risks.

Metal Exposure and Risk of Diabetes and Prediabetes among Chinese Occupational Workers

Objective To study the association between metal exposure and risk of diabetes and prediabetes among Chinese workers exposed to metals.Methods We used data obtained from the baseline survey of the Jinchang Cohort Study of workers in Jinchang Industry,the largest nickel production company in China.A total of 42,122 workers ≥20 years of age were included in the study.A standardized,structured questionnaire was used to collect epidemiological information.Physical examinations and laboratory tests were conducted to evaluate the health status of the participants and to measure various biomarkers including blood sugar,lipids,and urinary metal concentrations.Logistic regression was used to study the association between occupational groups categorized according to the measured metal levels(office workers,low-level;mining/production workers,mid-level;and smelting/refining workers,high-level)and risk of diabetes and prediabetes.Results The overall prevalence of diabetes and prediabetes was 7.5% and 16.8%,respectively.The adjusted odds ratios for diabetes among mining/production workers and smelting/refining workers compared to office workers were 1.5(95% CI:1.3,1.7)and 3.8(95% CI:3.4,4.3),respectively.No association was observed between these occupational groups and prediabetes in this study.Conclusion Occupations associated with higher levels of metal exposure were associated with an increased risk of diabetes in this cohort.More studies are needed to confirm this observed association.

Occupational exposures and colorectal cancers:A quantitative overview of epidemiological evidence

A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer.In more recent times,however,a growing evidence has shown that other determinants can be very important in increasing(or reducing) incidence of this malignancy.The hypothesis that environmental and occupational risk factors are associated with colorectal cancer is gaining ground,and high risks of colorectal cancer have been reported among workers in some industrial branches.The aim of this study was to investigate the epidemiologic relationship between colorectal cancer and occupational exposures to several industrial activities,by means of a scientific literature review and meta-analysis.This work pointed out increased risks of colorectal cancer for labourers occupied in industries with a wide use of chemical compounds,such as leather(RR = 1.70,95%CI:1.24-2.34),basic metals(RR = 1.32,95%CI:1.07-1.65),plastic and rubber manufacturing(RR = 1.30,95%CI:0.98-1.71 and RR = 1.27,95%CI:0.92-1.76,respectively),besides workers in the sector of repair and installation of machinery exposed to asbestos(RR = 1.40,95%CI:1.07-1.84).Based on our results,the estimated crude excess risk fraction attributable to occupational exposure ranged from about 11% to about 15%.However,homogeneous pattern of association between colorectal cancer and industrial branches did not emerge from this review.

Occupational exposure to vinyl chloride and liver diseases

Portal hypertension,liver fibrosis,and angiosarcoma of the liver(ASL)have been reported among workers exposed to vinyl chloride monomer(VCM)since the 1970s.In 2007,the International Agency for Research on Cancer established the association of VCM with hepatocellular carcinoma(HCC),though only on the basis of the few cases available.Thereafter,recent reports from the United States cohort and a European sub-cohort of vinyl chloride workers provided compelling evidence of a strong association between cumulative VCM exposure and HCC risk.Further areas of research include the risk of liver cancer at lower levels of exposure and different patterns of risk of ASL and HCC with the time since exposure.The evidence of interaction between VCM exposure and other known liver carcinogens such as alcohol and chronic viral infection provides clues for the health surveillance of exposed workers.Notably,also the risk of VCM-associated chronic liver disease is modulated by alcohol consumption,viral infection,and genetic polymorphism.A counter-intuitive finding from cohort studies of exposed workers is the lower mortality from liver cirrhosis with respect to the general population;this can be attributed to the healthy worker effect and to the selection of liver cancer as the cause of death in the presence of concomitant chronic liver disease.Studies designed to overcome these intricacies confirmed an association between cumulative VCM exposure and the risk of liver cirrhosis.

Toxic hepatitis in occupational exposure to solvents

The liver is the main organ responsible for the metabolism of drugs and toxic chemicals, and so is the primary target organ for many organic solvents. Work activities with hepatotoxins exposures are numerous and, moreover, organic solvents are used in various industrial processes. Organic solvents used in different industrial processes may be associated with hepatotoxicity. Several factors contribute to liver toxicity; among these are: species differences, nutritional condition, genetic factors, interaction with medications in use, alcohol abuse and interaction, and age. This review addresses the mechanisms of hepatotoxicity. The main pathogenic mechanisms responsible for functional and organic damage caused by solvents are: inflammation, dysfunction of cytochrome P450, mitochondrial dysfunction and oxidative stress. The health impact of exposure to solvents in the workplace remains an interesting and worrying question for professional health work.

Human health and occupational exposure to pesticides among smallholder farmers in cotton zones of Côte d'Ivoire

While precautionary efforts are being made to minimize human health problems associated with agricultural pesticides, the continued occurrence of occupational poisoning from these chemicals raises major concerns among stake- holders. Information gap on human health problems associated with pesticides poses major obstacles to making informed policy decisions, particularly in developing countries where most of the poisonings occurs. In this study, we identified acute human health symptoms associated with pesticide use in cotton zone of C?te d’Ivoire and, documented the response of rural households to the symptoms. The results show that cotton farmers in Cote d’Ivoire suffer from different occupational health hazards from exposure to agricultural pesticides. Key health symptoms reported by pesticide applicators are headache, rheum, cough, skin rash and sneezing. Pesticide applicators reported four times higher symptoms of ill health than other household members who do not normally handle pesticides. Although, households recognized pesticides as an important cause of ill health, some of the symptoms have been accepted as norm by individuals who apply pesticides. Official data on pesticide poisoning in the country is most likely to be seriously under-estimated as applicators visited formal health centers for medical assistance in only 2% of poisoning cases reported. There is a high likelihood that households in the study area under-estimated pesticide-related health costs in making farm production decision-making. Approaches to use economic instruments for reliable monitoring and reporting procedures to formulate appropriate policies and regulations to minimize exposure to pesticides are recommended. Health planners and policy makers should aim at reducing the risks posed by pesticide to farm households by, improving awareness of farmers;promote complementary approach (e.g. Integrated Pest Management) and, use of economic instruments and improved surveillance to bridge the gap in the documentation of pesticide poisoning cases among farmers.

Occupational Radiation Exposure and Changes in Thyroid Hormones in a Cohort of Chinese Medical Radiation Workers

Objective This study aimed to evaluate the association between occupational radiation exposure and changes in thyroid hormone levels among medical radiation workers.Methods This retrospective cohort study included 2,946 radiation workers from 20 Guangzhou hospitals.Data on general characteristics,participant radiation dosimetry,and thyroid function test results[thyroid-stimulating hormone(TSH),triiodothyronine(T3),and thyroid hormone(T4)]were extracted from dosimetry and medical records.The generalized estimating equation was used to evaluate the trend of changes in thyroid hormone levels over time and was adjusted for age,gender,and occupation.Results The average annual effective dose was very low and showed a general downward trend.During the follow-up period,changes in T3 and T4 levels among radiation workers were-0.015[95% confidence interval(CI)-0.018 to-0.012]nmol/L per year and-2.294(95%CI-2.426 to-2.162)nmol/L per year,respectively.Thyroid hormone levels were significantly different between males and females.T3 levels in the group of upper quartile of dose were significantly higher than in the lower quartile group(P=0.006).No significant decreased trend in thyroid hormone levels was observed with increasing average effective doses.Conclusion Thyroid hormone secretion might be affected even in low-dose radiation exposure environments.

An investigation into the occupational protection status of clinical nursing staff exposed to anti-tumor drugs

Objective:To investigate the occupational protection status of clinical nursing staff vocationally exposed to anti-tumor drugs.Methods:A self-designed questionnaire was used to survey 180 clinical nursing staff vocationally exposed to anti-tumor drugs.Results:Recognition of the need for protection and dependent occupational protection behaviors were very poor in clinical nursing staff vocationally exposed to anti-tumor drugs.The management of the occupational protection of clinical nursing staff vocationally exposed to anti-tumor drugs was also seriously underdeveloped.Conclusion:There is deficiency in the understanding and related protection practices of clinical nursing staff vocationally exposed to anti-tumor drugs in our hospital.The protection measures currently employed in medical practice are inadequate in virtually every aspect considered.It is recommended that all clinical nursing staff should receive full occupational protection training in these matters.The training must raise nursing staff's awareness of the need for occupational protection and standardize their occupational protection behaviors to conform to "best practice" models.These "best practice" models should be quickly established and all staff made cognizant of them forthwith.In addition,where occupational protection systems are already in place,they should be improved to come into line with the new "best practice" models instigated.

Relationship between Symptoms, Use of PPE and Habits Related to Occupational Exposure to BTEX Compounds in Workers of Gas Stations in Bahia, Brazil

To show the risks and harm caused by the occupational exposure to the benzene, toluene, ethylbenzene and xylenes compounds (BTEX), the working conditions of 113 persons employed at gas stations in the cities of Riach?o do Jacuipe, Feira de Santana and Salvador in the state of Bahia, Brazil were investigated by experts who correlated protection measures required by law and those applied to the workers. Data collection was performed by help of a questionnaire and non-participant observation record. The age groups of the workers in the three cities surveyed were between 18 to 25 years (30.08%) and 26 to 33 years (34.51%) of the total. The study revealed an association between occupational habits of workers at gas stations and the prevalence of symptoms due to the exposure to the BTEX compounds. Regarding the use of Personal Protective Equipment (PPE) most workers wear boots. The data show that these workers reported symptoms such as headache, rhinitis, leg pain, drowsiness, cough, fatigue, insomnia, tremors and palpitations. These disorders are related back to previous exposure to BTEX compounds which is associated with inadequate occupational habits of the workers which potentiate chemical contamination in their respective environment.

Positive Associations between Bilateral High-Frequency Hearing Loss and Hypertension Risk in Short-Term Occupational Noise Exposure

Noise is one of the most common occupational hazards worldwide[1], and millions of workers are exposed to harmful levels of noise in the workplace[2]. Noise-induced hearing loss(NIHL) is a leading cause of occupational and recreational injury and disease[3]. There is evidence that occupational noise exposure is also associated with other health effects, such as hypertension and cardiovascular diseases, digestive disorders, behavioral disorders.

Establishment of Occupational Exposure Limit for Warfarin in China

This study aims to establish the occupational exposure limit （OEL） in the air for workplace of warfarin based on the available toxicological studies and field investigations by using questionnaire and air monitoring. The clinical therapeutic dose was used as lowest observed effect level （LOEL）, and no observed effect level （NOEL） was achieved by using a safety factor. The highest concentration of warfarin monitored in the worksite of centrifuge washing, drying and packing were 0.029 mg/m3, 0.052 mg/m3 respectively, which did not exceed the OEL 0.2 mg/m3 recommended by NIOSH and ACGIH. Considering its feasibility for enforcement and protection for workers, we recommend OEL 0.2 mg/m3 of warfarin in China.

Hepatocellular carcinoma and the risk of occupational exposure

Hepatocellular carcinoma(HCC)is the most common type of liver cancer.The main risk factors for HCC are alcoholism,hepatitis B virus,hepatitis C virus,nonalcoholic steatohepatitis,obesity,type 2 diabetes,cirrhosis,aflatoxin,hemochromatosis,Wilson’s disease and hemophilia.Occupational exposure to chemicals is another risk factor for HCC.Often the relationship between occupational risk and HCC is unclear and the reports are fragmented and inconsistent.This review aims to summarize the current knowledge regarding the association of infective and non-infective occupational risk exposure and HCC in order to encourage further research and draw attention to this global occupational public health problem.

Parental Occupational Exposure and Risk of Acute Leukemia in Children: A Tunisian Population-Based Case-Control Study

Background: In recent decades, the incidence of children’s hematological malignancies has been increasing worldwide including Tunisia. Their severity is reflected in the importance of the medical, social and economic impact. This increase remains fully unexplained, and the involvement of genetic, environmental and occupational factors is strongly suspected. Materials and methods: Our study was a cross-sectional survey of the type case-control conducted in the University Hospital of Farhat Hached of Sousse during the period ranging between 1 July 2011 and 30 June 2012, and which included children with acute leukemia compared to children unharmed by neoplastic disease. Cases and controls were matched by age and gender. Our objective was to describe the socio-occupational characteristics of the parents of children with acute leukemia and to identify potential occupational factors implicated in the genesis of acute leukemia. Results: The number of acute leukemia cases in the Hematology Service and day hospital of the University Hospital of Farhat Hached during the study period was 66 cases divided into in 40 boys and 26 girls with a sex ratio of 1.53. Our cases and controls were matched by age and gender. The risk of incidence of leukemia in children from smoking fathers was higher (p = 0.02, OR = 2.24, IC = [1.11 - 4.52]). The risk of incidence of leukemia in children from alcoholic fathers was higher with p = 0.009, OR = 3.9;CI = [1.33 - 11.39]. After adjusting different variables, the difference persisted significantly with pa = 0.03 and ORa = 3.5, ICa = [1.09 - 11.6]. 25.7% of cases had a family history of blood disease and neoplasia, whereas no control presented that. The difference was statistically significant (p = 0.006, OR = 1.46, IC = [1.38 - 1.56]). The parental occupational exposures associated to the occurrence of acute leukemia in children were pesticides with a statistically significant difference (p = 0.03, OR = 2.94, IC = [1.06 - 8.13]). This difference persisted after adjustment with different variables pa = 0.01, ORa 3.75;ICa = [1.27 - 11.03]. This difference had become significant after adjustment with the different variables pa = 0.03, ORa = 2.67, ICa = [1.06 - 6.7]. Conclusion: Our results showed some support for a positive association between childhood acute leukemia risk and parental occupational exposure to pesticides and cement. Additionally, acute leukemia risk among children might be increased with parental alcohol consumption.

A systematic review of occupational exposure to respirable coal mine dust(RCMD)in the U.S.mining industry

Cumulative inhalation of respirable coal mine dust(RCMD)can lead to severe lung diseases,including coal worker's pneu-moconiosis(CWP),silicosis,mixed dust pneumoconiosis,dust-related diffuse fibrosis(DDF),and progressive massive fibrosis(PMF).Statistics from the number of reported cases showed a significant decrease in the progression of respiratory diseases in the 1990s.However,an unexpected increase in the number of CWP cases was reported in the late 1990s.To date,there has been no comprehensive systematic review to assess all contributing factors to the resurgence of CWP cases.This study aims to investigate the effects of various mining parameters on the prevalence of CWP in coal mines.A systematic review using the preferred reporting items for systematic reviews and meta-analysis(PRISMA)method was conducted to investigate the health effects of RCMD exposure and identify the factors that may contribute to the recent resurgence of CWP cases.The systematic review yielded a total of 401 papers,which were added to the database.The total number of 148 and 208 papers were excluded from the database in the process of screening and eligibility,respectively.Then,18 papers were considered for data selection and full-text assessment.The review revealed that factors including geographic location,mine size,mining operation type,coal-seam thickness,coal rank,changes in mining practices,technology advancement,and engi-neering dust control practices are contributing to the recent resurgence of CWP among coal workers.However,the evidence for root causes is limited owing to the methodological constraints of the studies;therefore,further detailed studies are needed.

Effect of Occupational Manganese Exposure on Uric Acid Levels in Human Urine

Objective To investigate the effect of long-term and low-level occupational Mn exposure on the level of uric acid （UA） in human urine. Methods In this study, 65 volunteers were recruited, who were working on welding and foundry work in an plant in Gansu province, China. Additionally, 29 control samples were collected from individuals who did not have any history of excessive Mn exposure. An improved high performance liquid chromatography system equipped with a diode-array detector （HPLC-DAD） method was developed to determine the UA level in human urine. A Spectra AA 220 Atomic Absorption Spectrophotometer （AAS） was used to measure the Mn level in the urine. Results The analytical method was validated acceptable accuracy, precision, and recovery significantly lower than that of control samples for concentrations ranging from 3.82-45.84 pg/mL with Overall, the UA levels of Mn exposure samples were （P〈O.O5）. Conclusion The practical method developed here is suitable for both routine monitoring of UA level in human urine and metabolism research. Long-term and low-level occupational Mn exposure may lead to a lower UA level in urine, and UA might be an indicator of the early stage of manganism.

Nervous system disorders induced by occupational and environmental toxic exposure

Encephalopathy, extrapyramidal features, neurodegenerative diseases, and peripheral neuropathy are commonly encountered in presentations of occupational neurotoxic syndromes. Epidemiological findings have suggested the role of pesticides, solvents and metals on the onset and progression of neurological diseases. The aim of this review is to present clinical manifestations of occupational and environmental neurologic disorders, to discuss toxic’s implications of these conditions, and to give indications about occupational branches and main jobs concerned. Better to know and categorize the clinical manifestation of neurologic disorders and toxics implicated, will improve the clinical management of occupational neurologic diseases. We performed a research of studies, case reports and review, particularly among most recent, available into Pub Med databases about occupational and environmental neurologic disorders and main toxics incriminated.

Mycosis Fungoides in Relation to Environmental and Occupational Exposures: A Case-Control Study in the Tunisian Center

Introduction: The mycosis fungoides (MF) is the most common cutaneous T-cell lymphomas representing about 50% of all cutaneous lymphomas. Its pathogenesis remains poorly understood. Thus, its rising incidence rates call for an explanation. Several environmental and occupational factors have been implicated in the pathogenesis of this disease. Objective: To determine the potential occupational factors correlated in the occurrence of MF. Methods: Case-control study was carried out at the teaching Hospital Farhat Hached of Sousse (Tunisia) to investigate associations of MF and occupational risk factors. A questionnaire on lifetime job history was administered to 24 cases and controls. Cases were patients with MF and whose diagnosis was suspected by a dermatologist and confirmed by pathological examination. Controls were patients consulting in the occupational medicine department and matched to cases by age and gender. Bivariate analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Results: The average age of onset of the disease was 55.41 ± 17.4 years with a sex ratio of 2.42. We found an increased risk of MF associated with tobacco consumption higher than 40 Pack-year (OR = 6.6;95% CI = 1.22 to 35.4), exercise in the textile sector (OR = 9.4;CI = 1.06 to 84.3) and exposure to diesel exhaust (OR = 9.47;95% CI = 1.06 to 84.3). Conclusion: Occupational factors could play a role in the pathogenesis of MF. Regarding our study, smoking, working in the textile industry and exposure to diesel exhaust appear to be involved in the pathogenesis of MF. Further investigation is needed to confirm these findings.

A cross-sectional study on the effects of occupational noise exposure on hypertension or cardiovascular among workers from automobile manufacturing company of Chongqing, China

For the past few years, noise pollution has been more and more serious, and it may lead to several diseases. While the humans expose to noise in quantity for a long time, their blood pressure will change, and even cause changes in cardiac function. In our study, we attempt to find the relationship between occupational noise and hypertension and impaired hearing, cardiac function. It may be helpful to obtain some useful information on occupational noise exposure of humans. The participants were divided into noisy group ≥90 dB (A) and non-noisy group ≤70 dB (A). We performed this research in an automobile manufacturing company of Chongqing, China during 2011-2012. Our study showed that there may be positive associations between?occupational noise and hypertension and impaired hearing, but no conclusion can be drawn between occupational noise and ECG.

Occupational exposures to blood and body fluids (BBF): Assessment of knowledge, attitude and practice among health care workers in general hospitals in Lebanon

Healthcare workers (HCWs) who are employed in traditional health care workplaces face a serious danger that may threaten their life;it is their exposure to blood and body fluids (BBF). In Lebanon, the introduction of a hospital accreditation system has put a particular emphasis on staff safety, and on the evaluation of professional practice (EPP) programs. Methods: A cross-sectional survey was conducted amongst 277 HCWs working in 4 general hospitals in South Lebanon. Objective: 1) describe the prevalence and the risk factors for occupational exposure to BBF among HCWs;2) evaluate knowledge, attitude, and practices of HCW concerning blood-borne pathogens and adherence to universal safety precautions. Results: The mean age of the respondents was 32.14 years (SD = 10.33), 57.4% were females. 43.3% of HCWs expressed that they use gloves all the time for every activeity of care. 67.1% were aware that needles should not be recapped after use;registered nurses and nursing students were more aware than physicians and nursing assistants (nurse) in this subject. 30% of HCWs declared having had at least one occupational exposure to BBF;62.7% of all accidental exposure was reported to the department responsible for managing exposures. Percutaneous injuries were the most frequently reported. Vaccination coverage was 88.4% for hepatitis B, and 48.4% against influenza. The source patient was tested in 43.4% of reported BBF exposures. Accidental exposure to BBF was more frequent in older people (OR = 3.42;p = 0.03) and the more experienced. Subjects working in intensive care unit ward reported more exposure to BBF (OR = 3;p = 0.04). Participants incurring exposure to BBF resorted to different measures after the injury suggesting a lack of a uniform policy for post-exposure prophylaxis. Conclusion: Exposure to BBF represents an important and frequently preventable occupational hazard for HCWs in Lebanon that requires continuous EPP of HCWs, and a comprehensive approach for prevention and management.