Hepatitis B transmission through blood and body fluids exposure of school personnel

BACKGROUND: Hepatitis B transmission from students to members of staff has been documented in schools, particularly nurseries and day care centres. AIMS: To investigate the frequency of exposure to blood and other body fluids within day schools and to document practices adopted by school personnel to avoid direct contact and decontaminate the environment. METHODS: Questionnaire survey among 21 public day schools in Malta. RESULTS: Episodes of significant blood exposure were rare, occurring at frequencies of 0.071 95% confidence interval (CI): 0-0.148] incidents per thousand student days. Contact with larger volumes of other body fluids, namely urine and vomitus, was more likely: 0.12 (95% CI: 0.008-0.383) and 0.088 (95% CI: 0.048-0.128) episodes per 1000 student days, respectively. School personnel generally used correct personal protective equipment, particularly gloves, in cases of contact with blood and body fluids. Environmental disinfection methods varied considerably with only 38% of schools (95% CI: 21-59%) using recommended hypochlorite preparations. CONCLUSIONS: Exposure to quantities of blood sufficient to result in HBV transmission in day schools is rare. Emphasis should be placed on risk assessment at individual school level, concentrating on correct management of body fluid exposures through effective staff education.