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Please please please answer...you're the best
Mar 30, 2009

Dr. Bob,

I am writing you now for some comfort and some of your knowledge. To be real with you, I am a nurse who has had an irrational fear of bloodborne infections over the last few years. I have gotten myself tested multiple times in the past, after thinking that I may have been through some possible exposures, but thankfully all of my tests to date have been negative. Your column has been extremely helpful to me and has helped me overcome some of my fears by learning more about HIV. I am also seeking psychological help for my worries. I do have a few questions for you that I really hope you can answer to help put my mind at ease since I respect so much what you have to say. Last week, I was undoing a dressing for a ptient with a fractured leg. Initially I wasnt wearing gloves, but as soon as I got down to the leg and noticed blood, my instinct was to put on some gloves. My worry now is that I came into contact with some blood, and I had some hangnails and dry skin on my hands that possibly could have come in contact with the blood before I got gloves. My questions to you are as follows:

1) Do you think that there is possibly a risk to myself and should I get tested?\ 2) Is this considered an occupational exposure? I know that if somebody has a severe dermatitis then they may be at risk, but what about a hangnail and some dry skin?? 3) What have been the documented methods of seroconversion in health care workers to date? Is it only needle exposures or large amounts of blood or have there been cases of drops of blood in small wounds similar to mine? Dr. Bob, you dont know how much you can help me if you can give me some more knowledge on occupational exposure in general to help ease my mind. Thanks so much and I will donate again to your charity.

Jenn

Response from Dr. Frascino

Hi Jenn,

To respond to your specific questions first:

1. No.

2. Yours would be an insignificant occupational exposure at best.

3. No cases similar to yours. Even in cases like mine with a hollow-bore needlestick and laceration while performing a procedure on a patient with advanced-stage AIDS the transmission risk is only 0.3%.

Jenn, I'm glad to hear you are getting psychological help for your irrational fears!

Thank you for your tax-deductible donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated.

Be well.

Dr. Bob



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