Frequency of Puncture Injuries in Surgeons and Estimated Risk of HIV Infection

To evaluate the occupational risk of human immunodeficiency virus (HIV) infection, we surveyed 202 surgeons working in the New York City metropolitan area. One hundred seventy-three (86%) surgeons reported at least one puncture injury in the preceding year (median number, 2 per year; interquartile range, 1 to 4 per year). Seventy-six percent of the injuries occurred during surgery, and the median injury rate was 4.2 per 1000 operating room hours. Twenty-five percent of the surgeons sustained yearly injury rates of 9 or more per 1000 operating room hours, and these high rates were independent of sex, age, type of practice, operative work load, or hospital location. Fifty-three percent of all injuries involved the index finger of the nondominant hand. If the prevalence of HIV infection in surgical patients is 5%, then the estimated 30-year risk of HIV seroconversion is less than 1% for 50% of the group, 1% to 2% for 25% of the group, 2% to 6% for 15% of the surgeons, and greater than 6% for 10% of the surgeons.