LAUSR

In the early 1980s, the human immunodeficiency virus (HIV) epidemic in the United States led to a paradigm shift in infection prevention. Published papers reported that healthcare personnel (HCP) were at risk for acquisition of HIV and hepatitis B virus (HBV) via percutaneous, mucous membrane, or non-intact skin exposure. The number of acute HBV infections among healthcare personnel (HCP) was estimated as 17,000 infections in 1983.1 In the United States, 58 confirmed and 150 possible cases of occupationally acquired HIV infection were reported to the Centers for Disease Control and Prevention (CDC) between 1985 and 2013.2 The threat of bloodborne pathogens to HCP led to institution of universal precautions (now called standard precautions), which recommend that HCP wear gloves for anticipated contact with all body fluids except sweat. Implementation of standard precautions plus pre-exposure hepatitis B vaccine, postexposure prophylaxis for HIV and HBV, and engineering controls (eg, blunted suture needles, self-sheathing needles, needleless connectors, etc) have dramatically reduced the risks for HIV and HBV acquisition by HCP. Since 1999, only 1 confirmed case of HIV (a laboratory technician who sustained a needle puncture while working with a live HIV culture in 2008) has been reported.2 The rate of HBV infections among HCP decreased ~98% from 1983 to 2010.1 Although some initial pushback occurred with the implementation of standard precautions due to concern that routine wearing of gloves would be poorly received by patients and impair the ability to perform procedures such as placing intravenous catheters, they are routinely practiced and accepted today. Similarly, the threat proffered by the sudden appearance of coronavirus disease 2019 (COVID-19) in the healthcare workplace resulted in the implementation of risk mitigation strategies that may also produce permanent behavioral modification in the healthcare setting. As it also occurred during the 1980s with the HIV/AIDS epidemic, the introduction of a new disease and new risks into the healthcare setting should result in long-lasting changes in patient care that at least offer potential for increased patient and staff safety.