Underreporting of blood and body fluid exposures among nurses: prevalence, reporting cascade, and modifiable organizational correlates.

Authors

Chunju Tang, Mei Zhang, Li Sun, Haiqin Pu, Xin Zhang, Yaqin Zhang, Hongyu Zhu

Published in

Frontiers in public health. Volume 14. Pages 1989101. Epub Oct 07, 2026.

Abstract

Occupational exposure to blood and body fluids is common among nurses, and incomplete reporting limits occupational surveillance and access to post-exposure assessment. This study estimated underreporting at the nurse level and the proportion of aggregate exposure counts that were unreported, and examined associated individual and workplace characteristics.
A census-based analytical cross-sectional survey was conducted between November 2025 and March 2026 among registered nurses at a tertiary infectious disease referral hospital in China, using a structured questionnaire with a 12-month recall period. Underreporting was defined among exposed nurses as failure to formally report at least one exposure. Modified Poisson regression with robust variance was used to estimate adjusted prevalence ratios (aPRs). Negative-binomial and hurdle models with an exposure offset served as sensitivity analyses for exposure opportunity.
Of 1,110 eligible nurses, 872 responded (78.6%); 392 (45.0%) reported at least one exposure, contributing 747 aggregate exposure counts. Underreporting affected 232 exposed nurses (59.2, 95% CI 54.3-63.9), and 373 of 747 exposure counts (49.9%) were unreported. Among under-reporters, 48.3% reported receiving none of the five assessed services after any exposure during the recall period, compared with 0.6% of complete reporters; clinical indications and exposure-specific service receipt were unavailable. Underreporting was associated with individual perceptions of safety climate (aPR per SD 0.77, 95% CI 0.70-0.84), vague or absent procedural knowledge (aPR 1.56, 95% CI 1.31-1.86), non-permanent employment (aPR 1.30, 95% CI 1.07-1.57), and night-shift frequency (aPR per level 1.14, 95% CI 1.04-1.25).
Underreporting was common at both the nurse level and across aggregate exposure counts. Perceived safety climate, procedural knowledge, employment security, and night-shift work were associated with underreporting and are potential targets for intervention research; the cross-sectional design does not establish causation or event-specific clinical consequences.

PMID:
42908935
Bibliographic data and abstract were imported from PubMed on 23 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.