Underreporting of blood and body fluid exposures among nurses: prevalence, reporting cascade, and modifiable organizational correlates.
- 1Jiangsu College of Nursing, Huai'an, Jiangsu, China.
- 2Department of Infection Control, Huai'an Fourth People's Hospital, Huai'an, Jiangsu, China.
- 3Department of Infection Control, The Fourth People's Hospital of Lianyungang, The Affiliated KangDa College of Nanjing Medical University, Lianyungang, Jiangsu, China.
Abstract
Background
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.Methods
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.Results
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).Conclusion
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.
Related
- Simulation diabetes prevalence under modifiable risk and healthcare access scenarios among low-income adults in high-growth U.S. states
- Feelings of Helplessness in ET: A Preliminary Analysis of Prevalence and Clinical Correlates.
- Executive dysfunction in COPD: prevalence and clinical correlates of cognitive impairment : A cross-sectional case–control study
- Metabolic syndrome prevalence and correlates among university and hospital staff in southwestern Uganda
- Prevalence and correlates of sexual harassment among female nursing students in Tanzanian higher educational institutions: a cross-sectional survey.
BibTeX
@article{tang2026underreporting,
title = {{Underreporting of blood and body fluid exposures among nurses: prevalence, reporting cascade, and modifiable organizational correlates.}},
author = {Chunju Tang and Mei Zhang and Li Sun and Haiqin Pu and Xin Zhang and Yaqin Zhang and Hongyu Zhu},
journal = {Frontiers in public health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1989101},
url = {https://europepmc.org/article/MED/42908935},
note = {CC BY},
}
RIS
TY - JOUR
TI - Underreporting of blood and body fluid exposures among nurses: prevalence, reporting cascade, and modifiable organizational correlates.
AU - Chunju Tang
AU - Mei Zhang
AU - Li Sun
AU - Haiqin Pu
AU - Xin Zhang
AU - Yaqin Zhang
AU - Hongyu Zhu
PY - 2026
DA - 2026/10/07
JO - Frontiers in public health
DO - 10.3389/fpubh.2026.1989101
UR - https://europepmc.org/article/MED/42908935
AB - Background 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.Methods 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.Results 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).Conclusion 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.
SN - 2296-2565
ER -