An estimated 59 million health care workers around the world offer their services in substandard living conditions where they are exposed to various infectious diseases including tuberculosis (TB), the human immunodeficiency virus (HIV), and hepatitis. A study presented at the 2014 annual meeting of the American Association for the Advancement of Science (AAAS) has revealed that neglectful working habits increase South African hospital workers' risk of contracting TB, HIV, and hepatitis.

According to the World Health Organization (WHO), South Africans are 300 times more likely to contract TB than Americans. Second only to HIV/AIDS, tuberculosis is the biggest cause of death among infectious disease worldwide. One quarter of all people living with HIV die as a result of TB. Fortunately, deaths related to TB have started to see a steep drop off, decreasing by 45 percent between 1990 and 2012. 

"In addition to massive workloads, healthcare workers in developing countries are more likely to get sick from the workplace," lead researcher Dr. Annalee Yassi, professor at the University of British Columbia's School of Population and Public Health, said in a statement

Yassi and her colleagues from UBC conducted a baseline survey including over 1,000 health care professionals from three South African hospitals in 2012. Approximately 18 percent of South Africa’s adult population is HIV-positive; however, researchers found that hospital workers failed to comply with basic and essential protocol when it comes to infectious disease such as recapping disposed needles, washing hands, and using medical gloves. Results determined that 20 percent of a hospital’s staff reported a needlestick or unprotected exposure to a patient’s bodily fluid.

Of the 1,000 hospital workers participating in the study, 68 percent had not been screened for TB and upward of 20 percent had neglected to receive the hepatitis vaccination. Another 55 percent of the participants admitted to not wearing respiratory protection while caring for an infectious patient.  Each hospital worker's risk of transmitting TB, HIV, and hepatitis increased with the number of patients in their care.

"Considerable progress is being made, including better standard operating procedures and screening," Yassi added. "But there's much more we can do to ensure a healthy workplace for the international health care workforce."

Yassi is currently working with the WHO in implementing appropriate occupational health guidelines for health care institutions in underdeveloped countries. The research team called for improvements in various areas of hospital protocol in developing countries like South Africa including confidentiality stigma, technological capacity, and staff training.