The Perceptive of Healthcare Workers on Blood Exposure Risk, Contributing Factors and Challenges Faced: A Qualitative study at Lagos State University Teaching Hospital

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They are greater risk compared to the general population 1–4 . This heightened risk is due to frequent contact with blood and other potentially infectious body fluids. Such exposure can occur through accidental incidents, and the severity and unpredictability of these events make them a serious occupational hazard 3,5 . Several studies have often linked high rates of occupational BBF exposure to inadequate knowledge and poor adherence to standard safety practices, insufficient training, lack of access to personal protective equipment (PPE), lack of resources, and overall non-compliance with infection prevention protocols 6 . The aim of this study is to examine the perspectives, and opinions of health workers regarding exposure risks to blood at Lagos State University Teaching Hospital (LASUTH), by employing a qualitative research design. Method : The study utilized a semi structured interview for collection of data. Thirteen Semi-structured interviews were conducted among healthcare workers to gain insight into perception of health workers regarding exposures risks to blood and body fluids: Results : Following thematic analysis, the summary of the semi-structured interview on The Perceptive of Healthcare Workers on Blood Exposure Risk, Contributing Factors and Challenges Faced were documented and grouped into broader themes and patterns reflecting key concepts and experiences shared by participants .These viewpoint were grouped under one of the main themes: Blood exposure risks and Healthcare workers concerns; Most Commonly Encountered Infections; Factors Leading to Exposure; Safety compliance and Challenges; Safety Education and Training; Institutional support and Compensation; Post-Exposure Incident Handling and Challenges; and Suggestions for safety improvement. Conclusions : This study reveals that healthcare workers at LASUTH face substantial risk of bloodborne exposure, driven by inadequate protective resources, inconsistent safety training, and delays in post-exposure management. While workers demonstrate strong awareness and adherence to safety practices, systemic challenges hinder effective protection. Strengthening institutional support, improving PPE availability, and enhancing training and response systems are essential to reduce occupational exposure risks. Health sciences/Diseases Health sciences/Health care Health sciences/Health occupations Health sciences/Medical research Health sciences/Risk factors Healthcare Workers Exposure Risks Blood Bloodborne Infection Qualitative Study Figures Figure 1 Introduction By virtue of their work, healthcare workers are at an elevated risk of occupational exposure to blood/ bodily fluids, and subsequently borne infection when compared to the general population 1–4 . This heightened risk is due to frequent contact with blood and other potentially infectious body fluids. Such exposure can occur through accidental incidents, and the severity and unpredictability of these events make them a serious occupational hazard 3,5 . Blood and body fluid (BBF) exposure is globally recognized as a significant concern, often resulting from needle-stick injuries or other percutaneous events 7,8 The research is centered around the issues of high risk of exposures to bloodborne infections in healthcare settings, and its effects on health workers, and consequently, the patients, the public, and the overall health environment and health outcomes. 9 . In general, healthcare workers in Nigeria face a significant risk of exposure to bloodborne infections, posing serious threats to both their health and patient safety. Continuous and unmanaged exposure to such infections leads to hazardous working environments, increased illness, extended hospital stays, higher morbidity and mortality rates, and ultimately compromises the quality of healthcare services and the efficiency of healthcare professionals. Aim/ Objectives: The study is aimed at understanding the experience, opinions and perspectives of health workers who at risk of occupational exposure to blood and bloodborne infection, and to gain a deeper understanding of factors leading to exposures and the challenges that health workers encounter dealing with occupational exposure to bloodborne diseases. Methodology A qualitative research method was utilized for data collection. A Semi structured interview was employed at the hospital. This method asked open ended questions, which was reliable in providing new ways of understanding the personal experiences, risk perception and challenges in dealing with blood exposures. Participants: This study was conducted at Lagos State University Teaching Hospital (LASUTH), a major tertiary healthcare institution located in Ikeja, Lagos, Nigeria. The target participants were Doctors, nurses, lab workers and cleaning staffs based on their routine exposure to bloods and blood samples from patients 10,11 1 . Convenience sampling was utilized to recruit participants from the hospital to ensure accessibility and availability of participants, particularly due to specific busy time constraints or tight departmental schedules. The size of participants for the was guided by the principle of theoretical saturation, the point at which no new information or themes emerge from additional data collection 12 . Therefore, semi-structured interview was conducted until data saturation was reached Ethical Considerations: Ethical approval was obtained from the Research Management Centre, MAHSA University (RMC/AUGUST/2025/EC06) and the Lagos State University College of Medicine Health Research Ethics Committee (LASUCOM-HREC) (CM/HREC.183/005B) and was carried out in accordance with the ethical standards of the Declaration of Helsinki. Participants were provided with clear and comprehensive information sheet regarding the study’s objectives, procedures, and their rights as participants. Written informed consent was obtained from participant. Participation was entirely voluntary, and individuals had the right to withdraw at any point without any consequences. Data Collection Procedure: The Semi-structured interview was conducted in person at the hospital. Each session took place in a quiet, private setting to encourage open conversation. The interview followed a semi-structured format, beginning with broad questions and narrowing to specific topics related to exposure risk and concern, factors contributing to exposure, safety compliance, institutional support, post-exposure procedures and safety compliance challenges. The researcher moderated the sessions, ensuring that each participant had the freedom of expression in responding to interview questions. All sessions were audio-recorded and transcribed verbatim for analysis. Analysis: Thematic analysis was used to interpret the qualitative data. The process involved: Transcription: Audio recordings from the FGDs were transcribed verbatim. Familiarization: Transcripts were read multiple times to gain a deep understanding of the data. Theme Development: Related codes were grouped into broader themes reflecting key concepts and experiences shared by participants. Interpretation: Themes were analyzed and interpreted in relation to the study objectives, and supporting quotes were extracted to illustrate findings. To enhance validity, themes were compared across groups and checked against the raw data for consistency. Results Summary of the focus group discussion: The focus group discussion was used in this research as it was a vital tool to reveal and examine the feelings, opinions, viewpoints, perception and experiences of health workers regarding the exposures to bloodborne infections while working and providing care to patients at Lagos State University Teaching Hospital (LASUTH). Their viewpoints and exchange of ideas as health workers contributed to the understanding of specific issue on exposures to bloodborne infection, as they are at higher risk of exposure than the general population. The summary of the focus group discussion on exposures to bloodborne infection among health workers, the risk perception, personal experience, associated factors and compliance to safety practices in the health facility is put forward below 1. Blood exposure risks and Healthcare workers concerns Exposure to blood and blood products is a significant concern for healthcare workers. By virtue of their work, they are at a higher risk of exposure to infection as they are constantly exposed to blood and body fluids, as well as other hazards while providing care to patients 1.1 Exposure to blood and blood products is a significant concern for healthcare workers: Doctors acknowledge exposure to infections during work, as working as a doctor involves exposures to blood and blood pathogens, especially from patients, which is a significant concern: “since we are being exposed to patients… we at very great risk, so it’s a very great concern” (respond from a female doctor). They believe they at a greater risk of infections compared to general workers: “Are you at a greater risk than a normal general worker? I would say so (male doctor working in emergency unit). And the risk of contracting blood-borne infections is high due to unknown patient infection status. A female doctor said: “…we have a lot of blood-borne infections. So, we don't know which patient actually has one of those blood-borne infections… And we at super high risk of contracting on one of those”. Furthermore, Procedures like setting lines and drawing blood increase exposure risk: “we have needle pricks when you are trying to set line ((attempting to insert intravenous line or cannula into patient’s veins for administering fluids, medication or for future blood draws)) … even when you’re trying to draw blood, sometimes blood could spill on you”. Nurses face exposure to blood, body fluids, and pathogens as a significant occupational risk. The risk of infection from patient contact is acknowledged as part of nursing duties. A male nurse said “I understand it's part of the job”. Nurses also expressed that while they are aware of the risk of exposure, it doesn’t affect their job responsibilities, as long as they take preventive measure and follow standard precautions. A nurse working in internal medicine expressed “as far as I am fully protected ((with PPE)), I don’t have any issue with it. Laboratory staff regularly exposed to blood samples from various patients. Lab professionals discussed exposure to blood pathogens as a concern, especially for new staff: … maybe for those that are just coming up ((new employees)), it might be like a concern for them… for our new staff and those that are just coming up, yes” (a female lab worker). Additionally, some individuals may have difficulty adapting to the lab environment due to health issues. One female participant recounted; “They had even a student that had, like say, one episode like that. This guy that had like a breathing respiratory problem… So, it's not everybody that can adapt to the environment. But with time and experience, we cope”. Cleaning Staff are also often exposed to blood and bodily fluids. Despite exposure, work practices remain consistent without change: “…when we are doing our work, we are supposed to put on our gloves and our nose mask… Any work we are doing, we are always putting our gloves and our nose mask… when you’re working in the hospital environment like this, we have to go with our gloves so it will not affect you” (female cleaning staff). 2. Most Commonly Encountered Infections Doctors, Nurses, Laboratory Staff, and cleaners face daily exposures to bloodborne pathogens, especially viral infections like hepatitis B and HIV. 2.1 Hepatitis B is identified as the most common bloodborne pathogen : Hepatitis B was identified as the most common infection risk in the department by Doctors, Nurses, Laboratory Staff, and cleaners. As argued by a nurse with considerable clinical experience: “Oh, Hepatitis! we mostly get hepatitis…. I would grade it as number one. This was affirmed by a female doctor that: “the commonest that I’ve seen is actually hepatitis B”. additionally, a laboratory staff also noted: “Yes, hepatitis B especially… It's most common one. Yes!”. 2.2 Hepatitis B is more common than HIV in healthcare settings: Hepatitis B is the most common infection contracted from patients, more so than HIV or hepatitis C. A doctor explained “Yeah, hepatitis B. people think it is HIV… No. but hepatitis B is actually more common… yes, than HIV… then, to a lesser degree, hepatitis C. While, E. Coli and Klebsiella were also noted as common encountered by lab workers, though not of blood origin. 2.3 Prior History of exposure: Being exposed to infection was agreed to being a devastating experience. As the person needs to follow certain examinations, and in some cases, go through Post Exposure prophylaxis or pharmaceutical regime. While cases of exposure to infection were rare, two participants did recount their personal experience of being exposed. A male nurse recounts: “it was in emergency ((it occurred while he previously worked in the emergency)) … was fluid from patients with AIDS… the patients threw up when we’re doing CPR… Subsequently, test result came out that the patients is type 2 HIV patient, Which, means they are highly infectious”. Another participant, a female doctor also shared her experience of exposure to hepatitis B patient: “during my internship here, there was a particular patient that, you know, had, um, (.) I think the patient had a delirium or so ((not in the right state of mind)) …, I was going to draw blood from the patient, then I mistakenly pricked myself… I had a needle prick… then I went to check and I realized that the patient is actually hepatitis B positive. But lucky for me, I had already been vaccinated. I had completed vaccination like two months prior to that”. Emphasizing vaccination against Hepatitis B provides protection for health workers. 3. Factors Leading to Exposure: Healthcare workers revealed many factors that may contribute to exposure incidents. 3.1 Limited availability of protective equipment: Healthcare workers agreed that exposure can often results from lack of protective equipment use: “as we all know, in the present situation we find ourself, not everything is readily available… you have to improvise…. Most of the things you are meant to use to protect yourself are not available” (a male nurse participant working in emergency). 3.2 Handling samples without PPE: Participants noted that handling samples without proper protection elevated risk. A female lab worker elaborated: “if you don’t wear your PPE… your gloves, your lab coat, face mask… you’ll be exposed…. Like when we are carrying out AFB ((Acid fast bacilli test)) … or when you’re working with sputum sample, normally you’re supposed to be on PPE… so if you’re not on all these things, you’ll be exposed… obviously”. 3.3 On-spot decisions during emergencies: Participants also describe emergency situation as a major factor that increases exposure risk. a male nurse working in emergency wards said: “it mostly has to do with on-spot decision… especially when you have to do something without thinking about it... you’re trying to safe life, so a lot of times you find yourself being exposed. This sentiment was also reiterated by another participant: “sometimes, when a very bad patient comes in, you’re supposed to quickly stabilize the patients…. In times like that, you’re not even thinking about safety protocols, you just want to do your best to save patient” (female doctor working in emergency). 3.4 Patients Behavior: The behavior of patients was discussed as a contributing factor to exposure risk. the participants pointed out that fear and stigma around certain infections affect patients’ behavior, sometimes leading to them hiding symptoms: “the fear of stigmatisation or fear of being turned back…. They tend to hide signs or symptoms” (male doctor). This contributes to risk of contracting infection due to the unknown patient’s infection status, unless they present with more obvious signs or symptoms. Other notable factors pointed out by participants that leads to Exposure: Human Error, Stress, Burnout from work overload, all significantly contributes to exposure incidents and increases pathogen exposure risk 4. Safety compliance and Challenges 4.1 Compliance with safety precautions among health workers is highly rated : Standard Precautions are followed by colleagues: “when it comes to the health practitioners trying to provide safety for themselves… I would say 8 ((8/10))” (nurse). Safety guidelines and protocols are adhered to by staff, and there are safety officers in the hospital that check if safety guidelines are followed, and emphasize the importance of following safety protocols strictly: “we have our safety officers… they check all those things” (female lab staff). They are required to wear nose mask and gloves to protect themselves. In general, Safety precautions are generally followed and enforced strictly 4.2 Compliance with safety protocols is consistently challenging: While safety protocol ideally should be strictly followed, compliance with safety protocols can be challenging due to lack of proper facilities, which impedes adherence to safety procedures: “the things that are supposed to make the protocols easy to follow are not even put in place” (female doctor). Lack of basic resources like water hinders proper hygiene practices. This was stated by a male dentist: “… there’s no water…. I’m working, I can’t wash my hands… so those are the main problems”. Another challenge affecting compliance with safety protocol is the limited availability of protective equipment. Due to the limited availability of protective equipment such as face mask and gloves, disposal of materials after every patient is difficult due to limited supplies. A male Dentist shared his frustration “these gloves, I’m supposed to be disposing after every patient, but I can’t…. We have limited, based on what is available to us”. Aseptic procedures are sometimes not followed due to inadequate resources. A female doctor working in pediatrics said: “…there’s a particular procedure in pediatrics called exchange blood transfusion for patients with uhm, sickle cell…. It’s supposed to be an aseptic procedure… you’re supposed to be draped, you’re supposed to wear your PPE, but then, you just do it by the bedside without full PPE”. While there is an effort to improve and enforce safety protocols consistently, the hospital’s effort to create a safe environment is not highly rated by staff “… in terms of the hospital trying to make… to create a safe environment for the staffs... I would say 6 ((rated 6/10)) (a male nurse working in emergency). A female doctor also ascertained: “on a scale of 1 to 10. I would say it’s about a 6… it’s not 100 percent. 5. Safety Education and Training 5.1 Hospital provides Safety Training and education for new staff: Safety training is organized by the hospital, but mainly during orientation for new staff, and has not been regular. Training includes a 10-day orientation for new staffs: “maybe you’re a newcomer ((new staff)) … you do 10 days training (female cleaner). And “for new staff, we usually do training for them… cause they’re just coming…” (male lab worker). 5.2 Continuous education is not maintained: While safety training has been organized in the past, participants reported that it has not been regular. A male doctor responded “they’ve had in the past ((organized safety training)), but it’s been a long time we’ve had any training”. The sentiment was also shared by a female lab staff: “it’s been long… it’s not frequented enough. Staff do not solely rely on the provided training by the hospital, some health workers do try to educate themselves in order to stay updated on current safety procedures and guidelines: “so… read journals, I go online, I search for articles… so that I’m abreast of what is going on in the western world... I try to apply that to my work today” (female resident doctor). Additionally, laboratory staffs regularly organize safety education and training among themselves, by assigning recent safety topics to research and present to their colleagues: “we pick someone, they give you a topic to work on and… then we present it to the whole staff” (female participant working in the lab). This is done to keep laboratory staff updated on safety measure. 6. Institutional support and Compensation 6.1 Hazard Allowance: The hospital provides financial compensation called “hazard allowance” to health workers as part of salary for exposure to daily risk. This Hazards allowance is likened to insurance for risk compensation: “it is part of our salary…it is for saying thank you for putting your life on the line, for what we are exposed to everyday. It is recognised a s a significant factor for staff safety and motivation. 7. Post-Exposure Incident Handling and Challenges 7.1 Post-exposure procedures in hospital: Protocols exist for exposure incidents, including post-exposure prophylaxis (PEP) is available for workers after needlestick or bloodborne exposure. The post exposure prophylaxis process is initiated after exposure. Initial responds include immediate reporting to supervisor, followed by testing and immediate prophylaxis (e.g., PEP for HIV, BCD for hepatitis): “for needle prick... the first thing you’re going to do is test, and then if the patients ((source of the infection)) is a positive patient, so you’re going to be placed on PEP ((post-exposure prophylaxis))…, and for hepatitis, prior to test results, the exposed person is immediately placed on… hepatitis vaccine to prevent any risk” (statement by a nurse working in emergency care unit). PEP is recommended if vaccination for hepatitis is not up to date, but PEP is not needed for hepatitis if vaccination was completed within the last 2 months after exposure. 7.2 Challenges and limitation of current post-exposure procedures: HealthCare workers complained that hospital support for exposure incidents is limited and often delayed. Exposure incidents are not addressed promptly, leading to staff dissatisfaction. As a result, some staffs often pay out of pocket at other health institute for post-exposure procedures due to the slow hospital process: the procedure, most of the time, we have to pay for it (at another hospital)… if you are going to through the process at the hospital….getting exemptions and all that, it takes so long… there’s like a millions miles to run just to before you can get what needs to be done within a short period of time, so a lot of times you find staffs paying for it …. Because the time it will take for the hospital to carry out such things is quite low” (a male nurse working in emergency). The delays in the hospital process increases psychological stress, and the psychological impact on the exposed staff can be significant: “other than the fact that the person is exposed, they are psychologically affected … they are scared of… have I gotten HIV… Do I want to live my life with something that I did not come with” (argument by a male nurse). 8. Suggestions for safety improvement 8.1 Regular safety training: The participants emphasized the need for the hospital to organize more frequent and comprehensive safety education and training for all staffs, particularly regular training sessions on infection control for all staff to improve safety: “I would like that there should be a regular training on infection control” (male doctor) 8.2 Enhance protective equipment: Participants advocated for the hospital to provide additional protective equipment to better safeguard health workers “they can also buy more things to protect ourself”. And also request for improved quality and quantity of protective gears “… we can also have better… protective gears too… better quality… there can never be enough” (female lab staff). Overall, the participants agreed that hospital needs to ensure adequate supply of protective equipment like gloves, mask, and water for hygiene 8.3 Highlight infection risk during disposal : Participants also suggested that continuous reminders about basic Standard Precautions, and highlighting risk of infection especially during disposal of sharp objects could also be useful in improving safety guidelines “also… updating standard basic procures like… maybe writings ((posters)) to let people know that… dispose your sharps, don’t keep sharps around” (a female doctor). 8.4 Increased Hazard compensation: The adequacy of the current hazard allowance provided to healthcare workers is considered insufficient. The participants argued that the allowance awas too low and insufficient for the level of the risk faced. And there are calls to assess adequacy of the allowance, recommending an increase “I feel like that ((hazard allowance)) could be increased from what it is presently right now” (a female lab attendant). Discussion This qualitative study explored the perspectives and lived experiences of healthcare workers (HCWs) regarding occupational exposure to blood and bloodborne infections at Lagos State University Teaching Hospital (LASUTH). The findings highlight several critical and previously under-reported dimensions of exposure risk, institutional challenges, and the behavioral and systemic factors influencing compliance with safety practices. A key finding is the high level of perceived vulnerability to bloodborne infections across all cadres of HCWs , including doctors, nurses, laboratory staff, and cleaning staff. Participants acknowledged that their routine clinical activities such as drawing blood, inserting IV lines, handling specimens, and cleaning contaminated areas place them at substantial risk. This perception aligns with global evidence indicating that HCWs are significantly more exposed to bloodborne pathogens than the general population 1 , 2 . However, this study offers new contextual insight: the unpredictability of patient behavior and emergency situations was repeatedly emphasized as a major contributor to exposure, emphasizing the unique operational realities within LASUTH. Consistent with previous research, hepatitis B emerged as the most commonly encountered infection 13 – 15 , perceived to be even more prevalent than HIV among exposed staff. This aligns with the epidemiological pattern in many low- and middle-income countries 16 – 18 . Importantly, the accounts provided suggest that successful hepatitis B vaccination offers reassurance and reduces anxiety during exposure events , reinforcing the importance of complete immunization coverage. The findings also reveal important systemic contributors to exposure , including limited PPE availability, absence of adequate water supply, understaffing, workflow pressures, burnout, and the necessity of rapid decision-making in emergencies. While HCWs expressed strong personal commitment to safety behavior, they also highlighted that poor resource availability often undermines their ability to follow standard precautions. This disconnect reveals a structural limitation: safety compliance is not solely a behavioral issue but also a function of institutional readiness . Another important insight is the inconsistency of safety training . Although orientation programmes exist for new staff, continuous professional development in infection prevention and control (IPC) is lacking. Staff described self-directed learning and internally organized team briefings, particularly in the laboratory, demonstrating initiative but also pointing to institutional gaps in structured education. Post-exposure management procedures were also found to be ineffective and often delayed , a challenge not widely documented in similar qualitative studies. Participants emphasized that the time required to access testing and prophylaxis within the hospital system frequently forces them to pay out-of-pocket at private facilities. This not only affects timely medical intervention but also heightens psychological distress. Such delays contradict best-practice recommendations that emphasize immediate assessment and initiation of PEP. Overall, the study highlights significant institutional limitations , including inadequate PPE supplies, irregular training, insufficient hazard compensation, and a post-exposure protocol that lacks efficiency. These findings reinforce the conclusion that occupational exposure risk is not merely a function of frontline work but is strongly influenced by systemic and administrative structures . Addressing these deficiencies is essential for improving staff safety and strengthening infection control systems. Conclusion This study achieved its objective of exploring the perceptions, experiences, and challenges faced by healthcare workers regarding occupational exposure to blood and bloodborne infections at LASUTH. The findings reveal that HCWs understand the inherent risks associated with their roles and demonstrate strong willingness to adhere to safety practices. However, their ability to do so is often constrained by systemic issues, including inadequate resources, insufficient protective equipment, irregular training, and delays in post-exposure care. The study concludes that occupational exposure risk is shaped by both individual behavior and institutional capacity , and meaningful improvement will require strengthening both aspects simultaneously. The observations underscore the critical need for improved PPE availability, regular IPC training, streamlined post-exposure protocols, and enhanced institutional support. Ultimately, the data indicate that without sustained investment in safety infrastructure and policy implementation, HCWs will continue to face preventable risks that threaten both their health and the quality of care they deliver. Recommendations: Based on the findings, the following recommendations are proposed: 1. Strengthen Infection Prevention and Control (IPC) Training • Implement mandatory, routine IPC training for all cadres of staff, not only new employees. • Schedule periodic refresher courses to reinforce standard precautions and update staff on new guidelines. • Develop unit-specific training modules addressing high-risk procedures and emergency response. 2. Improve Availability and Quality of Protective Equipment • Ensure consistent supply of essential PPE, including gloves, masks, gowns, and eye protection. • Improve water availability and sanitation infrastructure to support proper hand hygiene. • Procure higher-quality protective gear based on staff feedback. 3. Enhance Post-Exposure Management Systems • Streamline the reporting and PEP initiation process to ensure rapid response. • Establish a dedicated occupational health unit responsible for immediate evaluation, testing, and follow-up care. • Eliminate administrative delays that force HCWs to seek care externally. 4. Increase Hazard Allowance and Broader Institutional Support • Review and revise the hazard allowance to reflect the actual risk exposure level of HCWs. • Provide psychological support services for staff undergoing exposure incidents. • Improve staffing levels to reduce burnout and error-related exposure. 5. Reinforce Safety Compliance Through Environmental and Administrative Measures • Provide visual reminders (posters, signage) on proper disposal of sharps and standard precautions. • Ensure the presence of functional safety officers across departments. • Establish accountability mechanisms to monitor compliance. 6. Promote a Culture of Safety • Encourage open reporting of exposure incidents without fear of blame. • Recognize departments demonstrating exemplary adherence to safety protocols. • Foster teamwork and communication to enhance safety during high-pressure clinical situations Declarations Funding The study was not supported by any external funding. The authors declare no financial or personal interest in this article. Data Availability Declaration The datasets generated during the current study are not publicly available due to ethical and confidentiality considerations but are available from the corresponding author on reasonable request and with appropriate ethical approval. Author Contribution All authors read and approved of the final manuscript. GJ was responsible for the study conceptualization, methodology, data synthesis, analysis and manuscript drafting. Discussion, Critical revisions of paper and study supervision: NAA. All authors have read and agreed to the published version of the manuscript Acknowledgement: I would like to express my gratitude to my supervisor for their suggestion and contributions to the completions of this research Conflict of Interest The author declares no potential conflict of interest Data Availability The datasets generated during the current study are not publicly available due to ethical and confidentiality considerations but are available from the corresponding author on reasonable request and with appropriate ethical approval. References Oyibo P, Okumagba M, Ntaji M, AWUNOR N, Adesoye O. Occupational blood and body fluids exposures: Prevalence, sources and predictors among healthcare providers in south-south Nigeria. The Egyptian Journal of Community Medicine. 2022;0(0). Heba Nasser Rayan, Samia Mohamed Adam, Hanaa Mohamed Abdrabou. Effect of Training Program Regarding Occupational Health Hazards on Nurse Interns’ Knowledge and Practice. 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Knowledge, attitude, and practice towards hepatitis B and C virus infection and associated factors among adults living at selected woredas in Gamo Zone, Southern Ethiopia: a cross-sectional study. BMC Public Health [Internet]. 2024;24(1):995. Available from: https://doi.org/10.1186/s12889-024-18387-z Abdela A, Woldu B, Haile K, Mathewos B, Deressa T. Assessment of knowledge, attitudes and practices toward prevention of hepatitis B virus infection among students of medicine and health sciences in Northwest Ethiopia. BMC Res Notes. 2016;9(1). Ahmed Elmukashfi Elsheikh T. Knowledge, Attitude and Practice of Heath Care Workers Regarding Transmission and Prevention of Hepatitis B Virus Infection, White Nile State, Sudan, 2013. American Journal of Health Research. 2016;4(2). Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8343117","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":634110839,"identity":"7735250f-c834-4f98-a40a-28fd9225f8a3","order_by":0,"name":"Jamiu, Olalekan, Ishola Garba","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABAUlEQVRIiWNgGAWjYDACdgbGAwwHwEw2BoYKIMXM3IBfCzMDA5KWMyARRlK0MLaBaAJa+JmZHxz4cMYuT9797LMHP+fVRvO3A7X8qNiGU4tkM5vBwRk3kosNz6SbG/ZuO5474zBjA2PPmds4tRgcBiKeD8yJGxvS2CR4tx3LbQBqYWZsw6eF/cPhPx/qEzf2P2OT/DvnWO58wlp4gBbdOJw4XyKNTZq3oSZ3AyEtks08BQd7zhxP3CDxjN1Y5tiB3I1ALQfx+YWfvX3jgx/HqhPn96exPXxTU5c77/zhgw9+VODWgnDhATB1GEweIKweCOQbwFQdUYpHwSgYBaNgZAEAOT1jRwP3kRQAAAAASUVORK5CYII=","orcid":"","institution":"MAHSA University","correspondingAuthor":true,"prefix":"","firstName":"Ishola","middleName":"Garba Olalekan","lastName":"Jamiu","suffix":""},{"id":634110840,"identity":"da1d2a10-fc17-47df-a082-05a8f4e07a40","order_by":1,"name":"Nahla Abduljaleel Alsaidi","email":"","orcid":"","institution":"MAHSA University","correspondingAuthor":false,"prefix":"","firstName":"Nahla","middleName":"Abduljaleel","lastName":"Alsaidi","suffix":""}],"badges":[],"createdAt":"2025-12-12 07:53:34","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8343117/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8343117/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108630057,"identity":"5fd96b93-d36c-402d-8e48-36b42e72bfc1","added_by":"auto","created_at":"2026-05-06 16:33:41","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":72264,"visible":true,"origin":"","legend":"\u003cp\u003eStages in Framework within the Research\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8343117/v1/bb6e38930717e1d4d2663919.png"},{"id":109204400,"identity":"5da76f49-f75e-4d5d-8087-a199096aad2c","added_by":"auto","created_at":"2026-05-13 14:59:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":229546,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8343117/v1/1f1d2407-2a8b-4a7e-871d-2760d07b6303.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Perceptive of Healthcare Workers on Blood Exposure Risk, Contributing Factors and Challenges Faced: A Qualitative study at Lagos State University Teaching Hospital","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBy virtue of their work, healthcare workers are at an elevated risk of occupational exposure to blood/ bodily fluids, and subsequently borne infection when compared to the general population \u003csup\u003e1\u0026ndash;4\u003c/sup\u003e. This heightened risk is due to frequent contact with blood and other potentially infectious body fluids. Such exposure can occur through accidental incidents, and the severity and unpredictability of these events make them a serious occupational hazard \u003csup\u003e3,5\u003c/sup\u003e. Blood and body fluid (BBF) exposure is globally recognized as a significant concern, often resulting from needle-stick injuries or other percutaneous events \u003csup\u003e7,8\u003c/sup\u003e The research is centered around the issues of high risk of exposures to bloodborne infections in healthcare settings, and its effects on health workers, and consequently, the patients, the public, and the overall health environment and health outcomes.\u0026nbsp;\u003csup\u003e9\u003c/sup\u003e. In general, healthcare workers in Nigeria face a significant risk of exposure to bloodborne infections, posing serious threats to both their health and patient safety. Continuous and unmanaged exposure to such infections leads to hazardous working environments, increased illness, extended hospital stays, higher morbidity and mortality rates, and ultimately compromises the quality of healthcare services and the efficiency of healthcare professionals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAim/ Objectives:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study is aimed at understanding the experience, opinions and perspectives of health workers who at risk of occupational exposure to blood and bloodborne infection, and to gain a deeper understanding of factors leading to exposures and the challenges that health workers encounter dealing with occupational exposure to bloodborne diseases.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003eA qualitative research method was utilized for data collection. A Semi structured interview was employed at the hospital. This method asked open ended questions, which was reliable in providing new ways of understanding the personal experiences, risk perception and challenges in dealing with blood exposures.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipants:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted at Lagos State University Teaching Hospital (LASUTH), a major tertiary healthcare institution located in Ikeja, Lagos, Nigeria. The target participants were Doctors, nurses, lab workers and cleaning staffs based on their routine exposure to bloods and blood samples from patients\u003csup\u003e10,11 1\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConvenience sampling\u003c/strong\u003e was utilized to recruit participants from the hospital to ensure accessibility and availability of participants, particularly due to specific busy time constraints or tight departmental schedules. The size of participants for the was guided by the principle of theoretical saturation, the point at which no new information or themes emerge from additional data collection\u003csup\u003e12\u003c/sup\u003e. Therefore, semi-structured interview was conducted until data saturation was reached\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Considerations:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the Research Management Centre, MAHSA University (RMC/AUGUST/2025/EC06) and the Lagos State University College of Medicine Health Research Ethics Committee (LASUCOM-HREC) (CM/HREC.183/005B) and was carried out in accordance with the ethical standards of the Declaration of Helsinki. Participants were provided with clear and comprehensive information sheet regarding the study\u0026rsquo;s objectives, procedures, and their rights as participants. Written informed consent was obtained from participant. Participation was entirely voluntary, and individuals had the right to withdraw at any point without any consequences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection Procedure:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Semi-structured interview was conducted in person at the hospital. Each session took place in a quiet, private setting to encourage open conversation. The interview followed a semi-structured format, beginning with broad questions and narrowing to specific topics related to exposure risk and concern, factors contributing to exposure, safety compliance, institutional support, post-exposure procedures and safety compliance challenges. The researcher moderated the sessions, ensuring that each participant had the freedom of expression in responding to interview questions. All sessions were audio-recorded and transcribed verbatim for analysis.\u003c/p\u003e\n\u003cp\u003eAnalysis:\u003c/p\u003e\n\u003cp\u003eThematic analysis was used to interpret the qualitative data. The process involved:\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eTranscription: Audio recordings from the FGDs were transcribed verbatim.\u003c/li\u003e\n \u003cli\u003eFamiliarization: Transcripts were read multiple times to gain a deep understanding of the data.\u003c/li\u003e\n \u003cli\u003eTheme Development: Related codes were grouped into broader themes reflecting key concepts and experiences shared by participants.\u003c/li\u003e\n \u003cli\u003eInterpretation: Themes were analyzed and interpreted in relation to the study objectives, and supporting quotes were extracted to illustrate findings.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eTo enhance validity, themes were compared across groups and checked against the raw data for consistency.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eSummary of the focus group discussion:\u003c/p\u003e \u003cp\u003eThe focus group discussion was used in this research as it was a vital tool to reveal and examine the feelings, opinions, viewpoints, perception and experiences of health workers regarding the exposures to bloodborne infections while working and providing care to patients at Lagos State University Teaching Hospital (LASUTH). Their viewpoints and exchange of ideas as health workers contributed to the understanding of specific issue on exposures to bloodborne infection, as they are at higher risk of exposure than the general population.\u003c/p\u003e \u003cp\u003eThe summary of the focus group discussion on exposures to bloodborne infection among health workers, the risk perception, personal experience, associated factors and compliance to safety practices in the health facility is put forward below\u003c/p\u003e\n\u003ch3\u003e1. Blood exposure risks and Healthcare workers concerns\u003c/h3\u003e\n\u003cp\u003eExposure to blood and blood products is a significant concern for healthcare workers. By virtue of their work, they are at a higher risk of exposure to infection as they are constantly exposed to blood and body fluids, as well as other hazards while providing care to patients\u003c/p\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e1.1 Exposure to blood and blood products is a significant concern for healthcare workers:\u003c/h2\u003e \u003cp\u003eDoctors acknowledge exposure to infections during work, as working as a doctor involves exposures to blood and blood pathogens, especially from patients, which is a significant concern: \u0026ldquo;since we are being exposed to patients\u0026hellip; we at very great risk, so it\u0026rsquo;s a very great concern\u0026rdquo; (respond from a female doctor). They believe they at a greater risk of infections compared to general workers: \u0026ldquo;Are you at a greater risk than a normal general worker? I would say so (male doctor working in emergency unit). And the risk of contracting blood-borne infections is high due to unknown patient infection status. A female doctor said: \u0026ldquo;\u0026hellip;we have a lot of blood-borne infections. So, we don't know which patient actually has one of those blood-borne infections\u0026hellip; And we at super high risk of contracting on one of those\u0026rdquo;. Furthermore, Procedures like setting lines and drawing blood increase exposure risk: \u0026ldquo;we have needle pricks when you are trying to set line ((attempting to insert intravenous line or cannula into patient\u0026rsquo;s veins for administering fluids, medication or for future blood draws)) \u0026hellip; even when you\u0026rsquo;re trying to draw blood, sometimes blood could spill on you\u0026rdquo;.\u003c/p\u003e \u003cp\u003e \u003cb\u003eNurses\u003c/b\u003e face exposure to blood, body fluids, and pathogens as a significant occupational risk. The risk of infection from patient contact is acknowledged as part of nursing duties. A male nurse said \u0026ldquo;I understand it's part of the job\u0026rdquo;. Nurses also expressed that while they are aware of the risk of exposure, it doesn\u0026rsquo;t affect their job responsibilities, as long as they take preventive measure and follow standard precautions. A nurse working in internal medicine expressed \u0026ldquo;as far as I am fully protected ((with PPE)), I don\u0026rsquo;t have any issue with it.\u003c/p\u003e \u003cp\u003e \u003cb\u003eLaboratory staff\u003c/b\u003e regularly exposed to blood samples from various patients. Lab professionals discussed exposure to blood pathogens as a concern, especially for new staff: \u0026hellip; maybe for those that are just coming up ((new employees)), it might be like a concern for them\u0026hellip; for our new staff and those that are just coming up, yes\u0026rdquo; (a female lab worker). Additionally, some individuals may have difficulty adapting to the lab environment due to health issues. One female participant recounted; \u0026ldquo;They had even a student that had, like say, one episode like that. This guy that had like a breathing respiratory problem\u0026hellip; So, it's not everybody that can adapt to the environment. But with time and experience, we cope\u0026rdquo;.\u003c/p\u003e \u003cp\u003e \u003cb\u003eCleaning Staff\u003c/b\u003e are also often exposed to blood and bodily fluids. Despite exposure, work practices remain consistent without change: \u0026ldquo;\u0026hellip;when we are doing our work, we are supposed to put on our gloves and our nose mask\u0026hellip; Any work we are doing, we are always putting our gloves and our nose mask\u0026hellip; when you\u0026rsquo;re working in the hospital environment like this, we have to go with our gloves so it will not affect you\u0026rdquo; (female cleaning staff).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e2. Most Commonly Encountered Infections\u003c/h3\u003e\n\u003cp\u003eDoctors, Nurses, Laboratory Staff, and cleaners face daily exposures to bloodborne pathogens, especially viral infections like hepatitis B and HIV.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e2.1 \u003cem\u003eHepatitis B is identified as the most common bloodborne pathogen\u003c/em\u003e:\u003c/h2\u003e \u003cp\u003eHepatitis B was identified as the most common infection risk in the department by Doctors, Nurses, Laboratory Staff, and cleaners. As argued by a nurse with considerable clinical experience: \u0026ldquo;Oh, Hepatitis! we mostly get hepatitis\u0026hellip;. I would grade it as number one. This was affirmed by a female doctor that: \u0026ldquo;the commonest that I\u0026rsquo;ve seen is actually hepatitis B\u0026rdquo;. additionally, a laboratory staff also noted: \u0026ldquo;Yes, hepatitis B especially\u0026hellip; It's most common one. Yes!\u0026rdquo;.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Hepatitis B is more common than HIV in healthcare settings:\u003c/h2\u003e \u003cp\u003eHepatitis B is the most common infection contracted from patients, more so than HIV or hepatitis C. A doctor explained \u0026ldquo;Yeah, hepatitis B. people think it is HIV\u0026hellip; No. but hepatitis B is actually more common\u0026hellip; yes, than HIV\u0026hellip; then, to a lesser degree, hepatitis C. While, E. \u003cem\u003eColi\u003c/em\u003e and \u003cem\u003eKlebsiella\u003c/em\u003e were also noted as common encountered by lab workers, though not of blood origin.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Prior History of exposure:\u003c/h2\u003e \u003cp\u003eBeing exposed to infection was agreed to being a devastating experience. As the person needs to follow certain examinations, and in some cases, go through Post Exposure prophylaxis or pharmaceutical regime. While cases of exposure to infection were rare, two participants did recount their personal experience of being exposed. A male nurse recounts: \u0026ldquo;it was in emergency ((it occurred while he previously worked in the emergency)) \u0026hellip; was fluid from patients with AIDS\u0026hellip; the patients threw up when we\u0026rsquo;re doing CPR\u0026hellip; Subsequently, test result came out that the patients is type 2 HIV patient, Which, means they are highly infectious\u0026rdquo;. Another participant, a female doctor also shared her experience of exposure to hepatitis B patient: \u0026ldquo;during my internship here, there was a particular patient that, you know, had, um, (.) I think the patient had a delirium or so ((not in the right state of mind)) \u0026hellip;, I was going to draw blood from the patient, then I mistakenly pricked myself\u0026hellip; I had a needle prick\u0026hellip; then I went to check and I realized that the patient is actually hepatitis B positive. But lucky for me, I had already been vaccinated. I had completed vaccination like two months prior to that\u0026rdquo;. Emphasizing vaccination against Hepatitis B provides protection for health workers.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e3. Factors Leading to Exposure:\u003c/h3\u003e\n\u003cp\u003eHealthcare workers revealed many factors that may contribute to exposure incidents.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Limited availability of protective equipment:\u003c/h2\u003e \u003cp\u003eHealthcare workers agreed that exposure can often results from lack of protective equipment use: \u0026ldquo;as we all know, in the present situation we find ourself, not everything is readily available\u0026hellip; you have to improvise\u0026hellip;. Most of the things you are meant to use to protect yourself are not available\u0026rdquo; (a male nurse participant working in emergency).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Handling samples without PPE:\u003c/h2\u003e \u003cp\u003eParticipants noted that handling samples without proper protection elevated risk. A female lab worker elaborated: \u0026ldquo;if you don\u0026rsquo;t wear your PPE\u0026hellip; your gloves, your lab coat, face mask\u0026hellip; you\u0026rsquo;ll be exposed\u0026hellip;. Like when we are carrying out AFB ((Acid fast bacilli test)) \u0026hellip; or when you\u0026rsquo;re working with sputum sample, normally you\u0026rsquo;re supposed to be on PPE\u0026hellip; so if you\u0026rsquo;re not on all these things, you\u0026rsquo;ll be exposed\u0026hellip; obviously\u0026rdquo;.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e3.3 On-spot decisions during emergencies:\u003c/h2\u003e \u003cp\u003eParticipants also describe emergency situation as a major factor that increases exposure risk. a male nurse working in emergency wards said: \u0026ldquo;it mostly has to do with on-spot decision\u0026hellip; especially when you have to do something without thinking about it... you\u0026rsquo;re trying to safe life, so a lot of times you find yourself being exposed. This sentiment was also reiterated by another participant: \u0026ldquo;sometimes, when a very bad patient comes in, you\u0026rsquo;re supposed to quickly stabilize the patients\u0026hellip;. In times like that, you\u0026rsquo;re not even thinking about safety protocols, you just want to do your best to save patient\u0026rdquo; (female doctor working in emergency).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Patients Behavior:\u003c/h2\u003e \u003cp\u003eThe behavior of patients was discussed as a contributing factor to exposure risk. the participants pointed out that fear and stigma around certain infections affect patients\u0026rsquo; behavior, sometimes leading to them hiding symptoms: \u0026ldquo;the fear of stigmatisation or fear of being turned back\u0026hellip;. They tend to hide signs or symptoms\u0026rdquo; (male doctor). This contributes to risk of contracting infection due to the unknown patient\u0026rsquo;s infection status, unless they present with more obvious signs or symptoms.\u003c/p\u003e \u003cp\u003eOther notable factors pointed out by participants that leads to Exposure: Human Error, Stress, Burnout from work overload, all significantly contributes to exposure incidents and increases pathogen exposure risk\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e4. Safety compliance and Challenges\u003c/h3\u003e\n\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e4.1 \u003cem\u003eCompliance with safety precautions among health workers is highly rated\u003c/em\u003e:\u003c/h2\u003e \u003cp\u003eStandard Precautions are followed by colleagues: \u0026ldquo;when it comes to the health practitioners trying to provide safety for themselves\u0026hellip; I would say 8 ((8/10))\u0026rdquo; (nurse). Safety guidelines and protocols are adhered to by staff, and there are safety officers in the hospital that check if safety guidelines are followed, and emphasize the importance of following safety protocols strictly: \u0026ldquo;we have our safety officers\u0026hellip; they check all those things\u0026rdquo; (female lab staff). They are required to wear nose mask and gloves to protect themselves. In general, Safety precautions are generally followed and enforced strictly\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Compliance with safety protocols is consistently challenging:\u003c/h2\u003e \u003cp\u003eWhile safety protocol ideally should be strictly followed, compliance with safety protocols can be challenging due to lack of proper facilities, which impedes adherence to safety procedures: \u0026ldquo;the things that are supposed to make the protocols easy to follow are not even put in place\u0026rdquo; (female doctor). Lack of basic resources like water hinders proper hygiene practices. This was stated by a male dentist: \u0026ldquo;\u0026hellip; there\u0026rsquo;s no water\u0026hellip;. I\u0026rsquo;m working, I can\u0026rsquo;t wash my hands\u0026hellip; so those are the main problems\u0026rdquo;. Another challenge affecting compliance with safety protocol is the limited availability of protective equipment. Due to the limited availability of protective equipment such as face mask and gloves, disposal of materials after every patient is difficult due to limited supplies. A male Dentist shared his frustration \u0026ldquo;these gloves, I\u0026rsquo;m supposed to be disposing after every patient, but I can\u0026rsquo;t\u0026hellip;. We have limited, based on what is available to us\u0026rdquo;. Aseptic procedures are sometimes not followed due to inadequate resources. A female doctor working in pediatrics said: \u0026ldquo;\u0026hellip;there\u0026rsquo;s a particular procedure in pediatrics called exchange blood transfusion for patients with uhm, sickle cell\u0026hellip;. It\u0026rsquo;s supposed to be an aseptic procedure\u0026hellip; you\u0026rsquo;re supposed to be draped, you\u0026rsquo;re supposed to wear your PPE, but then, you just do it by the bedside without full PPE\u0026rdquo;. While there is an effort to improve and enforce safety protocols consistently, the hospital\u0026rsquo;s effort to create a safe environment is not highly rated by staff \u0026ldquo;\u0026hellip; in terms of the hospital trying to make\u0026hellip; to create a safe environment for the staffs... I would say 6 ((rated 6/10)) (a male nurse working in emergency). A female doctor also ascertained: \u0026ldquo;on a scale of 1 to 10. I would say it\u0026rsquo;s about a 6\u0026hellip; it\u0026rsquo;s not 100 percent.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e5. Safety Education and Training\u003c/h3\u003e\n\u003cdiv id=\"Sec23\" class=\"Section2\"\u003e \u003ch2\u003e5.1 Hospital provides Safety Training and education for new staff:\u003c/h2\u003e \u003cp\u003eSafety training is organized by the hospital, but mainly during orientation for new staff, and has not been regular. Training includes a 10-day orientation for new staffs: \u0026ldquo;maybe you\u0026rsquo;re a newcomer ((new staff)) \u0026hellip; you do 10 days training (female cleaner). And \u0026ldquo;for new staff, we usually do training for them\u0026hellip; cause they\u0026rsquo;re just coming\u0026hellip;\u0026rdquo; (male lab worker).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003e5.2 Continuous education is not maintained:\u003c/h2\u003e \u003cp\u003eWhile safety training has been organized in the past, participants reported that it has not been regular. A male doctor responded \u0026ldquo;they\u0026rsquo;ve had in the past ((organized safety training)), but it\u0026rsquo;s been a long time we\u0026rsquo;ve had any training\u0026rdquo;. The sentiment was also shared by a female lab staff: \u0026ldquo;it\u0026rsquo;s been long\u0026hellip; it\u0026rsquo;s not frequented enough. Staff do not solely rely on the provided training by the hospital, some health workers do try to educate themselves in order to stay updated on current safety procedures and guidelines: \u0026ldquo;so\u0026hellip; read journals, I go online, I search for articles\u0026hellip; so that I\u0026rsquo;m abreast of what is going on in the western world... I try to apply that to my work today\u0026rdquo; (female resident doctor). Additionally, laboratory staffs regularly organize safety education and training among themselves, by assigning recent safety topics to research and present to their colleagues: \u0026ldquo;we pick someone, they give you a topic to work on and\u0026hellip; then we present it to the whole staff\u0026rdquo; (female participant working in the lab). This is done to keep laboratory staff updated on safety measure.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e6. Institutional support and Compensation\u003c/h3\u003e\n\u003cdiv id=\"Sec26\" class=\"Section2\"\u003e \u003ch2\u003e6.1 Hazard Allowance:\u003c/h2\u003e \u003cp\u003eThe hospital provides financial compensation called \u0026ldquo;hazard allowance\u0026rdquo; to health workers as part of salary for exposure to daily risk. This Hazards allowance is likened to insurance for risk compensation: \u0026ldquo;it is part of our salary\u0026hellip;it is for saying thank you for putting your life on the line, for what we are exposed to everyday. It is recognised a s a significant factor for staff safety and motivation.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e7. Post-Exposure Incident Handling and Challenges\u003c/h3\u003e\n\u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003e7.1 Post-exposure procedures in hospital:\u003c/h2\u003e \u003cp\u003eProtocols exist for exposure incidents, including post-exposure prophylaxis (PEP) is available for workers after needlestick or bloodborne exposure. The post exposure prophylaxis process is initiated after exposure. Initial responds include immediate reporting to supervisor, followed by testing and immediate prophylaxis (e.g., PEP for HIV, BCD for hepatitis): \u0026ldquo;for needle prick... the first thing you\u0026rsquo;re going to do is test, and then if the patients ((source of the infection)) is a positive patient, so you\u0026rsquo;re going to be placed on PEP ((post-exposure prophylaxis))\u0026hellip;, and for hepatitis, prior to test results, the exposed person is immediately placed on\u0026hellip; hepatitis vaccine to prevent any risk\u0026rdquo; (statement by a nurse working in emergency care unit). PEP is recommended if vaccination for hepatitis is not up to date, but PEP is not needed for hepatitis if vaccination was completed within the last 2 months after exposure.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec29\" class=\"Section2\"\u003e \u003ch2\u003e7.2 Challenges and limitation of current post-exposure procedures:\u003c/h2\u003e \u003cp\u003eHealthCare workers complained that hospital support for exposure incidents is limited and often delayed. Exposure incidents are not addressed promptly, leading to staff dissatisfaction. As a result, some staffs often pay out of pocket at other health institute for post-exposure procedures due to the slow hospital process: the procedure, most of the time, we have to pay for it (at another hospital)\u0026hellip; if you are going to through the process at the hospital\u0026hellip;.getting exemptions and all that, it takes so long\u0026hellip; there\u0026rsquo;s like a millions miles to run just to before you can get what needs to be done within a short period of time, so a lot of times you find staffs paying for it \u0026hellip;. Because the time it will take for the hospital to carry out such things is quite low\u0026rdquo; (a male nurse working in emergency).\u003c/p\u003e \u003cp\u003eThe delays in the hospital process increases psychological stress, and the psychological impact on the exposed staff can be significant: \u0026ldquo;other than the fact that the person is exposed, they are psychologically affected \u0026hellip; they are scared of\u0026hellip; have I gotten HIV\u0026hellip; Do I want to live my life with something that I did not come with\u0026rdquo; (argument by a male nurse).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e8. Suggestions for safety improvement\u003c/h3\u003e\n\u003cdiv id=\"Sec31\" class=\"Section2\"\u003e \u003ch2\u003e8.1 Regular safety training:\u003c/h2\u003e \u003cp\u003eThe participants emphasized the need for the hospital to organize more frequent and comprehensive safety education and training for all staffs, particularly regular training sessions on infection control for all staff to improve safety: \u0026ldquo;I would like that there should be a regular training on infection control\u0026rdquo; (male doctor)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec32\" class=\"Section2\"\u003e \u003ch2\u003e8.2 Enhance protective equipment:\u003c/h2\u003e \u003cp\u003eParticipants advocated for the hospital to provide additional protective equipment to better safeguard health workers \u0026ldquo;they can also buy more things to protect ourself\u0026rdquo;. And also request for improved quality and quantity of protective gears \u0026ldquo;\u0026hellip; we can also have better\u0026hellip; protective gears too\u0026hellip; better quality\u0026hellip; there can never be enough\u0026rdquo; (female lab staff). Overall, the participants agreed that hospital needs to ensure adequate supply of protective equipment like gloves, mask, and water for hygiene\u003c/p\u003e \u003cp\u003e8.3 \u003cem\u003eHighlight infection risk during disposal\u003c/em\u003e:\u003c/p\u003e \u003cp\u003eParticipants also suggested that continuous reminders about basic Standard Precautions, and highlighting risk of infection especially during disposal of sharp objects could also be useful in improving safety guidelines \u0026ldquo;also\u0026hellip; updating standard basic procures like\u0026hellip; maybe writings ((posters)) to let people know that\u0026hellip; dispose your sharps, don\u0026rsquo;t keep sharps around\u0026rdquo; (a female doctor).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec33\" class=\"Section2\"\u003e \u003ch2\u003e8.4 Increased Hazard compensation:\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eThe adequacy of the current hazard allowance provided to healthcare workers is considered insufficient. The participants argued that the allowance awas too low and insufficient for the level of the risk faced. And there are calls to assess adequacy of the allowance, recommending an increase \u0026ldquo;I feel like that ((hazard allowance)) could be increased from what it is presently right now\u0026rdquo; (a female lab attendant).\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis qualitative study explored the perspectives and lived experiences of healthcare workers (HCWs) regarding occupational exposure to blood and bloodborne infections at Lagos State University Teaching Hospital (LASUTH). The findings highlight several critical and previously under-reported dimensions of exposure risk, institutional challenges, and the behavioral and systemic factors influencing compliance with safety practices.\u003c/p\u003e \u003cp\u003eA key finding is the \u003cb\u003ehigh level of perceived vulnerability to bloodborne infections across all cadres of HCWs\u003c/b\u003e, including doctors, nurses, laboratory staff, and cleaning staff. Participants acknowledged that their routine clinical activities such as drawing blood, inserting IV lines, handling specimens, and cleaning contaminated areas place them at substantial risk. This perception aligns with global evidence indicating that HCWs are significantly more exposed to bloodborne pathogens than the general population\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. However, this study offers new contextual insight: \u003cb\u003ethe unpredictability of patient behavior and emergency situations\u003c/b\u003e was repeatedly emphasized as a major contributor to exposure, emphasizing the unique operational realities within LASUTH.\u003c/p\u003e \u003cp\u003eConsistent with previous research, \u003cb\u003ehepatitis B emerged as the most commonly encountered infection\u003c/b\u003e\u003csup\u003e\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e, perceived to be even more prevalent than HIV among exposed staff. This aligns with the epidemiological pattern in many low- and middle-income countries\u003csup\u003e\u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. Importantly, the accounts provided suggest that \u003cb\u003esuccessful hepatitis B vaccination offers reassurance and reduces anxiety during exposure events\u003c/b\u003e, reinforcing the importance of complete immunization coverage.\u003c/p\u003e \u003cp\u003eThe findings also reveal important \u003cb\u003esystemic contributors to exposure\u003c/b\u003e, including limited PPE availability, absence of adequate water supply, understaffing, workflow pressures, burnout, and the necessity of rapid decision-making in emergencies. While HCWs expressed strong personal commitment to safety behavior, they also highlighted that poor resource availability often undermines their ability to follow standard precautions. This disconnect reveals a structural limitation: \u003cb\u003esafety compliance is not solely a behavioral issue but also a function of institutional readiness\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eAnother important insight is the \u003cb\u003einconsistency of safety training\u003c/b\u003e. Although orientation programmes exist for new staff, continuous professional development in infection prevention and control (IPC) is lacking. Staff described self-directed learning and internally organized team briefings, particularly in the laboratory, demonstrating initiative but also pointing to institutional gaps in structured education.\u003c/p\u003e \u003cp\u003ePost-exposure management procedures were also found to be \u003cb\u003eineffective and often delayed\u003c/b\u003e, a challenge not widely documented in similar qualitative studies. Participants emphasized that the time required to access testing and prophylaxis within the hospital system frequently forces them to pay out-of-pocket at private facilities. This not only affects timely medical intervention but also heightens psychological distress. Such delays contradict best-practice recommendations that emphasize immediate assessment and initiation of PEP.\u003c/p\u003e \u003cp\u003eOverall, the study highlights significant \u003cb\u003einstitutional limitations\u003c/b\u003e, including inadequate PPE supplies, irregular training, insufficient hazard compensation, and a post-exposure protocol that lacks efficiency. These findings reinforce the conclusion that \u003cb\u003eoccupational exposure risk is not merely a function of frontline work but is strongly influenced by systemic and administrative structures\u003c/b\u003e. Addressing these deficiencies is essential for improving staff safety and strengthening infection control systems.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study achieved its objective of exploring the perceptions, experiences, and challenges faced by healthcare workers regarding occupational exposure to blood and bloodborne infections at LASUTH. The findings reveal that HCWs understand the inherent risks associated with their roles and demonstrate strong willingness to adhere to safety practices. However, their ability to do so is often constrained by systemic issues, including inadequate resources, insufficient protective equipment, irregular training, and delays in post-exposure care.\u003c/p\u003e \u003cp\u003eThe study concludes that \u003cb\u003eoccupational exposure risk is shaped by both individual behavior and institutional capacity\u003c/b\u003e, and meaningful improvement will require strengthening both aspects simultaneously. The observations underscore the critical need for improved PPE availability, regular IPC training, streamlined post-exposure protocols, and enhanced institutional support. Ultimately, the data indicate that without sustained investment in safety infrastructure and policy implementation, HCWs will continue to face preventable risks that threaten both their health and the quality of care they deliver.\u003c/p\u003e\n\u003ch3\u003eRecommendations:\u003c/h3\u003e\n\u003cp\u003eBased on the findings, the following recommendations are proposed:\u003c/p\u003e\n\u003ch3\u003e1. Strengthen Infection Prevention and Control (IPC) Training\u003c/h3\u003e\n\u003cp\u003e\u0026bull; Implement mandatory, routine IPC training for all cadres of staff, not only new employees.\u003c/p\u003e \u003cp\u003e\u0026bull; Schedule periodic refresher courses to reinforce standard precautions and update staff on new guidelines.\u003c/p\u003e \u003cp\u003e\u0026bull; Develop unit-specific training modules addressing high-risk procedures and emergency response.\u003c/p\u003e\n\u003ch3\u003e2. Improve Availability and Quality of Protective Equipment\u003c/h3\u003e\n\u003cp\u003e\u0026bull; Ensure consistent supply of essential PPE, including gloves, masks, gowns, and eye protection.\u003c/p\u003e \u003cp\u003e\u0026bull; Improve water availability and sanitation infrastructure to support proper hand hygiene.\u003c/p\u003e \u003cp\u003e\u0026bull; Procure higher-quality protective gear based on staff feedback.\u003c/p\u003e\n\u003ch3\u003e3. Enhance Post-Exposure Management Systems\u003c/h3\u003e\n\u003cp\u003e\u0026bull; Streamline the reporting and PEP initiation process to ensure rapid response.\u003c/p\u003e \u003cp\u003e\u0026bull; Establish a dedicated occupational health unit responsible for immediate evaluation, testing, and follow-up care.\u003c/p\u003e \u003cp\u003e\u0026bull; Eliminate administrative delays that force HCWs to seek care externally.\u003c/p\u003e\n\u003ch3\u003e4. Increase Hazard Allowance and Broader Institutional Support\u003c/h3\u003e\n\u003cp\u003e\u0026bull; Review and revise the hazard allowance to reflect the actual risk exposure level of HCWs.\u003c/p\u003e \u003cp\u003e\u0026bull; Provide psychological support services for staff undergoing exposure incidents.\u003c/p\u003e \u003cp\u003e\u0026bull; Improve staffing levels to reduce burnout and error-related exposure.\u003c/p\u003e\n\u003ch3\u003e5. Reinforce Safety Compliance Through Environmental and Administrative Measures\u003c/h3\u003e\n\u003cp\u003e\u0026bull; Provide visual reminders (posters, signage) on proper disposal of sharps and standard precautions.\u003c/p\u003e \u003cp\u003e\u0026bull; Ensure the presence of functional safety officers across departments.\u003c/p\u003e \u003cp\u003e\u0026bull; Establish accountability mechanisms to monitor compliance.\u003c/p\u003e\n\u003ch3\u003e6. Promote a Culture of Safety\u003c/h3\u003e\n\u003cp\u003e\u0026bull; Encourage open reporting of exposure incidents without fear of blame.\u003c/p\u003e \u003cp\u003e\u0026bull; Recognize departments demonstrating exemplary adherence to safety protocols.\u003c/p\u003e \u003cp\u003e\u0026bull; Foster teamwork and communication to enhance safety during high-pressure clinical situations\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThe study was not supported by any external funding. The authors declare no financial or personal interest in this article.\u003c/p\u003e\n\u003ch2\u003eData Availability Declaration\u003c/h2\u003e\n\u003cp\u003eThe datasets generated during the current study are not publicly available due to ethical and confidentiality considerations but are available from the corresponding author on reasonable request and with appropriate ethical approval.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eAll authors read and approved of the final manuscript. GJ was responsible for the study conceptualization, methodology, data synthesis, analysis and manuscript drafting. Discussion, Critical revisions of paper and study supervision: NAA. All authors have read and agreed to the published version of the manuscript\u003c/p\u003e\n\u003ch2\u003eAcknowledgement:\u003c/h2\u003e\n\u003cp\u003eI would like to express my gratitude to my supervisor for their suggestion and contributions to the completions of this research\u003c/p\u003e\n\u003ch2\u003eConflict of Interest\u003c/h2\u003e\n\u003cp\u003eThe author declares no potential conflict of interest\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThe datasets generated during the current study are not publicly available due to ethical and confidentiality considerations but are available from the corresponding author on reasonable request and with appropriate ethical approval.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eOyibo P, Okumagba M, Ntaji M, AWUNOR N, Adesoye O. Occupational blood and body fluids exposures: Prevalence, sources and predictors among healthcare providers in south-south Nigeria. The Egyptian Journal of Community Medicine. 2022;0(0). \u003c/li\u003e\n\u003cli\u003eHeba Nasser Rayan, Samia Mohamed Adam, Hanaa Mohamed Abdrabou. Effect of Training Program Regarding Occupational Health Hazards on Nurse Interns\u0026rsquo; Knowledge and Practice. Medico Legal Update. 2021;21(2). \u003c/li\u003e\n\u003cli\u003eNik Mansor NRN，, Kadir， A., Azahan A, Razman J, Zainah M,, Amirul S.S. Biological risk and occupational safety: Health among nurses. Asian Journal of Environment. 2019;3(2). \u003c/li\u003e\n\u003cli\u003eJacob A, Joy TM, Mohandas S, Lais H, Paul N. Assessment of knowledge, attitude, and practice regarding hepatitis B among medical students in a private medical college in Kochi. Int J Community Med Public Health. 2019;6(5). \u003c/li\u003e\n\u003cli\u003eOyekunle A, A.I. O, O.A. T, Ogunlade O. Exposure to Occupational-related Blood and Fluids Infections, Accidental Injuries and Precaution Practices among Healthcare Workers in a Tertiary Hospital in South-West, Nigeria. African Journal of Health, Nursing and Midwifery. 2021 Nov 18;4:43\u0026ndash;59. \u003c/li\u003e\n\u003cli\u003eAbere G, Yenealem DG, Wami SD. Occupational Exposure to Blood and Body Fluids among Health Care Workers in Gondar Town, Northwest Ethiopia: A Result from Cross-Sectional Study. J Environ Public Health. 2020;2020. \u003c/li\u003e\n\u003cli\u003eWHO. Needlestick injuries: Protecting health-care workers - preventing needlestick injuries. Vol. 2010, Occupational health. 2010. \u003c/li\u003e\n\u003cli\u003eAbadiga M, Mosisa G, Abate Y. Magnitude of needlestick and sharp injury and its associated factors among nurses working at health institutions in western ethiopia, 2020. Risk Manag Healthc Policy. 2020;13. \u003c/li\u003e\n\u003cli\u003eRusseng SS, Hidayanty H, Malik AF, Achmad H. Occupational Health and Safety Training Intervention on Women Health Officers\u0026rsquo; Safety Behavior at Public Health Center Wolasi, South Konawe Regency. J Pharm Res Int. 2020; \u003c/li\u003e\n\u003cli\u003eLee JH, Cho J, Kim YJ, Im SH, Jang ES, Kim JW, et al. Occupational blood exposures in health care workers: Incidence, characteristics, and transmission of bloodborne pathogens in South Korea. BMC Public Health. 2017;17(1). \u003c/li\u003e\n\u003cli\u003eDeanna D, Holly G. OSHA Bloodborne Pathogen Standards [Internet]. StatPearls Publishing.; 2023 [cited 2024 Jun 1]. Available from: https://pubmed.ncbi.nlm.nih.gov/34033323/#:~:text=Especially%20prone%20to%20exposure%20are,most%20prone%20to%20occupational%20exposure\u003c/li\u003e\n\u003cli\u003eStrauss A, Corbin J. Basics of Qualitative Research: Techniques and Grounded Theory Procedures for Developing Grounded Theory. The Modern Language Journal. 1998. \u003c/li\u003e\n\u003cli\u003eCDC. Centers for Disease Control and Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination. Nat Genet. 2013;45(10). \u003c/li\u003e\n\u003cli\u003eWHO. WHO | Hepatitis B WHO | Hepatitis B. WHO Fact sheet. 2015;(204 http://www.who.int/mediacentre/factsheets/fs204/en/). \u003c/li\u003e\n\u003cli\u003eCui F, Blach S, Manzengo Mingiedi C, Gonzalez MA, Sabry Alaama A, Mozalevskis A, et al. Global reporting of progress towards elimination of hepatitis B and hepatitis C. Lancet Gastroenterol Hepatol. 2023;8(4). \u003c/li\u003e\n\u003cli\u003eChonka T, Endashaw G, Zerihun E, Beyene Shashamo B. Knowledge, attitude, and practice towards hepatitis B and C virus infection and associated factors among adults living at selected woredas in Gamo Zone, Southern Ethiopia: a cross-sectional study. BMC Public Health [Internet]. 2024;24(1):995. Available from: https://doi.org/10.1186/s12889-024-18387-z\u003c/li\u003e\n\u003cli\u003eAbdela A, Woldu B, Haile K, Mathewos B, Deressa T. Assessment of knowledge, attitudes and practices toward prevention of hepatitis B virus infection among students of medicine and health sciences in Northwest Ethiopia. BMC Res Notes. 2016;9(1). \u003c/li\u003e\n\u003cli\u003eAhmed Elmukashfi Elsheikh T. Knowledge, Attitude and Practice of Heath Care Workers Regarding Transmission and Prevention of Hepatitis B Virus Infection, White Nile State, Sudan, 2013. American Journal of Health Research. 2016;4(2). \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Healthcare Workers, Exposure Risks, Blood, Bloodborne Infection, Qualitative Study","lastPublishedDoi":"10.21203/rs.3.rs-8343117/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8343117/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eHealthcare workers are at an elevated risk of occupational exposure to blood and body fluids, leading to infection with bloodborne pathogens. They are greater risk compared to the general population \u003csup\u003e1–4\u003c/sup\u003e. This heightened risk is due to frequent contact with blood and other potentially infectious body fluids. Such exposure can occur through accidental incidents, and the severity and unpredictability of these events make them a serious occupational hazard \u003csup\u003e3,5\u003c/sup\u003e. Several studies have often linked high rates of occupational BBF exposure to inadequate knowledge and poor adherence to standard safety practices, insufficient training, lack of access to personal protective equipment (PPE), lack of resources, and overall non-compliance with infection prevention protocols \u003csup\u003e6\u003c/sup\u003e. The aim of this study is to examine the perspectives, and opinions of health workers regarding exposure risks to blood at Lagos State University Teaching Hospital (LASUTH), by employing a qualitative research design.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e: The study utilized a semi structured interview for collection of data. Thirteen Semi-structured interviews were conducted among healthcare workers to gain insight into perception of health workers regarding exposures risks to blood and body fluids:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Following thematic analysis, the summary of the semi-structured interview on The Perceptive of Healthcare Workers on Blood Exposure Risk, Contributing Factors and Challenges Faced \u0026nbsp;were documented and grouped into broader themes and patterns reflecting key concepts and experiences shared by participants .These viewpoint were grouped under one of the main themes: Blood exposure risks and Healthcare workers concerns; Most Commonly Encountered Infections; Factors Leading to Exposure; Safety compliance and Challenges; Safety Education and Training; Institutional support and Compensation; Post-Exposure Incident Handling and Challenges; and Suggestions for safety improvement.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e: This study reveals that healthcare workers at LASUTH face substantial risk of bloodborne exposure, driven by inadequate protective resources, inconsistent safety training, and delays in post-exposure management. While workers demonstrate strong awareness and adherence to safety practices, systemic challenges hinder effective protection. Strengthening institutional support, improving PPE availability, and enhancing training and response systems are essential to reduce occupational exposure risks.\u003c/p\u003e","manuscriptTitle":"The Perceptive of Healthcare Workers on Blood Exposure Risk, Contributing Factors and Challenges Faced: A Qualitative study at Lagos State University Teaching Hospital","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-06 16:33:35","doi":"10.21203/rs.3.rs-8343117/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-14T21:53:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"142658820312267058959429911789519208426","date":"2026-05-08T08:51:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"130319434802764939225794048179737321761","date":"2026-04-27T15:54:43+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-27T13:25:48+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-27T10:18:19+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-17T17:07:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-16T16:00:51+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-12-15T15:34:33+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"88186ef5-3828-4e59-990a-2046a05374be","owner":[],"postedDate":"May 6th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-14T21:53:12+00:00","index":96,"fulltext":""},{"type":"reviewerAgreed","content":"142658820312267058959429911789519208426","date":"2026-05-08T08:51:34+00:00","index":95,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":67480922,"name":"Health sciences/Diseases"},{"id":67480923,"name":"Health sciences/Health care"},{"id":67480924,"name":"Health sciences/Health occupations"},{"id":67480925,"name":"Health sciences/Medical research"},{"id":67480926,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2026-05-06T16:33:35+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-06 16:33:35","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8343117","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8343117","identity":"rs-8343117","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}