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The Journal of Bone and Joint Surgery (American) 86:1065-1076 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.


Current Concepts Review

Transmission and Prevention of Occupational Infections in Orthopaedic Surgeons

Kwok Chuen Wong, MBChB, FRCSEd(Orth)1 and Kwok Sui Leung, MD, FRCSEd1

1 Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, 5/F, Clinical Science Building, Prince of Wales Hospital, Hong Kong Special Administrative Region, China. E-mail address for K.C. Wong: skcwong{at}ort.cuhk.edu.hk

Investigation performed at the Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.


Microorganisms are transmitted in hospitals mainly by contact, droplet, and airborne routes.

Orthopaedic surgeons have a substantial occupational risk of contracting a blood-borne infection because of frequent handling of sharp instruments and objects during operative procedures.

Aerosolization means the formation of aerosols and droplets when blood or other body fluids are mechanically disturbed. Smaller particles (<5 µm) will remain suspended in air. Pathogens that can survive in these small airborne particles may cause infection if they are inhaled.

Aerosol-generating procedures in patients with tuberculosis or severe acute respiratory syndrome (SARS) may facilitate airborne transmission.

The Hospital Infection Control Practices Advisory Committee and the Centers for Disease Control and Prevention have established guidelines for isolation precautions in hospitals.


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