A multicentre cross-sectional study was conducted between September 2019 and May 2020. The study participants were recruited from six participating multidisciplinary hospitals and dental care facilities located in three major urban centers of Georgia: Batumi (Western Georgia), Rustavi (Eastern Georgia), and the capital city, Tbilisi. Participant recruitment and data collection were conducted concurrently across all participating institutions during the same study period. The study was conducted before the implementation of Georgia's national hepatitis B (HBV) program, which was launched in April 2024. The study population included both medical healthcare workers(HCWs) and dental healthcare workers (DHCWs).

​

Participating healthcare institutions were selected using probability proportional to size (PPS) sampling, with the number of healthcare workers employed at each facility serving as the measure of size. Facilities were selected from the complete sampling frame of eligible multidisciplinary hospitals and dental healthcare facilities within each selected facility. A simple random sampling method was employed, using institutional staff lists as the sampling frame. Eligible participants were defined as actively employed HCWs and DHCWs with direct or indirect patient contact during the study period, aged 18 years or older, able to complete the questionnaire in Georgian, and providing written informed consent prior to participation. A total of 550 healthcare workers (HCWs) were invited to participate in the study. Of these, 108 did not respond. Overall, 442 healthcare workers completed the questionnaire and were included in the final analysis.

​

Data were collected using a structured, self-administered questionnaire developed for this study by adapting items from previously published questionnaires assessing occupational exposure, infection prevention and control, hepatitis B vaccination, and blood-borne infections. The questionnaire was modified to reflect the Georgian healthcare context and the study objectives. The questionnaire was developed in Georgian and administered anonymously in paper format. Participation was voluntary, and respondents completed the questionnaire independently without supervisors present to minimize social desirability bias. A pilot test was conducted among a small group of healthcare workers to evaluate the questionnaire's feasibility. Pilot participants were not included in the final analysis. The instrument was structured into four components: (i) sociodemographic and professional characteristics, (ii) knowledge and awareness of blood-borne infections, (iii) infection prevention and control (IPC) practices, including adherence to standard and transmission-based precautions; and (iv) perceptions regarding the acceptability of educational interventions.

​

Data analysis focused on identifying factors associated with occupational exposure to blood and body fluids among healthcare workers, with particular emphasis on infection prevention and control (IPC) practices and adherence to standard and transmission-based precautions.

​

Data entry and statistical analyses were performed using IBM SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY, USA). The primary outcome was occupational exposure to blood and body fluids during the six months preceding the survey, defined as at least one of the following events: needlestick injury, blood splash to the eyes, nose, or mouth, or a cut with a contaminated instrument. Participants reporting at least one of these events were classified as exposed (1), whereas those reporting none were classified as unexposed (0).

​

Independent variables included professional group (medical healthcare workers vs. dental healthcare workers), age (analyzed as a continuous variable and expressed per 10-year increase), sex, city of residence (Tbilisi, Batumi, or Rustavi), type of practice (governmental or private), and average daily patient load (<6, 6–10, 11–15, or >15 patients).

​

Bivariate associations between the outcome and categorical variables were assessed using the chi-square test, whereas continuous variables were compared using the independent-samples t-test. Multivariable analysis was performed to identify factors independently associated with occupational exposure to blood and body fluids among healthcare workers.

​

Because the prevalence of the primary outcome was high (53.6%), modified Poisson regression with a log link and robust sandwich variance estimator was used to estimate crude and adjusted prevalence ratios (PRs) with corresponding 95% confidence intervals (95% CIs). The primary multivariable analysis included participants with complete data for all model variables. Participants with missing values for one or more predictor variables were excluded from the analysis. Of the 442 participants, 390 had complete data for all variables included in the model, whereas 52 were excluded because of missing predictor data. Because only six healthcare institutions participated, institution-level clustering was not included in the regression models owing to insufficient numbers of clusters.

​

Hepatitis B vaccination status was determined using a self-reported yes/no question asking whether participants had been vaccinated against hepatitis B.

Ethical approval for the study was obtained from the Institutional Review Board (IRB) of the Health Research Union, Tbilisi, Georgia (IRB#: 00009520; IORG#: 0005619). Participation in the study was voluntary, and all participants provided written informed consent before enrolment. Permission to conduct the study was obtained from the participating healthcare institutions. To ensure confidentiality, each participant was assigned a unique study identification code, and all personal identifiers were removed from the analytical dataset. Only aggregated study findings were presented to the management of the participating institutions. Laboratory results were returned to each institution in sealed envelopes using coded identifiers only.

​

This study is a secondary analysis of data from the same multicentre cross-sectional survey previously reported by Kochlamazashvili et al. (2022). 3 The multivariable analyses and adjusted prevalence ratios presented here have not been previously reported.