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Study Objective: To record descriptions of occupational exposures to blood, determine factors predictive of exposure, and identify interventions that might reduce the frequency of exposure., Design: An analytic, cross-sectional survey., Study Population: A total of 601 nurses from surgical wards, operating rooms, and emergency departments. STUDY INSTRUMENT: An anonymous questionnaire developed by the authors on the basis of previously published guidelines was distributed between January and March 2003., Sampling: Random, with 18 hospitals selected from 2 urban and rural locations., Results: Almost half of respondents reported having had at least 1 puncture injury during the preceding year, 1 in 5 had exposure via mucous membranes, and more than half had worked at least once with a recent abrasion or cut on their hands. The number of injuries was independent of age (P=.26), duration of practice (P=.21), and workplace setting (P=.78). The percentage of nurses without percutaneous exposure during the preceding year was significantly higher in the group that received special HIV/AIDS training than in the group that did not (95% confidence interval, 5.8-24.1%; P<.002). The most recent exposure was primarily caused by hollow-bore needles, involved the palm and fingers II-V, was self-inflicted, took place during an elective procedure, and was not reported to the hospital's infection control center by 74% of respondents. The most common reason for not reporting the exposure (38% of cases) was the conviction that the source patient was not infected., Conclusions: Because of the large number of occupational exposures to blood, especially those due to injuries with hollow-bore needles, nurses should adopt more adequate behavioral strategies to prevent the transmission of blood-borne pathogens. Policies for providing adequate education programs tailored to encourage nurses to report all exposures are urgently required.