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Handcuffs May Pose a New Hepatitis Transmission Concern

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With so many cases of viral hepatitis having an unknown acquisition route, many possibilities have been suspected – including the re-use of contaminated handcuffs.

With over a million carriers of the Hepatitis B virus (HBV) and around four million infected with the Hepatitis C virus (HCV) in the United States alone, preventing hepatitis transmission has emerged as a critical public health goal. While efforts to educate the public about how hepatitis is spread has reduced the number of new infections each year, speculation remains about routes of transmission that have yet to be unidentified. Recently disclosed at a Canadian police conference, an independent company’s tests have revealed that dirty handcuffs are capable of transmitting viral hepatitis.

When it comes to viral hepatitis, the strains of most concern in the United States are HBV and HCV. These are the two types of infectious hepatitis most likely to cause chronic liver disease.

Hepatitis B Transmission

According to the U.S. Centers for Disease Control and Prevention, Hepatitis B is spread when blood, semen or other body fluids infected with the Hepatitis B virus enters the body of a person who is not infected. Activities most likely to transmit HBV include:

  • Birth (spread from an infected mother to her baby during birth)
  • Sex with an infected partner
  • Sharing needles, syringes or other drug-injection equipment
  • Sharing items such as razors or toothbrushes with an infected person
  • Sharing food that has been pre-chewed by an infected person
  • Direct contact with the blood or open sores of an infected person
  • Exposure to blood from needle sticks or other sharp instruments

However, even with all of our knowledge about the spread of HBV, the method for acquiring it remains unknown in approximately 30 to 40 percent of all Hepatitis B cases. In addition, Hepatitis B is 50 to 100 times more infectious than HIV.

Hepatitis C Transmission

According to the U.S. Centers for Disease Control and Prevention, Hepatitis C is spread when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with HCV by sharing needles or other equipment to inject drugs. Before 1992, when widespread screening of the blood supply began in the United States, Hepatitis C was also commonly spread through blood transfusions and organ transplants.

Activities most likely to transmit the Hepatitis C virus include:

  • Sharing needles, syringes or other equipment to inject drugsNeedle stick injuries in healthcare settings
  • Being born to a mother who has Hepatitis C
  • Less commonly, a person can also get HCV infection through:
  • Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes
  • Having sexual contact with a person infected with HCV

Although sharing injection drug use equipment poses the highest risk for HCV infection, approximately 20 to 40 percent of those with Hepatitis C have no identified route of transmission. In addition, HCV is 10 times more infectious than HIV.

Another Route for Infection

Considering the high level of infectivity and the significant percentage of unidentified viral hepatitis routes of transmission, there are likely other ways to contract HBV or HCV. From trying to figure out how the millions of people infected with HBV or HCV acquired their infection, any item containing blood or bodily fluids has become suspect.

Because of their exposure to blood, piercing, tattoo and surgical equipment have all come under suspicion as potential viral transmitters. Now, the seemingly impenetrable object, handcuffs, has come under scrutiny. A Canadian company that sells a system to clean handcuffs found that random checks of police and correction officer’s handcuffs revealed viruses, bacteria, dried blood and skin particles in the hinges. Although their findings serve to advance their own sales, they have uncovered a valid concern.

Used to restrain individuals associated with criminal activities, handcuffs can easily become contaminated with blood. When suspects are apprehended, a struggle may result where the cuffs are applied under violent circumstances. Such violence may lead to over-tightening of handcuffs, which could inflict trauma and cause bleeding at the wrists. In addition, handcuffs may be placed on a person who is already injured or the person could initiate a self-inflicted injury. Either way, any blood-producing injury can contaminate handcuffs. If the contaminated handcuffs are not properly sterilized between uses, the infectious particles could contact an open wound of the next handcuff wearer.

HBV and HCV are a concern on handcuffs because of their lifespan on inanimate objects. The Hepatitis B virus can survive outside the body for at least seven days. The Hepatitis C virus can survive outside the body at room temperature for up to four days.

Although there have been no reported incidents of viral hepatitis transmission from handcuffs, it is entirely possible. Spawned from a company’s quest to provide unique paths for disinfecting handcuffs, our vulnerability to viral hepatitis is realized. The implication of handcuffs in the spread of infectious disease is likely to lead to sterilization of these restraining devices between uses. In the meantime, you can commit to being a law-abiding citizen, or at least make sure to stay calm and thus injury-free if handcuffs ever find their way onto your wrists.

References:, Another reason not to break the law: handcuffs might be infected, Jason Magder, Retrieved August 31, 2008, Canwest Digital Media, August 2008., Viral Hepatitis, Retrieved August 31, 2008, Centers for Disease Control and Prevention, 2008., Why Clean, Retrieved August 31, 2008, Cuff Cleaner, 2008., Hepatitis B, Retrieved August 31, 2008, The American Liver Foundation, 2008., Hepatitis C, Retrieved August 31, 2008, Haitian Centers Council, Inc., 2008., Risk Factors for Hepatitis C in People with Unknown Transmission Routes, Liz Highleyman, Retrieved August 31, 2008,, 2008., Newest disease-spreading fear: Handcuffs, Retrieved August 31, 2008, United Press International, Inc., August 2008.

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