Reducing Needlestick Injuries from Active Safety Devices: A Passive Safety-Engineered Device Trial

Additional studies are required to identify risk factors for hepatitis C virus (HCV) transmission to health care workers after occupational exposure to HCV. We conducted a matched case-control study in 5 European countries from 1 January 1991 through 31 December 2002. Case patients were health care workers who experienced seroconversion after percutaneous or mucocutaneous exposure to HCV. Control subjects were HCV-exposed health care workers who did not experience seroconversion and were matched with case patients for center and period of exposure. Sixty case patients and 204 control subjects were included in the study. All case patients were exposed to HCV-infected fluids through percutaneous injuries. The 37 case patients for whom information was available were exposed to viremic source patients. As risk factors for HCV infection, multivariate analysis identified needle placement in a source patient's vein or artery (odds ratio [OR], 100.1; 95% confidence interval [CI], 7.3-1365.7), deep injury (OR, 155.2; 95% CI, 7.1-3417.2), and sex of the health care worker (OR for male vs. female, 3.1; 95% CI, 1.0-10.0). Source patient HCV load was not introduced in the multivariate model. In unmatched univariate analysis, the risk of HCV transmission increased 11-fold for health care workers exposed to source patients with a viral load >6 log(10) copies/mL (95% CI, 1.1-114.1), compared with exposures to source patients with a viral load < or =4 log10 copies/mL. In this study, HCV occupational transmission was found to occur after percutaneous exposures. The risk of HCV transmission after percutaneous exposure increased with deep injuries and procedures involving hollow-bore needle placement in the source patient's vein or artery. These results highlight the need for widespread adoption of needlestick-prevention devices in health care settings, together with other preventive measures.

To assess the rate and determinants of sharp injuries during the previous 6 months among health care workers at first-level care facilities in two districts of Pakistan. Cross-sectional survey at public, general practitioners and non-licensed private practitioners selected through stratified random sampling. At each facility, we interviewed a prescriber and a dispenser/injection provider about knowledge of bloodborne pathogens transmission and preventive practices, risk perception, and use of precautions and sharp injuries received during the previous 6 months. Multivariable Poisson regression was used to assess the factors associated with the number of sharp injuries. Fifty-four percentage of the 233 workers had at least one injury during the previous 6 months. The overall rate of sharp injuries per person per year was 3.7; among non-physician prescribers (9%), it was 4.3; among dispensers (69%), it was 3.7, and among physicians (18%), it was 2.1. In the multivariable model, work experience, risk perception and type of health care worker were significantly associated with receiving sharp injuries during the previous 6 months. In the model including dispensers only, a higher knowledge score was associated with fewer sharp injuries, while perceived severity of disease and lack of professional qualification were associated with more. Sharp injuries are common in Pakistan. Better knowledge about modes of bloodborne pathogen transmission and professional qualification may reduce their incidence.

Keeping Healthcare Workers Safe Through Policy Initiatives

Needlestick injuries (NSIs) as defined by accidentally puncture the skin by needles. The occupational exposures to NSIs are considered to be much higher in the developing world and multiple risk factors eg. improper use of protective equipment (like failure to use suitable-sized gloves), working in surgical or intensive care units, insufficient work experience, young age, needle recapping, unsuitable needle disposal, intravenous cannulation may contribute to NSIs. To determine the occurrence/ prevalence of needle stick and sharp injuries (NSIs) among healthcare workers working in a tertiary care hospital and the factors responsible for NSIs. A cross-sectional study was conducted in a tertiary care hospital among HCws in the hospital over a period of one year Jan 2020-December 2020. Nursing staffs are most frequently reported NSI. Among the groups, most common cause of NSIs was found to be recapping of needle followed by cleaning, HGT and procedure. The most common cause of NSI among housekeeping staffs found to be needle lying on the floor and accidental mixing of sharp biomedical waste with other waste. The HCWs from critical care unit eg. ICUs are the most commonly reported NSIs HCWs are always at high risk of attaining NSIs. The nursing staffs followed are the most vulnerable group who gets the sharp/NSI and require extra attention. As a preventive measures regular training and education of nursing staffs and all other categories of health care workers to be ensured in healthcare settings.

Risk of exposure to blood‑borne pathogens has always been a problem for healthcare professionals including dental professionals. The emergence of acquired immunodeficiency syndrome (AIDS) in 1981 brought the issue to the forefront of public health policy. Percutaneous injuries, which include needle stick injuries (NSI), expose dental healthcare workers to deadly blood‑borne pathogens such as Hepatitis C virus (HCV), Hepatitis B virus (HBV), and Human Immunodeficiency Virus (HIV). The risk of transmission of HCV, HBV, and HIV from patient to the healthcare personnel is 3%, 30%, and 0.3%, respectively. [1,2] Although the likelihood of being infected by a blood‑borne virus (BBV) may be low after a single exposure, the consequences for the dental professional who becomes infected are potentially serious and include the potential of transmission of blood‑borne pathogens and associated detrimental effects on their personal and professional lives. [3] Needles used for injecting local anesthesia during restorative procedures and the use of sharps during endodontic and prosthodontic procedures pose a high risk of transmission of BBVs. Procedures in restorative dentistry that may make the patient to cause a sudden jerky movement can lead to increase probability of NSI. Thus, education and training regarding the use of universal precautions when handling body fluids should be conducted. New employees should go through the training program stressing the need to report all injuries and the availability of chemoprophylaxis. Improving sharps disposal by introducing improved sharps containers in the dental clinics. Sharps should be disposed immediately. Recapping and re‑sheathing should be discouraged and new arrangements for sharps disposal should be done to avoid overfilling boxes. NSI prevention strategies for dental professionals should be implemented in the dental curriculum and during the pre‑occupational/occupational training programs. Since a relatively high percentage of patients are positive for major blood‑borne infections, the risk of exposure to blood‑borne pathogens for healthcare workers through NSI should not be ignored. Regular health checkups, tests for serum antibodies and antigens of HBV, and appropriate hepatitis B vaccination are mandatory for occupational safety of healthcare workers. Report of NSI cases should be encouraged since it is needed for root cause analysis of the adverse events and future prevention. The report of NSI events is also highly important for the injured parties in view of risk assessment and implementation of appropriate prophylactic measures for blood‑borne infections.

Exposure to blood-borne pathogens poses a serious risk to health care workers (HCWs). We review the risk and management of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in HCWs and also discuss current methods for preventing exposures and recommendations for postexposure prophylaxis. In the health care setting, blood-borne pathogen transmission occurs predominantly by percutaneous or mucosal exposure of workers to the blood or body fluids of infected patients. Prospective studies of HCWs have estimated that the average risk for HIV transmission after a percutaneous exposure is approximately 0.3%, the risk of HBV transmission is 6 to 30%, and the risk of HCV transmission is approximately 1.8%. To minimize the risk of blood-borne pathogen transmission from HCWs to patients, all HCWs should adhere to standard precautions, including the appropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments. Employers should have in place a system that includes written protocols for prompt reporting, evaluation, counseling, treatment, and follow-up of occupational exposures that may place a worker at risk of blood-borne pathogen infection. A sustained commitment to the occupational health of all HCWs will ensure maximum protection for HCWs and patients and the availability of optimal medical care for all who need it.

A key limiting factor in the scale up and sustainability of HIV care and treatment programmes is the global shortage of trained health care workers. This paper discusses why it is important to move beyond conceptualising health care workers simply as 'inputs' in the delivery of HIV treatment and care, and to also consider their roles as partners and agents in the process of health care. It suggests a framework for thinking about their roles and responses in HIV care, considers the current evidence base, and concludes by identifying key areas for future research on health care workers' responses in HIV treatment and care in low and middle income settings.

Background: Health care workers are continually exposed to occupational health hazards. The study aimed to assess the prevalence of some occupational health hazards and their reporting behavior . Methods: A hospital based cross-sectional study was conducted in August 2014 among health care workers in Bida, Northcentral Nigeria. A total of 200 health care workers from all the departments were included using the multi-staged random sampling technique. Relevant quantitative and qualitative data were collected using semi-structured self-administered questionnaire. The participants were divided into clinical health care workers and non-clinical health care workers. The frequency distribution of the variables were calculated and presented in the form of frequency tables and figures. Results : The overall prevalence of occupational health hazard was 56.8% (n = 108). The most common occupational health hazard among clinical health care workers were needle stick injury (40.7%) and infections with hepatitis B and C viruses (13.9%) and among the non-clinical health care workers were stress (32.8%) and back pain (10.3%). Majority of the health care workers who had occupational health hazards reported appropriately to the committee concerned. Conclusions: Occupational health hazards are common among hospital health care workers and were adequately reported. Training of the health workers on measures to mitigate these hazards may also enhance the reporting behavior and its management when it occurs.

Needle stick injury (NSI) is a common incidence in a health care facility which can have a great impact on the psychological status of a health care worker (HCW). In the present study, over a decade, 76 incidents of NSI were reported. Nurses (47.3%) were at high risk followed by doctors (28.94%). Recapping (30.2%) was the major activity associated with NSI. Percutaneous injury (97.3%) with a hollow bore needle to the fingers was the most common type of injury. Three (3.9%) of the sources were positive for Hepatitis B virus (HBV), and one (1.3%) for human immunodeficiency virus (HIV). Postexposure prophylaxis was administered to eight (10.5%) HCWs with high-risk exposure. The incidence of NSI is low, as there exists an underreporting which cannot be denied. Following stringent universal precautions and adoption of safety-guided devices can reduce the rate of injury to a great extent. Regular training, monitoring, auditing, and adequate control modalities are the core strategies to reduce the incidence of NSI.

Needle stick injuries are major occupational hazards commonly associated with all cadres of healthcare workers. More than 20 different types of blood-borne pathogens are contracted through needle stick injuries. There are several therapies to prevent needle stick injuries, but the likelihood of contracting human immunodeficiency virus, hepatitis B virus and hepatitis C virus will lead to psychological distress such as anxiety, depression, and post-traumatic stress disorder, as well as a reduction in quality of life among health care workers. A retrospective analysis was conducted among health care workers working in a tertiary care hospital, Patna (Bihar) from 1 April 2023 to 31 March 2024. Data from healthcare workers were collected in a needle stick Performa, and a retrospective analysis was done. Around 116 needle stick injuries were reported, 59 cases were in the age group 26-40 years. Nurses were more exposed to needle stick injury compared to other cadres of health care workers. The site of needle injury was the right &amp; left hand in reported cases. Out of 20 needle stick injuries exposed to blood-borne viruses, 15 were given post-exposure prophylaxis. The occurrence of needle stick injury is quite common among healthcare workers and recapping needles is the most common cause of needle stick injury. Prevention of needle stick injury is an integral part of needle stick injury management in the place, and training of health care workers regarding safety measures should be an ongoing activity in the hospital.

Health care workers are exposed to a number of occupational hazards including injury from needle stick, which puts workers at risk of transmission of as many as 30 pathogens, of which the most life-threatening are the Hepatitis B virus (HBV), Hepatitis C virus (HCV), and the Human Immunodeficiency Virus (HIV). This letter focuses on various factors in the health sector of developing countries that have led to an increase prevalence of HBV, HCV and HIV in health care workers. A thorough literature review was performed to identify factors contributing to an increased prevalence of blood borne infections among health care workers in developing countries including Pakistan. Majority of the health care workers are at increased risk of acquiring blood borne infections due to needle stick injuries. The two most important risk factors for needle stick injuries include lack of precautions in needle handling by health care workers and defective or absent screening and vaccination protocols within health employees. Therefore, special preventative measure should be taken to minimize transmission risk of HBV, HCV and HIV in health care workers especially in the developing countries where occupational hazards such as needle stick injury is a major contributing factor in transmission of these blood borne infections.

BackgroundAccidental percutaneous injury and acquiring blood-borne diseases are common problems among health care workers (HCWs). However, little is known about the prevalence and associated factors for needle stick injury among HCWs in Ethiopia.MethodsA cross sectional study was conducted by including 526 HCWs (physicians, nurses, laboratory technicians, midwives and others), working in two public hospitals (Hawassa Referral and Adare District hospitals), from January 1–30, 2014. Binary logistic regression was done to assess the association of selected independent variables with accidental percutaneous injury.ResultsThe prevalence of at least one episode of percutaneous injury was about 46 % of which more than half (28 %) occurred within one year prior to the study period and only 24 % took prophylaxis for human immune deficiency virus (HIV) infection. The adjusted logistic regression analysis revealed that HCWs who recap needles were twice as likely to face a percutaneous injury. Chance of exposure to needle stick or sharp injuries also increased with increase in educational status. Having a previous history of needle stick or sharp injury was found as one of the risk factors for the occurrence of another injury. Nurses and cleaners were also at increased risk for the occurrence of percutaneous injuries.ConclusionNeedle stick and sharp injuries were common among HCWs in the study hospitals, which warrants training on preventive methods.

Prevalence of needlestick injuries and factors associated with their occurrence among health care workers at a private hospital in northern Namibia

Background: The objective of study was to determine prevalence of needle stick injuries among health care workers in a tertiary care hospital of Assam and to assess the knowledge, attitude and practices on needle stick injuries among them.Methods: It was a cross-sectional study conducted from June 2016 to August 2016 amongst health care workers of a tertiary care centre of Assam. Sample size was calculated to be 90. A total of 10 departments were selected purposively based on their magnitude of risk exposure and the required sample size was allocated proportionally among these 10 departments. The required numbers of health workers from each of the ten departments were selected by using simple random sampling. A predesigned and pretested proforma was used to collect the data. Data were presented in terms of percentages and significance was tested using chi-square and Fisher’s exact test.Results: Prevalence of needle stick injury among the health workers was found to be 21.1%. Regarding spread of diseases after an accidental needle stick injury, 100% were aware of HIV, 98.9% were aware of Hepatitis B and 67.8% were aware of Hepatitis C. Regarding their attitude to report to in-charge medical officer, only 21.1% had reported about their injury. Around 58.9% of health care workers used gloves regularly for prevention of such injuries. Practice of recapping among the health care workers was 66.7% and out of total needle stick injuries, recapping contributed to 26.3%. While considering sharp waste disposal, 37.8% health care workers did not follow proper waste disposal guidelines. Only 26.3% of health care workers had done screening for HIV/AIDS and Hepatitis B after their injury.Conclusions: There is a need to have a pre-employment training to improve the knowledge, attitude and practice regarding accidental needle stick injuries among the health care workers.

Introduction: Needlestick and sharp injuries continue to occur in every phase of sharp device usage or disposal, despite World Health Organization (WHO) guidance to reduce them in healthcare settings. Each year, an estimated 32.4%–44.5% of healthcare professionals worldwide report at least one incident of accidental needle-stick or sharp injury. The purpose of this study was to identify the prevalence and factors associated with needle stick and sharp injuries (NSSI). Methods: A retrospective cross-sectional study of all reported incidents of needlestick injuries in the state of Johor, Malaysia from January 2019 to December 2021 was conducted. The percentage of NSSI was determined and stratified by age, gender, job title, location and site of injury, and procedure/task during which the injury occurred. Results: There were 713 cases in reported during the studied time period. The fraction of NSSI was shown to have a significant relationship with all examined variables (P &lt;0.001). During the three-year study period, the reported proportion of NSSI was highest among House officers (34.9 %), followed by medical officers (19.4 %), Nurses (15.8 %), and other personnel (25.8 %). Hospital wards were the most common location for injuries (48.7%). Injuries occurred most commonly while working with patients (36.5%). Conclusion: Given the high prevalence of NSSI, it is necessary to conduct training programmes focused on new methods of safely using sharp objects, adequate education on occupational safety and standards, reinforce personnel practical skills, and pay more attention to reporting and improving occupational behaviours in order to reduce the prevalence of NSIs and, as a result, the potential risk Blood Borne Disease transmission.