Needle stick injuries: An overview of the size of the problem, prevention & management

Abstract

Over 20 million dedicated health care providers (HCP) expose themselves to biological, chemical, and mechanical hazards daily. The World Health Organization estimates that approximately three million health care providers are exposed to blood and body fluid due to needle stick or sharps injuries annually. Blood and body fluid exposures have resulted in 57 documented cases of HIV seroconversion among healthcare personnel through 2001. Two thousand workers a year become infected with hepatitis C, and 400 contact hepatitis B. There are more than 20 additional types of infectious agents documented to be transmitted through needle sticks. More than 80% of needle stick injuries are preventable with the use of safe needle devices. Legislation has been developed in many countries to protect HCPs by encouraging employers to use best practices to prevent these exposures. Many different protocols for post exposure management of needle stick injuries or blood and body fluid exposure have been proposed. Effectiveness of a protocol depends on early initiation of post exposure management. HIV prophylaxis has the smallest window of time treatment and has to be initiated as soon as possible, preferably in the first few hours. Hepatitis B Immunoglobulin (HBIg) could be given within the first seven days. Healthcare institutions should develop policies and procedures to reduce needle stick injuries by proactively instituting these recommendations, vaccinating all HCP for Hepatitis B (HBV), and incorporating improved engineering controls into a comprehensive needle stick injury prevention program. In this review, we present historical background, nature and size of the problem, followed by review of the state of the art of the prevention, clinical management, and corporate responsibilities.

Knowledge and response of health care workers after needle - stick injury in a tertiary care hospital setting in tribal Rajnandgaon, Chhattisgarh, India

“…Several studies on NSI and sharp injuries among health care workers have been reported from all over the world. [1][2][3]5,[7][8][9][11][12][13] In the present study, around 40% of the HCWs reported having received NSI in their carrier, which is a concerning number. Few of the studies in North India had found a high prevalence of NSI (79.5% and 73%, which is higher as compared to the present study.…”

“…The measures which can be taken to reduce these occupationally related bloods borne infections to health care personnel includes eliminating unnecessary injections, adhering to universal precautions, immunization against Hepatitis B, provision of personal protective equipment and the management of exposures. 7,[11][12][13][14] Keeping in mind this background information, the present study was planned and undertaken to know the extent of occupational exposure to needle stick injuries among health care personnel and their response to these injuries in a setting of tertiary care hospital.…”

“…[6][7][8][9][10] Hence not only doctors and nurses even laboratory technicians, housekeeping personnel and hospital waste handlers are at risk of harboring the blood borne infections. 2,11 According to the World Health Organization (WHO), out of 35 million health workers worldwide, about 3 million receive percutaneous exposures to blood borne pathogens each year; two million of those to HBV, 0.9 million to HCV and 170, 000 to HIV. These injuries may result in 16, 000 HCV, 66, 000 HBV and 1000 HIV infections.…”

Occupational Exposure to Needle Stick Injuries among Health Care Personnel in a Tertiary Care Hospital: A Cross Sectional Study

“…More than 90% of these infections occur in developing countries. The measures which can be taken to reduce these occupationally related blood borne infections to health care personnel includes eliminating unnecessary injections, adhering touniversal precautions, immunization against Hepatitis B, provision of personal protective equipment and the management of exposures [7,[11][12][13][14].…”

“…Occupational exposure to blood can result from percutaneous injury (needle stick or other sharps injury), mucocutaneous injury (splash of blood or other body fluids into the eyes, nose or mouth), or contact with non-intact skin [6][7][8][9][10]. Hence not only doctors and nurses even laboratory technicians, housekeeping personnel and hospital waste handlers are at risk of harboring the blood borne infections [2,11]. According to the World Health Organization, out of 35 million health workers worldwide, about 3 million receive percutaneous exposures to blood borne pathogens each year; two million of those to HBV, 0.9 million to HCV and 170, 000 to HIV.…”