Needlesticks can expose workers to a number of bloodborne pathogens that can cause serious or fatal infections. The pathogens that pose the most serious health risks are Hepatitis B virus (HBV), Hepatitis C virus (HCV), and human immunodeficiency virus (HIV), the virus that causes AIDS. HBV vaccination is recommended for all health care workers (unless they are immune because of previous exposure). HBV vaccine has proven highly effective in preventing infection in workers exposed to HBV. However, no vaccine exists to prevent HCV or HIV infection.

On an annual basis, the Centers for Disease Control and Prevention (CDC) estimates that more than 380,000 percutaneous injuries from contaminated sharps (i.e., needles and other sharp devices) occur among health care workers in the U.S., with most happening to members of the nursing staff. Estimates for all health care settings are as high as 600,000 to 800,000, with approximately half of those accidents going unreported.

Yet, the CDC also says that for every 10 sharps injuries that occur, between six and eight of them could potentially have been prevented if safer medical devices had been used. Additionally, the cost of an injury from a contaminated sharp can be far greater than the pain or discomfort of the injury itself, not to mention the associated psychological effects or emotional trauma that may occur.

Four kinds of needles usually cause needlestick injuries: these are hypodermic needles, blood collection needles, suture needles, and needles used in IV delivery systems. Past studies have shown that needlestick injuries are often associated with certain activities, such as recapping needles, transferring a body fluid between containers, and failing to dispose of used needles properly in puncture-resistant sharps containers.

The following steps can be used to protect workers from needlestick injuries:

Avoid the use of needles where safe and effective alternatives are available.

Select and evaluate devices with safety features that reduce the risk of needlestick injury.

Only use devices with safety features.

Avoid recapping needles.

Plan for safe handling and disposal of needles before using them.

Promptly dispose of used needles in appropriate sharps disposal containers.

Report all needlestick injuries promptly to ensure appropriate follow-up care is provided.

Direct staff to tell a supervisor about any needlestick hazards observed.

Participate in training related to infection prevention.

Have staff get a hepatitis B vaccination.

Note: On November 6, 2000, President Clinton signed HR 5178, the Needlestick Safety and Prevention Act. The Act requires health care facilities to use newer safety devices to reduce the number of needlestick injuries suffered by health care workers and patients. To prevent transmission of disease, these safety devices automatically cover needle tips after they have been used. The law also requires employers to establish an injury log to record the kind of devices and location of all needlestick accidents.

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