A needlestick injury is a wound caused by a sharp object, such as a needle or a scalpel, that penetrates the skin and may expose the person to blood or other body fluids. Needlestick injuries are a common occupational hazard for health care workers, who may be at risk of contracting infections such as hepatitis B, hepatitis C, or HIV from the source patient.
According to the World Health Organization (WHO), an estimated 3 million health care workers suffer from needlestick injuries each year, resulting in more than 1.3 million deaths and 23 million years of life lost due to disability or premature death. Needlestick injuries also have psychological and economic impacts, such as anxiety, depression, absenteeism, and litigation costs.
The causes of needlestick injuries can be classified into three categories: human factors, device factors, and environmental factors. Human factors include lack of training, fatigue, stress, distraction, or negligence. Device factors include design flaws, malfunction, or improper use of safety features. Environmental factors include inadequate lighting, cluttered workspaces, or lack of disposal containers.
The solutions to prevent needlestick injuries can also be grouped into three categories: engineering controls, administrative controls, and personal protective equipment (PPE). Engineering controls involve the use of safer devices, such as retractable needles, self-sheathing needles, or needleless systems. Administrative controls involve the implementation of policies, procedures, and training programs to reduce the risk of exposure. PPE involves the use of gloves, gowns, masks, or eye protection to minimize contact with blood or body fluids.
The prevention of needlestick injuries is a shared responsibility among health care workers, employers, device manufacturers, and regulatory agencies. By following the hierarchy of controls and adhering to the standard precautions, health care workers can protect themselves and their patients from the potential harm of needlestick injuries.
Causes and Solution of Needlestick Injuries
Needlestick injuries (NSIs) are the penetration of the skin by a hypodermic needle or other sharp object that has been in contact with blood, tissue or other body fluids before the exposure. NSIs are one of the most serious occupational hazards for healthcare workers (HCWs) and other workers who may encounter used needles in their work environment. NSIs can lead to transmission of blood-borne diseases, such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). According to the World Health Organization, in 2000, 66,000 hepatitis B, 16,000 hepatitis C, and 1,000 HIV infections were caused by NSIs .
Causes of NSIs
Studies have shown that NSIs are often associated with:
- Not using safety-engineered sharps or using them incorrectly
- Recapping needles after use
- Transferring a body fluid between containers
- Failing to dispose of used needles properly in puncture-resistant sharps containers
In addition, NSIs can occur due to placing needles in unexpected places after use, such as in bed sheets, pockets, or drawers. The risk of NSIs also varies depending on the type and location of the needle, the type and amount of blood or fluid the needle was exposed to, and the immune status of the source and the recipient .
Solution of NSIs
The prevention and management of NSIs require a comprehensive approach that involves:
- Education and training of workers on the risks and prevention of NSIs
- Implementation and enforcement of standard precautions and safe work practices
- Provision and proper use of safety-engineered sharps devices
- Prompt reporting and evaluation of NSIs
- Post-exposure prophylaxis (PEP) and follow-up care for exposed workers
Education and training should include information on the epidemiology, transmission, and prevention of blood-borne diseases, as well as the correct use and disposal of sharps devices. Standard precautions include wearing gloves, gowns, masks, and eye protection when handling blood or body fluids, washing hands before and after contact with patients or specimens, and avoiding recapping or bending needles. Safe work practices include using one-handed technique or a safety device to recap needles, disposing of sharps immediately after use in designated containers, labeling and segregating infectious waste, and avoiding contact with sharps that are not required for the task .
Safety-engineered sharps devices are those that have built-in features that prevent or reduce the risk of NSIs. These include needles that retract, sheath, or blunt after use, syringes with sliding needle covers, needleless systems for intravenous access, and blunt sutures.
Management of needlestick injuries
If a worker experiences a needlestick injury, they should follow these steps as soon as possible:
- Wash any cuts or needlesticks with soap and water right away.
- If any water splashes on your nose, mouth, or skin while cleaning your injury, clean that area off, as well.
- If water splashes into your eyes while cleaning the injury, use saline or sterile water to rinse your eyes with clean hands.
- Alert a supervisor as soon as possible.
- If you’re in a medical setting, you should prioritize getting the immunization and health history of any person whose blood was on the instrument that injured you.
- Your employer may recommend or require that you take a course of preventive medication for HIV (post-exposure prophylaxis, or PEP) and hepatitis B.
The worker should also receive counseling and support throughout the process, as needlestick injuries can cause significant anxiety, stress, and emotional distress.
Legal and psychological implications of needlestick injuries
Needlestick injuries can have legal and psychological implications for both the workers and the employers. Workers who are injured by a needlestick may be entitled to compensation for medical expenses, lost wages, pain and suffering, and other damages. Employers who fail to comply with the OSHA standard or other regulations may face fines, penalties, lawsuits, and reputational damage.
Needlestick injuries can also affect the mental health and well-being of the workers. Some of the psychological effects of needlestick injuries are:
- Fear of infection and transmission to others
- Guilt, shame, and self-blame
- Anger, frustration, and resentment
- Anxiety, depression, and post-traumatic stress disorder
- Loss of confidence and trust
- Impaired job performance and satisfaction
- Social isolation and stigma
Workers who experience needlestick injuries should seek professional help if they have any of these symptoms or if they feel overwhelmed by their emotions. They should also seek support from their colleagues, family, and friends. They should not feel alone or ashamed of their situation, as needlestick injuries can happen to anyone.
Conclusion
Needlestick injuries are a serious occupational hazard that can expose workers to blood-borne diseases such as hepatitis B, hepatitis C, and HIV. They can also cause legal and psychological problems for the workers and the employers. Therefore, it is important to prevent needlestick injuries by using safer devices and practices, and to manage them promptly and effectively by following the post-exposure protocol. Workers who experience needlestick injuries should also receive adequate medical care, counseling, and support to cope with the physical and emotional consequences of their injury.
