Needlestick injuries, despite a wealth of published information about their hazards and prevention and despite safety programs addressing the risks, remain an ongoing problem in the health care industry. Some hospitals report that one-third of their nursing and laboratory staff suffer such injuries each year.
Accidental punctures by contaminated needles can inject hazardous fluids into the body through the skin. While there is potential for injection of hazardous drugs, injection of infectious fluids, especially blood, is by far the greatest concern. Even small amounts of infectious fluid can spread certain diseases effectively. Accidental injection of blood-borne viruses is the major hazard of needlestick injuries, especially the viruses that cause AIDS (the HIV virus), hepatitis B, and hepatitis C. In some cases, needlestick injuries have also transmitted viruses, bacteria, fungi, and other microorganisms in hospitals, laboratories or veterinary facilities.
Needlestick injuries happen when healthcare staff are using them, disassembling them, or disposing of them. When not disposed of properly, needles can become concealed in linen or garbage and injure other workers, especially maintenance workers who encounter them unexpectedly. Staff must be especially careful when they are withdrawing a needle from a patient (particularly a patient who is bleeding) and while disposing of that needle. They must also be careful when pulling a needle out of its rubber stopper of a vacuum tube, which can jab the hand in a rebound reflex. There is also a risk of a patient not holding still and accidentally jarring the needle.
Reducing the risk
Needlestick injuries are preventable. Employees must be aware of the risks and trained in the proper use, assembly, disassembly and disposal of needles. Employers should provide written safety guidelines for the prevention of needlestick injuries. In situations where it's necessary to recap a needle, an unprotected hand must never be exposed to a needle tip. And to minimize the risk at the disposal stage, facilities should use only puncture-resistant containers for needles, and plenty of them so that they don't become overloaded.
Better equipment design would greatly reduce the number of needlestick injuries and the occupational disease risk they present. For years, the health care industry has called for safer devices using protected needles, or needle-free systems with self-sealing ports, or syringes with safety features. Workers need to understand the risks associated with needlestick injuries and know the proper means to prevent them as well as protect themselves from harm.