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Incidents of potentially serious needlestick injuries among health care workers can be significantly reduced - and in many cases prevented - according to a new report.

Needlestick injuries in health care workers can be significantly reduced and in many cases, prevented, according to a report published by the Health Protection Agency (HPA). 37% of all injuries reported took place when health care workers were disposing of needles, and in those cases where injuries took place during a procedure, such as taking blood or putting in stitches, adequate education and training could prevent them.

Bloodborne Virus

The report considers needlestick injuries sustained by health care workers where the patient they were treating was either known to have a bloodborne virus (BBV) such as hepatitis C, hepatitis B, or HIV, or where the patient did not know whether they were carrying a BBV. It is essential that health care workers who receive such an injury report it immediately so that they can be given preventative treatment as soon as possible. Virologists and microbiologists involved in the testing of health care workers sustaining injury should also raise awareness of the need to carry out appropriate tests, adhering to national guidelines for their timing.

As part of its surveillance programme the HPA’s Communicable Disease Surveillance Centre examined 1,800 reports of needlestick injuries amongst UK health care workers between July 1997 and June 2003.

The commonest type of exposure (54% of the reports), was to a hepatitis C positive source; the second most common was exposure to an HIV positive source (32%). Most of the reported cases involved members of the nursing profession (43%), with doctors being the second most affected group (35%).

The surveillance of occupational exposures to bloodborne viruses (BBVs) in health care workers looks at the type of exposures reported to the scheme and the situation surrounding the event. The scheme also collects data on the number of health care workers exposed to hepatitis B (HBV), hepatitis C (HCV) and HIV, and information on the use and management of treatment following exposure to these viruses.

Occupational Exposure

The first documented case in the UK of a health care worker acquiring HIV following an occupational exposure was in 1984. Following this, a passive surveillance system was established, involving health care workers in England, Wales and Northern Ireland for exposures to HIV. This was changed to a more active surveillance system in July 1997, and was expanded to include hepatitis B and hepatitis C. In total, there have been five documented cases of occupationally acquired HIV infections in health care workers in the UK, from 1984 to 1999. Through the enhanced CDSC surveillance scheme, there have also been three health care workers found who acquired hepatitis C following needlestick injuries between 1996 and 2001.

Needlestick injuries can be prevented by adherence to universal precautions, safer disposal of clinical waste such as needles, and the raising of awareness amongst health care workers of the risks of needlestick injuries.

Chief Executive of the HPA, Professor Pat Troop said: “At the moment, there are too many occupational exposures to hepatitis C, hepatitis B and HIV from needlestick injuries occurring within health care settings, many of which are preventable. It is important that those health care workers who have been injured in this way seek immediate treatment to prevent the onset of infection.”

“Occupational health departments are encouraged to report, in anonymised format, such exposures to the Agency’s Communicable Disease Surveillance Centre, in order that we can gain a better understanding of why and how these injuries occur. This requires in-depth information on the type of injury, staff involved and the health of the source patient”

The full report can be found here.

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