Needlestick Safety & Prevention

According to the CDC, there are approximately 600,000 to 800,000 needlesticks each year, and many more are not reported. The Needlestick Safety and Prevention Act was signed into law in 2000. The law addresses the ongoing problem of occupational exposure to bloodborne pathogens from accidental sharps injuries.

Provisions of the Needlestick Safety and Prevention Act

• The law allowed the Occupational Safety and Health Administration (OSHA) to revise its Bloodborne Pathogens Standard. It strengthened OSHA's requirement for employers who use sharps to identify, evaluate and implement safer medical devices. By law all employers must maintain a log of all sharps injuries and allow non-management health care workers to evaluate and choose new devices.

Background

• More than 8 million people in the United States work in hospitals, clinics and other health care settings. EPINet estimates that an average hospital has approximately 30 needlestick injuries per 100 beds per year. Although nurses immediately come to mind, other workers may come in contact with sharps, including physicians, housekeeping, patient techs and lab personnel. No one working in a hospital is immune from needlesticks.

  The three most dangerous pathogens are HIV, hepatitis B and hepatitis C. They are potentially fatal, but infection can be prevented.

Hepatitis C

• According to the CDC, hepatitis C (HCV) is the most common chronic bloodborne infection in the United States. It affects approximately 4 million people. No statistics are available on how many health care workers have developed HCV occupationally; however, 2 percent to 4 percent of the cases of acute HCV have occurred in health care workers exposed to blood in the workplace. HCV infection can occur with mild or no symptoms. Chronic infection develops in 75 percent to 85 percent of patients and 70 percent develop active liver disease. Ten to 20 percent of those with active liver disease develop cirrhosis, making HCV especially dangerous.

Hepatitis B

• The CDC estimated in 1995 that approximately 800 health care workers were infected with Hepatitis B (HBV). This is a 95 percent decline from 1983, when there were an estimated 17,000 cases. The decline was largely due to the OSHA requirement of universal precautions and the widespread immunization of health care workers against the HBV virus.

HIV

• A study in the "Journal of Infectious Disease" states that the rate of infection for HIV among worldwide studies of health care workers exposed to HIV is 0.3 percent. Nonetheless, HIV is still perhaps the most feared bloodborne pathogen. Studies suggest that the risk rises when workers are exposed to a larger quantity of blood, procedures that involve needlesticks in veins and arteries, or deep injuries.

Prevention

• Simple steps to prevent needlesticks include:
  Use needleless devices whenever possible.
  Avoid recapping needles.
  Always dispose of sharp objects in a proper sharps container. Do not force sharps in if container is full.
  Report needlesticks promptly so that appropriate treatment can begin.
  Maintain required yearly education on needlestick and sharps safety as required by employer.