Sharps Injuries and Blood Exposures on Rise

A new study warns that healthcare workers are experiencing an increase in sharps injuries and blood and body fluid exposures (BBFEs), with the ratio of injuries per average daily census (ADC) rising to 33.7%, compared to 31.7% in 2015.

Newly released occupational exposure surveillance data collected by the International Safety Center (League City, TX, USA) from healthcare centers in the United States shows that for the first time in the 33 years since the Exposure Prevention Information Network (EPINet) injury reporting forms were launched, physicians represent the highest percentage (34.2%) of workers reporting a sharps injury or needlestick, a marked rise compared to 29.2% in 2015. Previously, nurses were the most affected worker segment, with an injury frequency of 33.4% in 2016 and 37.8% in 2015.

BBFEs have also increased, accounting for 12.9% ADC in 2016, versus 11.4 in 2015. BBFEs are on the rise especially in the operating room (OR), accounting for 20% of departmental exposures. Exposures mostly occur to unprotected skin by of workers who are not wearing personal protection equipment. In 2016, more exposures occurred through gaps in protective clothing (5.3%), a marked increase from 2.9% in 2015. Nearly 50% of all BBFEs occurred in patient or exam rooms, and almost 70% involved exposures to the eyes. Less than 6% of workers (including housekeeping, laundry, and janitorial personnel) indicated they were wearing eye protection during an exposure.

The rise in injuries is associated with three major causes: failure to use a safe medical device that protects against accidental sharps contact and needlesticks; failure to activate safety mechanisms when devices with sharps injury protections are used; and unsafe work practices during multi-step processes, such as passing instruments by hand during surgical procedures. Of the 30.2% of injured workers who reported using a device with a safety mechanism, over 60% did not activate the safety feature.

“The reports indicate inadequate use of safer medical devices, even though devices with sharps injury protections have been available for decades,” said Amber Mitchell, PhD, MPH, president and executive director of the International Safety Center. “Eye exposures are extremely troublesome, as the pathogens are contacting very high risk, mucus membranes which are also highly susceptible to viral and bacterial infectious disease and multidrug resistant organisms.”

Healthcare workers worldwide experience millions of sharps incidents per year, and as many as two-thirds of these events go unreported. They have been responsible for infections from more than 20 different agents, including human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Most needlestick injuries carry no adverse health consequences, but the possibility of infection with life-threatening microbes exists. The rate of infection following needlestick exposure has been calculated for HIV as 0.3%; figures for HCV and HBV have been reported as 1.7% and as high as 30%, respectively.

Related Links:
International Safety Center