Needlestick injuries – making the point for safety

Summary

An article outlining the significance of needlestick injuries - their risks to healthcare workers, their cost, and the importance of prevention.

Content

Needlestick injuries account for 17% of accidents to NHS staff and are the second most common cause of injury, behind moving and handling (nhsemployers.org). The major risk of needlestick injuries is that they can transmit infectious diseases to healthcare workers, especially blood-borne viruses. Many occupational exposure incidents could have been avoided by adopting precautions and by disposing of clinical waste appropriately (nhsemployers.org).

Needlestick injuries are wounds caused by needles that accidentally puncture the skin (ccohs.ca). When penetrating the skin, this is called a percutaneous injury, whilst if blood or other body fluid splashes into the eyes, nose, mouth or onto broken skin, the exposure is said to be mucocutaneous (nhsemployers.org). Needlestick injuries can occur at any stage when people use, disassemble or dispose of needles. Causes of needlestick injuries include non-compliance with standard infection control precautions, inadequate disposal of clinical waste, overfull sharps bins, and not using Personal Protective Equipment (resolution.nhs). When needlestick injuries occur in a workplace setting, this is called occupational exposure.

If the needle or sharp instrument is contaminated with blood or other body fluid, there is the potential for transmission of infection (nhsemployers.org), which is why needlestick injuries are so dangerous. The major blood-borne pathogens, or blood-borne viruses (BBVs) of concern associated with needlestick injury are hepatitis B, hepatitis C & human immunodeficiency virus (HIV) (nhsemployers.org). However, there are more than 20 diseases that can be transmitted, either transiently or persistently, such as Epstein-Barr virus and malarial parasites. BBVs are carried by some people in their blood and have the potential to cause severe disease (whilst causing few or no symptoms in others); notably, they can spread to others regardless of whether the carrier of the virus is or isn’t symptomatic. BBVs can also be found in bodily fluids other than blood, for example, semen, vaginal secretions and breast milk (hse.gov.uk). Even small amounts of infectious fluid can spread certain diseases effectively (ccohs.ca).

Employers have a legal requirement to take steps to prevent healthcare staff being exposed to infectious agents from sharps injuries (resolution.nhs). The Health and Safety (Sharp Instruments in Healthcare) Regulations of 2013 state that all employers are required under existing health and safety law to ensure that the risks of sharps injuries from needles are adequately assessed, and that appropriate preventative and control measures are put in place (hse.gov.uk), such as correct disposal of used sharps and effective workforce training.

Needlestick injuries generate significant direct and indirect costs. Between 2012 and 2017, successful claims cost the NHS over £4 million (resolution.nhs). It has been shown that economic efforts directed at preventing occupational exposures and infections, including the provision of safety-engineered devices, may be offset by the savings from a lower incidence of needlestick injuries (Mannocci, 2016). Such devices include needle-free connectors that provide injection ports which can be accessed without needles. For instance, in Belgium, the investment and use of safety-engineered sharp devices has greatly reduced the incidence of needlestick injuries and the costs associated with their management (Hanmore, 2013).

Needlestick injuries are a well-known risk in the health and social care sector. Because of their potential for disease transmission, such injuries can cause worry and stress to the many thousands who receive them. Most needlestick injuries can, however, be prevented, and there are legal requirements on employers to take necessary steps to prevent healthcare staff being exposed to the transmission of diseases via this safety issue.

References

• Canadian Centre for Occupational Health and Safety (2021). ‘Needlestick and Sharps Injuries’. [online] Available at: https://www.ccohs.ca/oshanswers/diseases/needlestick_injuries.html
• Hanmore, E. (2013). ‘Economic benefits of safety-engineered sharp devices in Belgium - a budget impact model’. BMC Health Serv Res. [online] Available at: https://pubmed.ncbi.nlm.nih.gov/24274747
• Health and Safety Executive (2001). ‘Blood-borne viruses in the workplace’. [online] Available at: https://www.hse.gov.uk/pubns/indg342.pdf
• Health and Safety Executive (2013). ‘Health and Safety (Sharp Instruments in Healthcare) Regulations 2013’. [online] Available at: https://www.hse.gov.uk/pubns/hsis7.htm
• Health and Safety Executive (2020). ‘Sharps injuries’. [online] Available at: https://www.hse.gov.uk/healthservices/needlesticks/index.htm
• Mannocci, A. et al. (2016). ‘How Much do Needlestick Injuries Cost? A Systematic Review of the Economic Evaluations of Needlestick and Sharps Injuries Among Healthcare Personnel’. Infection Control and Hospital Epidemiology, 37(6). [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890345
• NHS Employers (2011). ‘Needlestick injury’. [online] Available at: https://www.nhsemployers.org/-/media/Employers/Documents/Retain-and-improve/Health-and-wellbeing/Needlestick-Injury-22-02-2011.pdf?la=en&hash=44A54B023D6C14CE21C749A226435581BD8F4FE8
• NHS Resolution (2017). ‘Did you know? Preventing needlestick injury’. [online] Available at: https://resolution.nhs.uk/wp-content/uploads/2017/05/NHS-Resolution-Preventing-needlestick-injuries-leaflet-final.pdf