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Sharps and needlestick injuries are wounds caused by needles and other sharp medical instruments e. Sharps and needles may only cause small wounds in the ngi, but the effects can be worse. Such instruments come in contact with blood and other body fluids and may carry the risk of infections. More than 20 dangerous bloodborne pathogens including HIV and hepatitis 50026 be transmitted through accidental injuries with contaminated needles and sharps [1].

This article gives an overview about the risks associated with sharps and needlestick injuries, and about European legislation. It will focus on prevention measures, such as safe injection practices, safe medical devices, and training. In addition, it will provide information on what to do in case of an injury. Sharps and needlestick injuries remain a serious problem in the healthcare sector. Studies estimate around 1. Other workers at risk of sharps injuries are: In bvi, it is not just medical professionals who are at risk from sharps injuries, but rather anyone who comes into contact with needles or medical sharps contaminated with blood or other body fluids.

The majority of sharps injuries occur to nurses, because their daily routine involves using needles and sharps see also health service. While nurses who work in acute medical situations are identified as having the highest risk, many other healthcare workers are also at risk [5]such as [7]:. Workers outside the healthcare sector may also be at risk because they may come across material that is contaminated with blood and bodily fluid, such as needles used 50266 intravenous drug users [5].

Sharps or needlestick injuries are generic terms for injuries where infectious blood or other body fluids can come into contact with wounds or mucous membranes [5] The most common injuries are needlestick punctures or cuts with medical instruments, but also include [8]:. Factors that can influence the bgl of sharps bi are equipment, design of instruments, working conditions and working practices see also Job design and Organisational measures.

Working under such a demanding situation may result in fatigue, poor concentration, and carelessness, thus increasing the risk of sharps injuries. Studies show that long working hours and sleep deprivation among medical trainees results in fatigue, which is associated with a 3-fold increase in the risk of sharps injury [10] see also Accidents and incidents Tab.

Sharps injuries can also be associated with certain working practices that increase the risk of exposure to infectious body fluids, such as unsafe collection bggi disposal of sharps waste and re-capping of needles [11] [12]. Many devices cause sharps injuries: Hollow-bore needles contaminated with blood account for most of the injuries among the devices. The highest risk of being infected by gbi needles comes from blood collection, intravenous cannulation, and percutaneously placed syringes [14].

According to the HPA survey, over three quarters of occupational exposure to blood and other high-risk body fluids occurred in wards, operating theatres, 502 and emergency units and intensive care units [13]. Infections from bloodborne pathogens can result in 5206 illness and even death.


Hepatitis C represents the most serious health risk as it is ten times more transmissible than HIV and there is currently no vaccine [17]. The risk of infection depends on a range of factors, such as the depth of wound, the type of sharp vgi, whether or not the device was previously in a vein or artery, and how infectious the bgu is [7].

The Directive is supplemented by individual Directives [19] see also Legislation. Its aim was to protect workers against risks to their health bgj safety, arising or likely to arise from exposure to biological agents at the workplace. This Directive sets out provisions 50266 guarantee improved OSH where workers may be exposed to biological agents as a result of their work. The Agreement makes clear that healthcare staff are at risk of serious infections due to their daily work.

More than 20 bvi pathogens, including hepatitis B, C, and HIV, can be transmitted as a result of needlestick injuries [1]. It applies to all workers private and public in the healthcare sector, as well as students, agency nurses, and healthcare staff in other workplaces, such as prisons. The key requirement of the Directive is risk assessment.

The aims of the Directive are:. This directive states that employers must take all appropriate steps to ensure that neither the worker nor the unborn child is exposed to a health risk in the workplace see also Expectant mothersGenderand Young workers. Risk assessment means identifying hazards and controlling the risks in the workplace.

The guiding principles that should be considered throughout the risk assessment process can be broken down into five steps [5] [26]:. All sharps injuries are bggi hazard that can lead to a risk of infection: What might cause harm? What can go wrong? Bgk measures to eliminate or reduce sharps injuries can be done in different ways. The hierarchy of controls, reflecting the efficacy of the measures, indicates that the first priority and most effective level is the elimination or substitution of needles and other sharps, where possible, i.

The next level is to isolate the hazard through the use of an engineering control, e.

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This is followed by work-practice controls universal precautions, no recapping and administrative controls policies and training programmes. Work practice controls should not be a substitute for engineering controls and should only be considered if the technology to eliminate or reduce the hazard is not yet available.

Training measures, however, should complement all types of controls. The last priority and least effective are individual control measures: Different systems are available to eliminate unnecessary use of needles.

Needle-free systems provide an alternative to needles for some procedures, reducing the risk of injury from contaminated sharps, e. Safety devices are designed to prevent workers being injured by contaminated needles or other sharps. They are equipped with safety features which prevent needlestick injuries Tab. Until now it has not been technically possible to use safety devices with premature babies [28]. There is evidence that the use of safe devices, when combined with training and safe work practice, can reduce the risk of needlestick injuries.

A pilot-study to test different safe devices was carried out in 12 hospitals in Hamburg, Germany. A French study [30] showed that passive safety devices were more effective in preventing needlestick injuries than active devices. Healthcare staff must be involved in the implementation of new safety devices in hospitals, and the following criteria must be considered adapted from Unison [31]:.


Various databases provide information and examples of safe medical devices: Safe devices database [32]. Effective measures to prevent sharps injuries also include administrative and work practice controls [7] [33].

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These reduce the likelihood of exposure by changing the way work is done. Administrative bggi measures include policies and programmes to limit the exposure to sharps injuries, e. Training and big guidelines must be available for all workers including new recruits, agency staff, self-employed and ancillary workers. Workers should be involved in decisions about safe working practices see also OSH management systems and workers’ participation.

Working practices controls aim to change the behaviour of the workers. Appropriate training is needed to ensure that all workers are aware of the risks of exposure to biological agents, and know about safe work procedures and the use of safe medical device, as well as standard operating procedures see also OSH training.

Personal protective equipment is the least effective control measure. PPE provides a barrier between the worker and the hazard. It can only prevent exposure to blood or other body fluids, but it cannot protect workers from sharps and needlestick injuries.

It is recommended in the others [35]. Sharps and needlestick injuries are highly underreported. According to a Swiss study, the highest level of non-reporting needlestick injuries is among doctors [36].

The main reasons identified were desensitisation seeing injuries as “business as normal” and underestimating the real risk.

It is, however, important to report injuries, so that appropriate treatment can follow without delay.

Reporting injuries is also important for identifying the causes of an injury, and for taking the necessary measures to prevent further injuries. If workers are contaminated with blood or other body fluids, they should take the following actions without delay [38] [8]:.

Immediate action is required in cases of accidental exposure to bloodborne pathogens through sharp injuries. This involves proper risk assessment, individual medical advice and consultation, and the prescription of post exposure prophylaxis PEPif appropriate PEP is unpleasant to take and may have side-effects and toxic effects.

After exposure to Hepatitis B, active and passive immune-prophylaxis is an effective tool to prevent infection in non-vaccinated workers.

Whilst there is no effective PEP available, an early interferon-monotherapy may reduce the risk of chronic illness. BG BAU- Berufsgenossenschaft der Bauwirtschaft statutory accident insurance for constructionReinigungsarbeiten mit Infektionsgefahr in medizinischen Bereichen Protecting cleaners from infection risks in healthcare facilitiesBGRupdated Retrieved 10 Mayfrom: HSE, Health and Safety Executive UKControlling the risks of infection at work from human remainsa guide for those involved in funeral services including embalmers and those involved in exhumation,Available at: Kleiner Stich mit Ngi.

Retrieved 10 Mayfrom http: Mental health promotion in the health care sector. Prevention of sharp injuries. Retrieved from ” https: Personal tools Log in. Overuse of injections and unnecessary sharps Lack of supplies:

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