Needle Stick and Sharp Instruments Injuries Among Health Care Providers at Cardiology Institute, Ahmedabad
Keywords:
Needle Stick Injury, Health Care Worker, Post Exposure ProphylaxisAbstract
Background: Needle stick and sharp instruments injury (NSI) is one of the major occupational hazards to health care workers (HCW) and distributed to worldwide at every level of health care setting. Objective: To estimate true incidence, to analyze NSI of self reported cases and to know outcome of post exposure prophylaxis(PEP) for Human Immunodeficiency Virus(HIV) as well as Hepatitis B virus infection among NSI cases. Materials and Methods: Study Design: analysis of documents of NSI for the period from December 2008 to November 2009 and rapid cross sectional survey among all nurses for history of NSI in month of June 2010. Setting: U N Mehta institute of cardiology and research centre, Ahmedabad. Participants: 277 nurses, 150 doctors and 33 physiotherapists. Results: The reported incidence of NSI among nurses, doctors and physiotherapists was 0.029, 0.0066 and 0.03 per person per year respectively. 60% of injuries associated with hollow bore needles. 10% injuries were due to recapping of used syringe needle. All 100% reported injuries were self inflicted. 90% HCW immediately washed their hand with soap and water after injury. 90% of the reported injuries were associated with contaminated instruments. In 40% injuries, sources were HBsAg positive and in 20% injuries, sources were HIV positive. All at risk HCW on PEP were found sero-negative for HBsAg and HIV at 0, 1 and 6 months.
References
Kelen GD, Fritz SF, Qaqish B. Unrecognized HIV infection in emergency Department patients N Engl J Med 1998;38:1645-1650
Jagger J, Hunt EH, Brand-Elnaggar J, Pearson RD. Rates of needlestick injury caused by various devices in a university hospital. N Engl J Med 1988; 319:284-288.
De Laune S: Risk reduction through testing, screening, and infection control precautions- with special emphasis on needlestick injuries. Infect Control Hosp Epidemiol 1990; 11(10):563-565.
Gerberding JL. Incidence and prevalence of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and cytomegalovirus among health care personnel at risk for blood exposure: Final report from a longitudinal study. J Infect Dis 1994;170:1410-7.
Tokars JI, Marcus R, Culver DH, Schable CA, McKibben PS, Bandea CI, et al. Surveillance of HIV infection and zidovudine use among health care workers after occupational exposure to HIV-infected blood. Ann Intern Med 1993;118:913-9.
Jagger J, Pearson RD: Universal precautions: Still missing the point on needlesticks. Infect Control Hosp Epidemiol 1991; 12(4):211-213.
Centers for Disease Control. Risk of acquiring hepatitis C for health care workers and recommendations for prophylaxis and follow-up after occupational exposure. Hepatitis Surveillance Report 1996; 56:3-6.
Pruss-Ustun A, Rapiti E, Hutin Y. Sharps injuries: Global burden of disease from sharps injuries to health-care workers. Geneva, World Health Organization, 2003 (WHO Environmental Burden of Disease Series, No. 3).
Elder A, Paterson C. Sharps injuries in UK health care: A review of injury rates, viral transmission and potential efficacy of safety devices. Occup Med (Lond) 2006;56:566-74.
http://www.nacoonline.org/National_AIDS_Control_Program/PEP_full/ : accessed on 30 June 2010
Tadashi Yoshida, Ikuo Saito. Hepatitis B booster vaccination for health care workers. The Lancet 2000; 355:1464
Saulat Jahan :Epidemiology of needle stick injuries among health care workers in a secondary care hospital in Saudi Arabia. Ann Saudi Med.2005;25(3):233-238
Pournaras S, Tsakris A, Mandraveli K, Faitatzidou A, Douboyas J, Tourkantonis A. Reported needle stick and sharp injuries among health care workers in a Greek general hospital. Occup Med (Lond) 1999;49:423-6.
B H Hamory. Underreporting of needle stick Injuries in a University Hospital. Am J Infect Control 1983;11:174-177.
E Roy and P Robillard. Underreporting of Accidental Exposures to Blood and Other Body Fluids in Health Care Settings:An Alarming Situation. Adv Exposure Prev 1995;1(4):11
C M Mangione. Occupational Exposure to HIV: Frequency and Rates of Underreporting of Percutaneous and Mucocutaneous Exposures by Medical House Staff. Am J Med 1991;90:85-90.
D Haiduven, S Simpkins, E Phillips and D A Stevens. Percutaneous/Mucocutaneous Injury Reporting in a PublicTeaching Hospital. J Hosp Inf 1999;41:151-154.
Osborn EHS, Papadakis MA, Gerberding JL [1999]. Occupational exposures to body fluids among medical students. A seven-year longitudinal study. Ann Intern Med 130(1):45-51.
CDC (Centers for Disease Control and Prevention) [1997ª]. Evaluation of safety devices for preventing percutaneous injuries among health-care workers during phlebotomy procedures. Minneapolis- St.Paul, New York City, and San Francisco 1993-1995. MMWR. 46(2):21-25.
EPINet [1999]. Exposure prevention information network data reports. University of Virginia: International Health Care Worker Safety Center http://www.healthsystem.virginia.edu/internet/ epinet/soi99.cfm (Accessed 30 June 2010)
Elder A, Paterson C. Sharps injuries in UK health care: A review of injury rates, viral transmission and potential efficacy of safety devices. Occup Med (Lond) 2006;56:566-74.
Abu-Gad HA, Al-Turki KA. Some epidemiological aspects of needle stick injuries among the hospital health care workers: Eastern province, Saudi Arabia. Eur J Epidemiol 2001;17(5):401-407
US Department of Health and Human Services. National Institute for Occupational Safety and Health (NIOSH). NIOSH ALERT Preventing Needle stick Injuries in Health Care Settings. Publication No. 2000-108. 2000: http://www.cdc.gov/niosh/ 2000-108.html (Accessed 30 June 2010)
Lymer UB, Schutz AA, Isaksson B. A descriptive study of blood exposure incidents among health care workers in a university hospital in Sweden. J Hosp Inf 1997;35:223-235.
Needlestick Injuries among health care workers in Washington State 1996-2000: http: //www.lni.wa.gov/Safety/Research/files/ NeedleStick.pdf (Accessed 30 June2010)
Ruben FL, Norden CW, Rockwell K, Hruska E. Epidemiology of accidental needle puncture wounds in hospital workers. Am J Med Sci 1983 Jul-Aug;286(1):26-30.
International Health Care Worker Safety Center. Exposure Prevention Information Network. Uniform Needle stick and Sharp Object Injury Report 77 Hospitals 1993-1995 [February 1998]. Available on www.dir.ca.gov/OSHSB/sharps2.HTML (Accessed 30 June 2010)
Preventing needle stick injuries in health care settings: www.cdc.gov/niosh/2000-108.html (Accessed 30 June 2010)
Rahul Sharma, SK Rasania, Anita Verma, Saudan Singh. Study of prevalence and response to needle stick injuries among health care workers in a tertiary care hospital in Delhi, India.2010;35:74-77.
A McGeer et al. Epidemiology of needle stick injuries in house officers. J Infect Dis 1990;162: 961-964.
Rele M, Mathur M, Turbadkar D. Risk of needle stick injuries in health care workers - A report. Indian J Med Microbiol 2002;20:206-7.
McCormick RD, Maki DG. Epidemiology of needle stick injuries in hospital personnel. Am J Med 1981 Apr;70(4):928-32.
RD McCormick et al. Epidemiology of hospital sharps injuries: a 14-year prospective study in the pre-AIDs and AIDs eras. Am J Med 1991;91: 301S-307S.
Krasinski K, LaCouture R, Holzman RS. Effect of changing needle disposal systems on needle puncture injuries. Infect Control 1987;8(2):59-62.
Yassi A, McGill M [1991]. Determinants of blood and body fluid exposure in a large teaching hospital: hazards of the intermittent intravenous procedure. Am J Infect Control 1991;19(3):129-135.
Bilski B, Needle stick injuries in nurses– the Poznañ study. Int J Occup Med Environ Health 2005; 18:251-254.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The authors retain the copyright of their article, with first publication rights granted to Medsci Publications.
