Resources from the International Healthcare Worker Safety Center

Note: Most of the articles below originally appeared in the Center's journal, Advances in Exposure Prevention. All AEP articles are copyrighted by the IHWSC and may only be downloaded and reproduced for educational purposes. They may not be linked to or reproduced on other websites without written permission of the IHWSC. For questions, click here.

◊ Cost of needlestick injuries

• Direct cost of follow-up for percutaneous and mucocutaneous exposures to at-risk body fluids (AEP 1998)
• Measuring the Cost of Sharps Injury Prevention (CDC worksheet)
• U.S. Government Accounting Office (GAO) report: "Occupational Safety: Selected Cost and Benefit Implications of Needlestick Prevention Devices for Hospitals"

◊ Efficacy of safety-engineered sharp medical devices in preventing needlesticks

• Decline in U.S. EPINet needlestick injury rates (AEP 2003)
• The impact of U.S. policies to protect healthcare workers from bloodborne pathogens: the critical role of safety-engineered devices (Journal of Infection and Public Health, 2008)

◊ Epidemiology of sharps injuries and blood exposurse; exposure risks to healthcare workers; implementing sharps surveillance and sharps safety programs 

• Blood and body fluid exposures to skin and mucous membranes (AEP 1995)
• Blood and body fluid exposure to workers' eyes while wearing goggles (AEP 1996)
• Epidemiology of percutaneous blood exposures in a 58-hospital network (chap. 5 in: Collins CH, Kennedy DA, eds. Occupational Bloodborne Infections: Risk and Management. New York: CAB International, 1997)
• Estimate of the annual number of percutaneous injuries in U.S. (ICHE 2004)
• Calculating percutaneous injury rates (AEP 2000)
• Caring for healthcare workers: a global perspective (ICHE 2007)
• Denominators for percutaneous injury rates (AEP 2000)
• Disposal-related sharps injuries (AEP 1995)
• Healthcare worker blood exposure risks: correcting some outdated statistics (AEP 2003)
• Hepatitis C in healthcare workers (AEP 1995)
• Implementing safety devices: two nurses share their experience (AEP 2003)
• Occupational transmission of bloodborne pathogens: case reports
• Rates of needle-stick injuries (NEJM - abstract)
• Risks to healthcare workers in developing countries (NEJM 2001)
• Risk of HIV infection after human bites (AEP 1996)
• Sample-size requirements for clinical trials of safety devices (AEP 2003)

◊ Interviews with occupationally infected healthcare workers

• A needlestick in the emergency room (Vanessa Burkhart) (AEP 2002)
• A nurse with a mission (Lynda Arnold) (AEP 1996)
• An HCV-infected surgeon's difficult choice (AEP 2003)
• A surgeon, a suture needle, and hepatitis C (AEP 2001)
• Firefighter/paramedic with occupationally acquired HIV (AEP2002)
• Occupational co-infection with HIV and HCV in clinical lab (Kristin Turner) (AEP 2005) 
• One unnecessary needle = HIV + HCV (Lisa Black) (AEP 1999) 
• Remarkable journeys: interviews with infected healthcare workers (AEP 2004)

◊ Occupational co-infection with HIV and HCV

• Occupational co-infection with HIV and HCV (AEP 2004)
• Occupational co-infection with HIV and HCV in a lab worker (AEP 2005)

◊ Device-specific sharps injury risks

• Arterial blood gas (ABG) syringes (AEP 1995)
• Bifurcated needles (smallpox administration) (AEP 2003)
• Glass capillary tubes (AEP 1998)
• Huber needles (AEP 1998)
• Phlebotomy devices (AEP 2003)
• Scalpel blades (AEP 2003)
• Suture needles and scalpel blades (AEP 1995)
• Syringes used for drawing blood: a risky use of injection equipment (AEP 2000)
• Vascular access devices (AEP 1998)

◊ Setting-specific sharps injury risks

• Blood banks: segment sampling (AEP 1999)
• Clinical labs (AEP 1996)
• Dialysis (AEP 2001)
• ER/Emergent care (AEP 2002)
• Home health care (AEP 2000)
• Intensive/critical care (AEP 2005)
• Laundry (AEP 1995)
• Outpatient/physicians' offices (AEP 1999)
• Paramedics study (Am J Indust Med 2008); Paramedics interview (AEP 2002)
• Pediatrics (AEP 1996)
• Phlebotomy (AEP 1994)
• Surgery (AEP 1998)

◊ Other resources

• Book: Preventing Occupational Exposures to Bloodborne Pathogens: Articles from Advances in Exposure Prevention, 1994-2003 (order form)
• Checklist for Sharps Injury Prevention 
• Fact Sheet: Percutaneous Injuries From Suture Needles
• Nursing2004 needle-stick and sharps-safety survey (Perry J, Robinson ES, Jagger J)

• Workbook for Designing, Implementing, and Evaluating a Sharps Injury Prevention Program
  
• Surveillance of U.S. Healthcare Personnel with HIV/AIDS, as of December 2002 
  
• Bloodborne pathogens in healthcare settings 
  
• Personal Protective Equipment (PPE) in Healthcare Settings
  - "Guidance for the Selection and Use of Personal Protective Equipment (PPE) in Healthcare Settings" - free downloadable Powerpoint presentation with guidance for presenters/trainers
  - "Sequence for Donning and Removing Personal Protective Equipment" - free downloadable poster

CDC articles:

• Case-Control Study of HIV Seroconversion in Health-Care Workers After Percutaneous Exposure to HIV-Infected Blood-- France, United Kingdom, and United States, January 1988-August 1994 (CDC/MMWR 1995)
  
• Evaluation of Safety Devices for Preventing Percutaneous Injuries Among Health-Care Workers During Phlebotomy Procedures
  
• Evaluation of Blunt Suture Needles in Preventing Percutaneous Injuries Among Health-Care Workers During Gynecologic Surgical Procedures
  
• Universal Precautions for Prevention of Transmission of HIV and Other Bloodborne Infections
  
• Guideline for Infection Control in Health Care Personnel, 1998
  
• Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease (CDC/MMWR 1998)
  
• Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis (MMWR 2001)
  
• Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis (MMWR 2005)

More CDC links here.

World Health Organization - documents and links relevant to healthcare worker safety:

• Aide Memoire on Health Care Worker Safety
  
• Healthcare waste - risks to workers
  
• Policy checklist for bloodborne pathogens exposure control
  
• SIGN: Safe Injection Global Network
  
• WHO Toolkit - Protecting Healthcare Workers: Preventing Needlestick Injuries
  • Presentations:
    • Preventing needlestick injury and occupational exposure to bloodborne pathogens
    • Efficacy of control measures used to prevent needlestick injuries
    • Post-exposure prophylaxis guidelines
      
• WHO Toolkit - Protecting Healthcare Workers (Spanish version)

Joint Commission:

• Sentinel Event Alert - Preventing Needlesticks and Sharps Injuries (2001)

Premier Safety Institute (U.S.):

• Safety device research - literature on the review, selection, testing, and evaluation of safety-engineered sharp devices
  
• Safety device studies - abstract list
  
• Tabular summary of safety device studies and findings