News & updates ·
conferences · publications
related to needlestick prevention, sharps safety, and occupational
- December 2010: NIOSH seeks comment on proposed list of
diseases that may pose bloodborne or airborne transmission risks for
- Center-sponsored national conference
Nov. 5-6, "Tenth Anniversary of the Needlestick Safety and Prevention
Act: Mapping Progress, Charting a Future Path," features keynote
address by John Howard, director of National Institute for Occupational
Safety and Health. Conference program, video of keynote address,
photos, and speaker presentations are available
FDA issues guidance document on labeling of lancets
(Nov. 29, 2010)
- WHO and ILO launch international guidelines to protect
health workers against HIV and TB.
September 2010: Center
receives official designation as a World Health Organization (WHO)
Collaborating Center for Occupational Health. Terms of reference
here. Information on Collaborating Centers in Occupational
Health available here.
- May 2010:
- March 2010: The
European Council approves a directive on the prevention of sharp
injuries in healthcare settings which will make use of safety devices a
legal requirement in EU countries. Press:
- February 2010: SHEA
releases updated guidelines on management of infected healthcare
- January 2010: OR
Manager article on "Blunting sharps injuries."
- December 2009:
- Chinese delegation visits Center
for training in occupational exposure prevention.
- Ginger Parker conducts EPINet sharps
injury surveillance training in Bogota and Medellin, Columbia, awarding
58 EPINet certificates.
- October 2009: Elayne
Kornblatt Phillips visits Sao Paulo, Brazil, to attend a WHO/PAHO
Collaborating Centers and National Reference Institutions meeting on
"Sustainable Development and Environmental Health."
- Center partners with Dikembe Mutombo
Foundation and BD to help support new Occupational Safety Center for
Health Workers at Biamba Marie Mutombo Hospital in Kinshasa, Democratic
Republic of Congo. More here and here.
- Ginger Parker travels to Maracay,
Venezuela, to participate in the First Regional Meeting for Latin
America and the Caribbean on Health Protection for Healthcare
- Center conducts EPINet training at
WHO-sponsored healthcare worker safety conference in Riyadh, Saudi
- EPINet 2007 data reports now
August issue of Health
Purchasing News discusses trends in sharps safety products,
with comments by Jane Perry. Read it here.
- Russian physicians visit Center for
one-week Training Program in Occupational Exposure Prevention.
- European healthcare employee and
employer trade organizations reach agreement on use of safety devices;
European Union expected to pass safety needle legislation by end
of 2009. Read more
- A blog on nursingtimes.net by
Susan Elden describes conditions for nurses in Swaziland, where the HIV
adult population prevalence is 25%. Click
- May 2009: A new tropical
disease risk for healthcare workers: Lujo virus. Read
Association of periOperative Registered Nurses (AORN) 58th Annual
Philadelphia, PA; March 18-24, 2011. Information.
Society of Healthcare Epidemiologists of America (SHEA) 2011
Annual Scientific Meeting. Dallas, TX; April 1-4, 2011. Information.
Association of Professionals in Infection Control and
Epidemiology (APIC) Annual Conference. Baltimore, MD; June 27-29, 2011.
First International Conference on Prevention and Infection Control
(ICPIC). Geneva, Switzerland; June 29-July 2, 2011. Abstract
submission deadline: March 4, 2011. Information.
Association of Occupational Health Professionals in Health Care
(AOHP) Annual Meeting. Minneapolis, MN; September 14-17, 2011. Information.
National Occupational Injury Research Symposium (NOIRS) 2011.
Morgantown, WV; October 18-20, 2011. Information.
Fifth International Congress of Asia Pacific Society of Infection
Control (hosted by Victoria Infection Control Professionals
Association). November 8-11, 2011; Melbourne, Australia. Information.
To add your conference, contact us
From the International Healthcare Worker Safety
Increase in sharps injuries in surgical settings versus non-surgical
settings after passage of national needlestick legislation.
national study to prevent blood exposure in paramedics: rates of
exposure to blood. Authors: Boal WL, Leiss JK,
Ratcliffe JM, Sousa S, Lyden JT, Li J, Jagger J. Published in: Int Arch
Occup Environ Health 2010 83:191-9.
Authors: Jagger J, Berguer R, Phillips EK, Parker G, Gomaa
AE. Published in: Journal of the American College of Surgeons 2010
ABSTRACT: The operating room is a high-risk setting for occupational
sharps injuries and bloodborne pathogen exposure. The requirement to
provide safety-engineered devices, mandated by the Needlestick Safety
and Prevention Act of 2000, has received scant attention in surgical
settings. Study design: We analyzed percutaneous injury surveillance
data from 87 hospitals in the United States from 1993 through 2006,
comparing injury rates in surgical and nonsurgical settings before and
after passage of the law. We identified devices and circumstances
associated with injuries among surgical team members. Results: Of
31,324 total sharps injuries, 7,186 were to surgical personnel. After
the legislation, injury rates in nonsurgical settings dropped 31.6%,
but increased 6.5% in surgical settings. Most injuries were caused by
suture needles (43.4%), scalpel blades (17%), and syringes (12%).
Three-quarters of injuries occurred during use or passing of devices.
Surgeons and residents were most often original users of the
injury-causing devices; nurses and surgical technicians were typically
injured by devices originally used by others. Conclusions: Despite
legislation and advances in sharps safety technology, surgical injuries
continued to increase during the period that nonsurgical injuries
decreased significantly. Hospitals should comply with requirements for
the adoption of safer surgical technologies, and promote policies and
practices shown to substantially reduce blood exposures to surgeons,
their coworkers, and patients. Although decisions affecting the safety
of the surgical team lie primarily in the surgeon's hands, there are
also roles for administrators, educators, and policy
Available at: http://www.ncbi.nlm.nih.gov/pubmed/19437031?dopt=Abstract
OBJECTIVE: The purpose of this analysis is to present incidence rates
of exposure to blood among paramedics in the United States by selected
variables and to compare all percutaneous exposure rates among
different types of healthcare workers. METHODS: A survey on blood
exposure was mailed in 2002-2003 to a national sample of paramedics.
Results for California paramedics were analyzed with the national
sample and also separately. RESULTS: The incidence rate for
needlestick/lancet injuries was 100/1,000 employee-years [95%
confidence interval (CI), 40-159] among the national sample and
26/1,000 employee-years (95% CI, 15-38) for the California sample. The
highest exposure rate was for non-intact skin, 230/1,000 employee-years
(95% CI, 130-329). The rate for all exposures was 465/1,000
employee-years (95% CI, 293-637). California needlestick/lancet rates,
but not national, were substantially lower than rates in earlier
studies of paramedics. Rates for all percutaneous injuries among
paramedics were similar to the mid to high range of rates reported for
most hospital-based healthcare workers. CONCLUSIONS: Paramedics in the
United States are experiencing percutaneous injury rates at least as
high as, and possibly substantially higher than, most hospital-based
healthcare workers, as well as substantially higher rates of exposure
to blood on non-intact skin.
• Safety scalpels and sutures have
come a long way.
Author: Perry J. Published in: Outpatient Surgery Magazine
2009 (May);10(5):48-51. Available at:
• Chinese EPINet and recall
rates for percutaneous injuries: an epidemic proportion of
underreporting in the Taiwan healthcare system.
Authors: Shiao JSC, McLaws ML, Lin MS, Jagger J, Chen
CJ. Published in: Journal of Occupational Health
Summary: As an occupational injury, percutaneous
injury (PI) can result in chronic morbidity and death for healthcare
workers (HCWs). A pilot surveillance system for PIs using the Chinese
version of Exposure Prevention Information Network (EPINet) was
introduced in Taiwan in 2003. We compared data from EPINet and recall
of PIs using a cross-sectional survey for rates to establish the
reliability of the new system. METHODS: HCWs from hospitals that had
implemented EPINet for > or =12 months completed a survey for recall
of contaminated PIs sustained between October 2004 and September 2005,
type of item involved, and reasons for reporting or not reporting the
PI. Comparative data from EPINet for the same period were analyzed.
RESULTS: The EPINet rate, 36.1/1,000 HCW (95%CI 31.8-41.1) was almost 5
times lower (p<0.0001) than the PI recall rate for 2,464 HCWs of
170/1,000 HCWs (95%CI 155.4-185.5). Approximately 2.5 PIs were recalled
for every 1,000 bed-days of care. The recall rate by physicians was
268.3/1,000, 188.5/1,000 for nurses, 88.9/1,000 for medical
technologists and 81.3/1,000 for support staff. Hollow-bore needle
items most commonly recorded on EPINet includ, disposable needles and
syringes were underreported by 81%, vacuum tube holder/needles by 67%,
and arterial blood gas needles by 75%. Nearly 63% of the reasons for
underreporting were related to the complexity of the reporting process,
while 37% were associated with incorrect knowledge about the risks
associated with PIs. CONCLUSIONS: EPINet data underestimates a
commonplace occupational injury with nearly four in five PIs not
reported. Addressing the real barriers to reporting must begin with
hospital administrators impressing on HCWs that reporting is essential
for designing appropriate safety interventions.
devices: we should already be there [letter]
Authors: De Carli G, Puro V, Jagger J. Published
in: Journal of Hospital Infection 2009;71(2):183-4.
Summary: Occupational exposure data from Italy's
Studio Italiano Rischio Occupazionale da HIV (SIROH) group supports the
efficacy of needlestick-prevention devices (NPDs) in reducing sharps
injury risk to healthcare workers. Data from 16 hospitals (2003-2006)
in which NPDs were implemented indicated that injury rates for NPDs
were, on average, 80% lower than for conventional devices. During the
same period, in hospitals that had not implemented NPDs 12 cases of
occupational hepatitis C infection were reported, and one case of
occupationally acquired HIV. Eleven of the 13 injuries that resulted in
infection involved devices for which safety alternatives were
The impact of U.S. policies to protect healthcare workers from
bloodborne pathogens: the critical role of safety-engineered
Authors: Jagger J, Perry J, Gomaa A, Phillips EK. Published
in: Journal of Infection and Public Health 2008 (Dec);1(2):62-71.
Summary: In the United States (U.S.), federal
legislation requiring the use of safety-engineered sharp devices, along
with an array of other protective measures, has played a critical role
in reducing healthcare workers' (HCWs) risk of occupational exposure to
bloodborne pathogens over the last 20 years. We present the history of
U.S. regulatory and legislative actions regarding occupational blood
exposures, and review evidence of the impact of these actions. In one
large network of U.S. hospitals using the Exposure Prevention
Information Network (EPINet) sharps injury surveillance program,
overall injury rates for hollow-bore needles declined by 34%, with a
51% decline for nurses. The U.S. experience demonstrates the
effectiveness of safety-engineered devices in reducing sharps injuries,
and the importance of national-level regulations (accompanied by active
enforcement) in ensuring wide-scale availability and implementation of
protective devices to decrease healthcare worker risk.
publications of interest (non-Center):
• Needlestick injury rates according to different types of
safety-engineered devices: results of a French multicenter study.
Authors: Tosini W, Ciotti C, Goyer F, Lolom I, L'Hériteau F,
Abiteboul D, Pellissier G, Bouvet E. Published in: Infection Control
and Hospital Epidemiology, 2010;31(April):402-7.)
Summary: To evaluate the incidence of needlestick injuries
(NSIs) among different models of safety-engineered devices (SEDs)
(automatic, semiautomatic, and manually activated safety) in healthcare
settings. DESIGN: This multicenter survey, conducted from January 2005
through December 2006, examined all prospectively documented
SED-related NSIs reported by healthcare workers to their occupational
medicine departments. Participating hospitals were asked
retrospectively to report the types, brands, and number of SEDs
purchased, in order to estimate SED-specific rates of NSI. Setting.
Sixty-one hospitals in France. RESULTS: More than 22 million SEDs were
purchased during the study period, and a total of 453 SED-related NSIs
were documented. The mean overall frequency of NSIs was 2.05 injuries
per 100,000 SEDs purchased. Device-specific NSI rates were compared
using Poisson approximation. The 95% confidence interval was used to
define statistical significance. Passive (fully automatic) devices were
associated with the lowest NSI incidence rate. Among active devices,
those with a semiautomatic safety feature were significantly more
effective than those with a manually activated toppling shield, which
in turn were significantly more effective than those with a manually
activated sliding shield (P < .001, chi(2) test). The same gradient
of SED efficacy was observed when the type of healthcare procedure was
taken into account. CONCLUSIONS: Passive SEDs are most effective for
NSI prevention. Further studies are needed to determine whether their
higher cost may be offset by savings related to fewer NSIs and to a
reduced need for user training.
• Occupational injury history and universal
precautions awareness: a survey in Kabul hospital staff.
Authors: Salehi AS, Garner P. Published in: BMC Infectious
Diseases 2010; 10:19 doi:10.1186/1471-2334-10-19.
Summary: Health staff in Afghanistan may be at high risk of needle
stick injury and occupational infection with blood borne pathogens, but
we have not found any published or unpublished data. Methods: Our aim
was to measure the percentage of healthcare staff reporting sharps
injuries in the preceding 12 months, and to explore what they knew
about universal precautions. In five randomly selected government
hospitals in Kabul a total of 950 staff participated in the study. Data
were analyzed with Epi Info 3. Results: Seventy three percent of staff
(72.6%, 491/676) reported sharps injury in the preceding 12 months,
with remarkably similar levels between hospitals and staff cadres in
the 676 (71.1%) people responding. Most at risk were
gynaecologist/obstetricians (96.1%) followed by surgeons (91.1%),
nurses (80.2%), dentists (75.4%), midwives (62.0%), technicians
(50.0%), and internist/paediatricians (47.5%). Of the injuries
reported, the commonest were from hollow-bore needles (46.3 %,
n=361/780), usually during recapping. Almost a quarter (27.9%) of
respondents had not been vaccinated against hepatitis B. Basic
knowledge about universal precautions were found insufficient across
all hospitals and cadres. Conclusion: Occupational health policies for
universal precautions need to be implemented in Afghani hospitals.
Staff vaccination against hepatitis B is recommended.
• The prevalence and risk factors for percutaneous
injuries in registered nurses in the home health care sector.
Authors: Gershon RR, Pearson JM, Sherman MF, Samar SM, Canton
AN, Stone PW. Published in: Am J Infect Control. 2009 Sep;37(7):525-33.
Epub 2009 Feb 12.
BACKGROUND: Patients continue to enter home health care (HHC) "sicker
and quicker," often with complex health problems that require extensive
intervention. This higher level of acuity may increase the risk of
percutaneous injury (PI), yet information on the risk and risk factors
for PI and other types of exposures in this setting is exceptionally
sparse. To address this gap, a large cross-sectional study of
self-reported exposures in HHC registered nurses (RNs) was conducted.
METHODS: A convenience sample of HHC RNs (N=738) completed a survey
addressing 5 major constructs: (1) worker-centered characteristics, (2)
patient-related characteristics, (3) household characteristics, (4)
organizational factors, and (5) prevalence of PIs and other blood and
body fluid exposures. Analyses were directed at determining significant
risk factors for exposure. RESULTS: Fourteen percent of RNs reported
one or more PIs in the past 3 years (7.6 per 100 person-years). Nearly
half (45.8%) of all PIs were not formally reported. PIs were
significantly correlated with a number of factors, including lack of
compliance with Standard Precautions (odds ratio [OR], 1.72; P=.019;
95% confidence interval [CI]: 1.09-2.71); recapping of needles (OR,
1.78; P=.016; 95% CI: 1.11-2.86); exposure to household stressors (OR,
1.99; P=.005; 95% CI: 1.22-3.25); exposure to violence (OR, 3.47;
P=.001; 95% CI: 1.67-7.20); mandatory overtime (OR, 2.44; P=.006; 95%
CI: 1.27-4.67); and safety climate (OR, 1.88; P=.004; 95% CI:
1.21-2.91) among others. CONCLUSION: The prevalence of PI was
substantial. Underreporting rates and risk factors for exposure were
similar to those identified in other RN work populations, although
factors uniquely associated with home care were also identified. Risk
mitigation strategies tailored to home care are needed to reduce risk
of exposure in this setting.
injuries among medical students: incidence and implications.
Accidental exposures to blood and body fluid in the
operation room and the issue of underreporting.
Authors: Sharma GK, Gilson MM, Nathan H, Makary MA. Published
in: Acad Med 2009;84(12):1815-21.
Summary: To determine the incidence of needlestick injuries in medical
school and to examine the behaviors associated with reporting injuries
to an occupational health office. Medical students have underdeveloped
surgical skills and are at high risk of needlestick injuries. METHOD:
Recent medical school graduates enrolled in a surgery residency at 17
medical centers were surveyed regarding needlestick injuries that they
sustained during medical school. The survey asked about the
circumstances and cause of injury and postinjury reporting. RESULTS: Of
699 respondents, 415 (59%) reported having sustained a needlestick
injury as a medical student; the median number of injuries per injured
respondent was 2 (interquartile range: 1-2). Respondents who sustained
a needlestick injury in medical school were more likely to sustain a
needlestick injury during residency than those who did not experience a
needlestick injury in medical school (odds ratio [OR]: 2.57; 95% CI:
1.84, 3.58). Of 89 residents who sustained their most recent
needlestick injury during medical school, 42 (47%) did not report their
injury to an employee health office. CONCLUSIONS: Needlestick injuries
and underreporting of these injuries are common among medical students
and place them at risk for hepatitis and human immunodeficiency virus.
Strategies aimed at improving reporting systems and creating a culture
of reporting should be implemented by medical centers.
Authors: Nagao M, Iinuma Y, Igawa J, Matsumura Y, Shirano M,
Matsushima A, Saito T, Takakura S, Ichiyama S. Published
in: Am J Infect Control 2009 (published online 13 April
Summary: A retrospective review of all exposure
injuries affecting members of the operative care line at a single
university hospital between January 2000 and December 2007 was
performed. A questionnaire survey on current status of adherence to
barrier precautions was also completed by 164 staff members. Of 136
exposure injuries, 87 (64.0%) were in surgeons, and 49 (36.0%) were in
scrub nurses. Surgeons were most commonly injured during suturing (49,
56%), followed by "handing over sharps" (7, 8%), whereas scrub nurses
were most commonly injured during "counting and sorting of sharps" (15,
41%), followed by "handing over sharps," and "splash." The
questionnaire survey revealed that compliance with goggles, face
shields, and double gloving was poor, and only 9% of respondents
routinely used the hands-free technique. Only 22% of staff who had
experienced exposure injuries reported every incident. Because
circumstances of exposure injuries in operating rooms differ by
profession, appropriate preventive measures should address individual
situations. To reduce exposure injuries in the operating room, further
efforts are required including education, mentoring, and competency
training for operation personnel.
• Accidental blood and body fluid exposure among
Authors: Naghavi SH, Sanati KA. Published in: Occup
Med (Lond) 2009;59(2):101-6.
Summary: Aim - To study the epidemiology and time
trends of blood and body fluids (BBF) exposures among hospital doctors.
METHODS: A 3-year study was carried out using data from the Exposure
Prevention Information Network of four teaching hospitals in the UK.
RESULTS: One hundred and seventy-five cases of BBF exposures in doctors
were reported over the 3-year study period. Eighty-one (46%) occurred
in senior doctors and 94 (54%) in junior doctors. Junior doctors had a
higher rate of BBF exposures compared to senior doctors: 13 versus 4
incidents per 100 person-years, respectively (relative risk 3, 95%
confidence interval 2-4). The most frequent setting for BBF exposures
among senior doctors was the operating theatre/recovery (59%). Among
junior doctors, it was the patient room (48%). The commonest original
reason for use of sharps by junior doctors was the taking of blood
samples (42%). Among senior doctors, it was suturing (41%). CONCLUSION:
While ongoing training efforts need to be directed towards both junior
and senior doctors, our data suggest that junior doctors are at higher
risk of BBF exposures and may need particular attention in prevention
strategies. An improvement in the safety culture in teaching hospitals
can be expected to reduce the number of BBF exposures.
• The incidence
and reporting rates of needle-stick injury amongst UK surgeons.
Authors: Thomas WJ, Murray JR. Published in: Ann R Coll Surg
Summary: Needle-stick injuries are common. Such
accidents are associated with a small, but significant, risk to our
career, health, families and not least our patients. National
guidelines steer institution-specific strategies to provide a
consistent and safe method of dealing with such incidents.
Surgeon-specific guidelines are not currently available. We have
observed that hospital sharps policy is often considered cumbersome to
the surgeon, resulting in on-the-spot decision making with potential
long-term implications. By their essence, these decisions are
inconsistent, not reproducible and, thus, we believe them to be unsafe.
The under-reporting to occupational health departments is well
documented. Current surgical practice has the potential to expose the
surgeon to unnecessary risk. The aims of this study were to establish
the true incidence of contaminations caused by needle-stick injury in
our hospital and to assess how well current protocols are really
implemented. SUBJECTS AND METHODS: We identified all surgeons of
consultant, non-career staff grade (NCSG) and registrar grade working
in a large 687-bed district general hospital serving a population of
550,000, in the UK. We designed a retrospective, anonymous 30-second
survey. Surgeons' awareness and opinion of local policy was sought in a
free-text section. RESULTS: Of the 98 surgeons in the hospital, 77%
responded to the questionnaire and 44% anonymously admitted to having a
needle-stick injury. Only 3 of the 33 (9%) who sustained an
needle-stick injury said that they followed the agreed local policy.
Twenty-three surgeons (70%) performed first aid type procedures such as
informing scrub nurse, changing needle and gloves. Seven surgeons (21%)
simply ignored the incident and continued. Forty-three surgeons
commented on the policy's nature with only 9 who regarded it as 'user
friendly'. CONCLUSIONS: Needle-stick injury is still a common problem,
particularly in the surgical cohort and remains significantly
under-reported. The disparity between hospital sharps policy and actual
surgical practice is considered and an explanation for the difference
sought. Without this awareness of 'real-life' surgical practice, the
occupational health figures for sharps injury will always tell a rosy
story under-estimating a real problem. We strongly advocate universal
precautions in the operating theatre. However, we acknowledge that
sharps injuries will occur. We should remain vigilant and act upon
contaminations without surgical bravado but with mater-of-fact
professionalism. This includes regular review of policy and,
particularly, promotion of surgical awareness.
• Exposures to blood and body fluids in
Brazilian primary health care.
Authors: Garcia LP, Facchini LA. Published in: Occup Med
Summary: Primary health care workers (HCWs) represent
a growing occupational group worldwide. They are at risk of infection
with blood-borne pathogens because of occupational exposures to blood
and body fluids (BBF). AIM: To investigate BBF exposure and its
associated factors among primary HCWs. METHODS: Cross-sectional study
among workers from municipal primary health care centres in
Florianópolis, Southern Brazil. Workers who belonged to occupational
categories that involved BBF exposures during the preceding 12 months
were interviewed and included in the data analysis. RESULTS: A total of
1077 workers participated. The mean incidence rate of occupational BBF
exposures was 11.9 per 100 full-time equivalent worker-years (95%
confidence interval: 8.4-15.3). The cumulative prevalence was 7% during
the 12 months preceding the interview. University-level education,
employment as a nurse assistant, dental assistant or dentist, higher
workload score, inadequate working conditions, having sustained a
previous occupational accident and current smoking were associated with
BBF exposures (P <or= 0.05). CONCLUSIONS: Primary Health Care
Centres are working environments in which workers are at risk of BBF
exposures. Exposure surveillance systems should be created to monitor
their occurrence and to guide the implementation of preventive
• Hands-Free Technique in the Operating Room:
Reduction in Body Fluid Exposure and the Value of a Training
Authors: Stringer B, Haines T, Goldsmith CH, Blythe J,
Berguer R, Andersen J, De Gara CJ. Published in: Public Health
Reports 2009;124 (S1):169-79.
Summary: This study sought to determine if (1)
using a hands-free technique (HFT)-whereby no two surgical team members
touch the same sharp item simultaneously-$75% of the time reduced the
rate of percutaneous injury, glove tear, and contamination (incidents);
and (2) if a video-based intervention increased HFT use to $75%,
immediately and over time. METHODS: During three and four periods, in
three intervention and three control hospitals, respectively, nurses
recorded incidents, percentage of HFT use, and other information in
10,596 surgeries. The video was shown in intervention hospitals between
Periods 1 and 2, and in control hospitals between Periods 3 and 4. HFT,
considered used when $75% passes were done hands-free, was practiced in
35% of all surgeries. We applied logistic regression to (1) estimate
the rate reduction for incidents in surgeries when the HFT was used and
not used, while adjusting for potential risk factors, and (2) estimate
HFT use of about 75% and 100%, in intervention compared with control
hospitals, in Period 2 compared with Period 1, and Period 3 compared
with Period 2. RESULTS: A total of 202 incidents (49 injuries, 125
glove tears, and 28 contaminations) were reported. Adjusted for
differences in surgical type, length, emergency status, blood loss,
time of day, and number of personnel present for $75% of the surgery,
the HFT-associated reduction in rate was 35%. An increase in use of HFT
of $75% was significantly greater in intervention hospitals, during the
first post-intervention period, and was sustained five months later.
CONCLUSION: The use of HFT and the HFT video were both found to be
• Health care workers' exposure to blood-borne
pathogens in Lebanon.
Authors: Musharrafieh UM, Bizri AR, Nassar NT, Rahi AC, Shoukair AM,
Doudakian RM, et al. Published in: Occupational Medicine (Oxford)
Summary: Accidental exposure to blood-borne
pathogens (BBPs) is a risk for health care workers (HCWs). AIM: To
study the pattern of occupational exposure to blood and body fluids
(BBFs) at a tertiary care hospital. Methods: This study reports a
17-year experience (1985-2001) of ongoing surveillance of HCW exposure
to BBFs at a 420-bed academic tertiary care hospital. Results: A total
of 1,590 BBF exposure-related accidents were reported to the Infection
Control Office. The trend showed a decrease in these exposures over the
years with an average +/- standard error of 96 +/- 8.6 incidents per
year. In the last 6 years, the average rate of BBF exposures was 0.57
per 100 admissions per year (average of needlestick injuries alone was
0.46 per 100 admissions). For 2001, the rates of exposure were found to
be 13% for house officers, 9% for medical student, 8% for attending
physicians, 5% for nurses, 4% for housekeeping, 4% for technicians and
2% for auxiliary services employees. The reason for the incident, when
stated, was attributed to a procedural intervention (29%), improper
disposal of sharps (18%), to recapping (11%) and to other causes (5%).
Conclusions: The current study in Lebanon showed that exposure of HCWs
to BBPs remains a problem. This can be projected to other hospitals in
the country and raises the need to implement infection control
standards more efficiently. Similar studies should be done
prospectively on a yearly basis to study rates and identify high-risk
• Hepatitis B virus, hepatitis C
virus and other blood-borne infections in healthcare workers:
guidelines for prevention and management in industrialised
Authors: FitzSimons D, François G, De Carli G, Shouval D,
Prüss-Ustün A, Puro V, Williams I, Lavanchy D, De Schryver A, Kopka A,
Ncube F, Ippolito G, Van Damme P. Published in: Occupational
and Environmental Medicine 2008;65(7):446-51.
Summary: The Viral Hepatitis Prevention Board (VHPB)
convened a meeting of international experts from the public and private
sectors in order to review and evaluate the epidemiology of blood-borne
infections in healthcare workers, to evaluate the transmission of
hepatitis B and C viruses as an occupational risk, to discuss primary
and secondary prevention measures and to review recommendations for
infected healthcare workers and (para)medical students. This VHPB
meeting outlined a number of recommendations for the prevention and
control of viral hepatitis in the following domains: application of
standard precautions, panels for counselling infected healthcare
workers and patients, hepatitis B vaccination, restrictions on the
practice of exposure-prone procedures by infected healthcare workers,
ethical and legal issues, assessment of risk and costs, priority
setting by individual countries and the role of the VHPB. Participants
also identified a number of terms that need harmonization or
standardisation in order to facilitate communication between