News & updates · conferences · publications
related to needlestick prevention, sharps safety, and occupational exposure prevention
News
Upcoming conferences:
• Second Pointers Conference: Prevention of Occupational Exposures, Treatment and Exposure Reporting Strategies for Healthcare Workers, November 27-28, London, U.K. Sponsored by the U.K. Health Protection Agency.
Description: The conference is built around the epidemiology, prevention and treatment of four major infectious diseases, Hepatitis B and C, HIV and Tuberculosis as they apply in the health care setting. Infections of healthcare workers from patients are a worrying observation and one for which we have to be particularly vigilant. We are aware of an increasing number of cases where healthcare workers have become infected through occupational exposures. However, infections in the healthcare setting are not just important to the healthcare worker, because sadly patients have been infected by healthcare workers in the process of their hospital care. During the conference we will be exploring international data on transmissions of bloodborne viruses from patients to healthcare workers and from healthcare workers to their patients, touching on national policy in their management and prevention.
More information: http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/1191942146589?p=1191942146589
Older news links:
"July 2007: Six Foreign Healthcare Workers in Libya are Released"
"Caring for Healthcare Workers: A Global Perspective" (editorial in Infection Control and Hospital Epidemiology, January 2007, by Janine Jagger)
OSHA Safety and Health Information Bulletin on use of blunt-tip suture needles
American College of Surgeons statement supports use of blunt suture needles
Sloan-Kettering before-and-after study of safety device implementation finds dramatic reduction in sharps injuries
Recent publications
• 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) 2008;58:94-8.
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 groups.
• Hepatitis B virus, hepatitis C virus and other blood-borne infections in healthcare workers: guidelines for prevention and management in industrialised countries.
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 experts.
• National incidence of percutaneous injury in Taiwan healthcare workers. Authors: Shiao JS, Lin MS, Shih TS, Jagger J, Chen CJ. Published in: Research in Nursing and Health 2008 Apr;31(2):172-9.
Summary: We established a standardized surveillance system using the Chinese Exposure Prevention Information Network to estimate the frequency of percutaneous injuries (PCIs) in Taiwanese healthcare workers (HCWs). Fourteen hospitals employing 8,132 HCWs participated and a total of 583 PCIs were reported. The annual number was estimated to be 8,058 PCIs per hospital size, 8,100 per HCWs, and 8,286 per inpatient-day; indicating similar estimates using different denominators. The estimated annual frequency of pathogen-specific PCIs was 1,168 for hepatitis B, 1,263 for hepatitis C, and 59 for HIV. This study documents the annual incidence of PCI among HCWs showing important potential exposure to viral hepatitis and HIV in Taiwan.
• Sharps injury and body fluid exposure among health care workers in an Australian tertiary hospital.
Authors: Bi P, Tully PJ, Boss K, Hiller JE. Published in: Asia-Pacific Journal of Public Health 2008;20(2):139-47.
Summary: To examine sharps injury and body fluid exposure among health care workers, a descriptive epidemiological study was conducted in a 1000-bed tertiary hospital between 2000 and 2003 using surveillance data of all reported sharps injuries and body fluid exposures. A total of 640 sharps injuries and body fluid exposures were reported from hospital and nonhospital staff, although no seroconversions to HIV, hepatitis B virus, or hepatitis C virus were observed during the study period. Nurses reported 47% of sharps injuries and 68% of body fluid exposures, medical staff reported 38% and 16%, and other nonmedical staff notified 5% and 4%, respectively, while nonhospital staff reported the rest. Hollow-bore needles accounted for 56% of sharps injuries, while 11% of the incidents were sustained during recapping and inappropriate disposal. Further research into Australian work practices, disposal systems, education strategies, and the use of safety sharps should be emphasized to implement strategies to reduce work-related injuries among health care workers.
• Working with risk: Occupational safety issues among healthcare workers in Kenya.
Authors: Taegtmeyer M, Suckling RM, Nguku PM, Meredith C, Kibaru J, Chakaya JM, Muchela H, Gilks CF. Published in: AIDS Care. 2008;20(3):304-10.
Summary: The objective of this study was to explore knowledge of, attitudes towards and practice of post-exposure prophylaxis (PEP) among healthcare workers (HCWs) in the Thika district, Kenya. We used site and population-based surveys, qualitative interviews and operational research with 650 staff at risk of needlestick injuries (NSIs). Research was conducted over a 5-year period in five phases: (1) a bio-safety assessment; (2) a staff survey: serum drawn for anonymous HIV testing; (3) interventions: biosafety measures, antiretrovirals for PEP and hepatitis B vaccine; (4) a repeat survey to assess uptake and acceptability of interventions; in-depth group and individual interviews were conducted; and (5) health system monitoring outside a research setting. The main outcome measures were bio-safety standards in clinical areas, knowledge, attitudes and practice as regards to PEP, HIV-sero-prevalence in healthcare workers, uptake of interventions, reasons for poor uptake elucidated and sustainability indicators. Results showed that HCWs had the same HIV sero-prevalence as the general population but were at risk from poor bio-safety. The incidence of NSIs was 0.97 per healthcare worker per year. Twenty-one percent had had an HIV test in the last year. After one year there was a significant drop in the number of NSIs (OR: 0.4; CI: 0.3-0.6; p<0.001) and a significant increase in the number of HCWs accessing HIV testing (OR: 1.55; CI: 1.2-2.1; p= 0.003). In comparison to uptake of hepatitis B vaccination (88% of those requiring vaccine) the uptake of PEP was low (4% of those who had NSIs). In-depth interviews revealed this was due to HCWs fear of HIV testing and their perception of NSIs as low risk. We concluded that Bio-safety remains the most significant intervention through reducing the number of NSIs. Post-exposure prophylaxis can be made readily available in a Kenyan district. However, where HIV testing remains stigmatised uptake will be limited - particularly in the initial phases of a programme.
|