Age and years in practice as factors associated with needlestick and sharps injuries among health care workers in a Portuguese hospital.
ABSTRACT Health care workers are attributed to the group at highest risk of occupationally acquired bloodborne diseases as the result of contact with blood and body fluids. A cross sectional study was conducted between November 2009 and February 2010 in the North of Portugal, to identify potential risk factors for needlestick and sharps injuries. A questionnaire was provided to 363 health care professionals. Logistic regression was used to identify risk factors associated to needlestick and sharps injuries, calculating odds ratio (OR) and their 95% confidence interval (CI). Sixty-five percent of health care workers (64.5%, 234/363) reported needlestick and sharps injuries in the previous 5 years. Of the injured workers, 74.8% were nurses. Of the total injuries reported, the commonest were from syringe needle unit. The multivariate logistic regression model showed that the strongest risk factor was having more than 10 years or more of work in health services (OR 3.37, 95% CI 1.82, 6.24). Another significantly related factor was being over 39 years-old (OR 1.94, 95% CI 1.03, 3.63). In Portugal, there is a lack of epidemiological evidence related to needlestick and sharps injuries. Considering that patients infected with hepatitis B and C virus are commonly encountered in the hospital environment and that the prevalence of HIV infection in Portugal is one of the highest in Europe, these results should be considered in the design of biosafety strategies at the Hospital Center.
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ABSTRACT: Abstract Objectives A high prevalence of viral hepatitis B and C was found among healthcare workers during a province-wide screening in Sindh Province, Pakistan. A follow-up study was undertaken to identify risk factors for this high prevalence in healthcare workers. Design Population based case–control design. Setting Public sector healthcare facilities in a rural district of Pakistan. Participants Healthcare workers who were screened for hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) antibodies. 178 healthcare workers employed at the public sector clinics and hospitals of the district were approached, of which 14 refused to participate. Cases had detectable serum antibodies against HCV and the presence of HBsAg. Healthcare workers non-reactive to HCV antibodies and with no HBsAg were controls. These were matched in a ratio of 1:1. Outcome measure Detectable serum HBsAg and HCV antibody titer were taken as outcome. OR for various exposures was calculated; those with p<0.25 were entered in a multivariate logistic regression model to find out significant predictors. Results Needle stick injury (OR=6; CI95 1.4 to 23), recapping the needle (OR=5.7; CI95 1.1 to 28), wound care at accident and emergency of a hospital (OR=5.5; CI95 1 to 28), female gender (OR=3.4; CI95 1 to 12) and more than 10 years of formal education (OR=0.25; CI95 0.07 to 0.8) were associated with hepatitis C. Hepatitis B was found to be associated with trying to bend or break a needle after use (OR=4.9; CI95 1 to 24). Conclusions Healthcare workers in Pakistan are at additional risk of exposure to bloodborne pathogens. Bi-dimensional risk factors present at individual and broader health systems levels are responsible. Occupational safety, health trainings and redesigning of the curriculum for allied health professionals are required.BMJ Open 07/2014; · 2.06 Impact Factor
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ABSTRACT: Healthcare workers are at risk of sharps injuries and subsequent infection from more than 40 bloodborne pathogens or species. Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) together account for the vast majority of cases. The Directive 2010/32/EU "Prevention from sharp injuries in the hospital and healthcare sector", issued to protect workers from these risks, requires an integrated approach to prevention including awareness-raising, education, training, elimination of unnecessary needles, safe procedures for sharps use and disposal, banning of recapping, vaccination, use of personal protective equipment, provision of safety-engineered devices, and appropriate surveillance, monitoring, response and follow-up. As laboratories represent a high-risk setting both in the preanalytical and analytical phase, we reviewed accidents and prevention in this setting in the light of the new legislation. Phlebotomy is the procedure carrying the highest risk of exposure and infection, involved in 30-50% of HIV and HCV cases detected in nationwide systems following accidental blood exposures implemented since the 1990s in Italy and France. In laboratories, problems in the management of sharps containers, recapping, needle disassembly by hand and blood transfer from syringes into tubes were observed and accounted for two-thirds of injuries. These accidents could be reduced through education and monitoring of behaviours, and introduction of medical devices incorporating safety-engineered protection mechanisms with appropriate training. Laboratory staff should be immunized against HBV, and know policies and procedures for the post-exposure management and prophylaxis. The management commitment to safety is crucial to ensure the necessary support to these changes.Biochemia Medica 02/2014; 24(1):45-56. · 2.40 Impact Factor
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ABSTRACT: Background: Needlestick and sharp injuries (NSSIs) are defined as percutaneous injuries with needles or sharp objects contaminated with blood or other body fluids. NSSIs are considered as a major occupational hazard among healthcare workers (HCWs) since needles and sharp objects are commonly used in hospitals. Objectives: The objective of this study is to conduct a systematic review on the published scientific literature to provide accurate assessment of needlestick and sharp injuries among healthcare workers including prevalence, risk factors, predictors, reporting, and interventions. Methods: The following selection criteria were used to perform a systematic search of the literature: research studies published in English language between 2011 and 2014, targeted population is the healthcare workers providing direct care to the patients in the hospitals. The outcome of the study is the needlestick and sharp injuries. The following databases were searched: ScienceDirect, Scopus, and EBSCO. The included search terms were: needlestick injury, sharp injury, NSI or NSSI and healthworkers. The search was limited to cross-sectional studies, retrospective studies, and randomized controlled trials conducted in the hospital. The criteria to select articles were limited to peer-reviewed scientific publications and review articles were excluded. Result: Based on the inclusion and exclusion criteria, screening was done to the 35 articles. 18 articles were found eligible to be included while 17 studies were excluded. The included studies consisted of 10 cross-sectional, 7 retrospective, and 1 intervention study. In general, higher NSSI rates were found in nurses (average reported between 64.1% - 44.3%) compared to other occupational groups (average NSSI rate reported were first year resident physician 45%, interns 26% and housekeeper 12.3%). Conclusion: NSSIs is an important occupational hazard among health workers in their daily working. More emphasis must be put on investigating methods and strategies to reduce NSSIs. Safety devices must be used more by HCWs to reduce NSSIs along with planning educational and training programs with close monitoring to practices.International Journal of Clinical Medicine Research. 10/2014; 1(4):151 - 160.