Move towards law on needlestick injury

Needlestick injury has been increasingly recognised as a major health and safety hazard for healthcare workers in the UK, and healthcare professionals have called for better protection for decades. For some time we have observed the positive effects of the US Needlestick Safety and Prevention Act of 2000,1 but only recently have the wheels of EU legislative activity begun to turn with real momentum. In June 2009, European social partners in the hospital and healthcare sector signed a Europe-wide framework agreement on the prevention of sharps injuries, which has been incorporated into a proposal for an EU Directive. Assuming this Directive is adopted, each member state will be required to bring into force legislation, or legally binding agreements, to ensure the safest possible working environment in the hospital and healthcare sector. However, full compliance for all healthcare employers is unlikely to be imposed until mid to late 2012. This article aims to explain more about the significance of needlestick injury, the proposed EU Directive and presents the case for an early adoption of a safety equipment policy.

Significance of needlestick

Sharps injuries are the most frequent occupational hazard faced by nurses, phlebotomists, doctors and other healthcare workers. Such injuries are particularly dangerous in view of their potential for transmitting life-threatening pathogens. Over 20 dangerous bloodborne pathogens can be transmitted by contaminated needles or other sharp objects, including hepatitis B (HBV), hepatitis C (HCV) and HIV. Most injuries are from hollow-bore needles used in injection syringes, blood-drawing devices and intravenous catheters – the everyday tools of the healthcare worker and the most deadly, as they contain residual blood. On suffering an injury from a contaminated needle, the risk of infection is one in three for hepatitis B, one in 30 for hepatitis C and one in 300 for HIV (see Fig. 1).2 However, the number of needlestick injuries reported may not accurately indicate the size of the problem.4,5 Between 60% and 80% of incidents go unreported.6 Figures from the public service trade union UNISON and the Royal College of Nursing (RCN) estimate that more than 100,000 needlestick injuries occur each year in the UK, and more than one million are estimated to occur in the European Union each year. Under-reporting may be due to several reasons: reporting is considered too time consuming, staff members are too busy, and there may be an underestimation of the risks associated with such an exposure.7 Nurses suffer the majority of such injuries, which occur when drawing blood, administering drugs or in the operating theatre, and account for nearly two out of three needlesticks. Doctors rank second to nurses in absolute numbers of needlesticks, but they rarely report injuries when they happen. Emergency crews, medical and ancillary staff, and paramedics are also at risk. A surprisingly large number of needle injuries occur to persons other than the user of the sharp. Downstream workers, such as housekeeping staff, are also frequently injured (see Fig. 2). An important study on needlestick injuries, published by the RCN in 2008,9 estimated the annual cost of dealing with needlestick injuries at £500,000 per National Health Service (NHS) Trust. The cost associated with each inoculation injury has been estimated to range between ?15,000 to ?1,000,000 for an injury resulting in transfer of a bloodborne virus.10