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FACTS NEEDLESTICK INJURY

	Health care workers (HCW's) suffer between 600,000 and one million injuries from conventional needles and sharps annually. These exposures can lead to hepatitis B, hepatitis C and Human Immunodeficiency Virus (HIV), the virus that causes AIDS.
	At least 1,000 HCW's are estimated to contract serious infections annually from needlestick and sharps injuries.
	Registered nurses working at the bedside sustain an overwhelming majority of these exposures.
	Needlestick injuries are preventable. Over 80% of needlestick injuries could be prevented with the use of safer needle devices.
	Less than 15% of U.S. hospitals use safer needle devices and systems.
	In 1992, the Food and Drug Administration issued an alert to all health care facilities to utilize needleless IV systems wherever possible. This alert is merely a recommendation, not a mandate. Therefore, health care facilities are under no legal obligation to comply.
	More than 20 other infections can be transmitted through needlesticks, including: tuberculosis, syphilis, malaria and herpes.
	In March 2000, the Centers for Disease Control and Prevention estimated that more than 380,000 percutaneous injuries from contaminated sharps occur annually among health care workers in United States hospital settings.
	Estimates for all health care settings are that 600,000 to 800,000 needlestick and other percutaneous injuries occur among health care workers annually. Such injuries can involve needles or other sharps contaminated with bloodborne pathogens, such as HIV, HBV, or HCV.
	In More than 12,000 cases, Hepatitis B, C or HIV are contracted and an estimated hundred lives are lost annually.
	In March 2000, the Centers for Disease Control and Prevention estimated that, depending on the type of device used and the procedure involved, 62 to 88 percent of sharps injuries can potentially be prevented by the use of safer medical devices

COST SAVINGS FROM NEEDLESTICK PREVENTION

Hospitals and health care employers in California are expected to save over $100 million per year after implementing the California Occupational Safety and Health Administration's requirement for safe needle devices.

According to the American Hospital Association, one case of serious infection by bloodborne pathogens can soon add up to $1 million or more in expenditures for testing follow-up, lost time and disability payments.

The cost of follow-up for a high-risk exposure is almost $3,000 per needlestick injury even when no infection occurs.

Safe needle devices cost only a fraction more than standard devices.

Hepatitis B

Hepatitis B is now preventable due to the vaccine that must be offered to HCWs and is given to children at birth.

Regulatory and legislative efforts were largely responsible for the reduction of deaths from hepatitis B as a result of vaccine programs.

Following these regulatory and legislative efforts, including the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard, cases of hepatitis B in health care workers dropped from 17,000 annually to 400 annually-and continue to drop.

Hepatitis C

Testing for hepatitis C after needlestick injuries was only recommended in 1998. It is a silent epidemic. There could be thousands and thousands of nurses with occupationally acquired hepatitis C who do not know it.

Hepatitis C is the most frequent infection resulting from needlestick and sharps injuries. Of health care workers who become infected, 85% become chronic carriers.

Chronic carriers have the potential to spread the disease to others, including their partners.

Drugs that slow the progression of hepatitis C are available, but average $1,700 each month.

Hepatitis C leads to liver failure, liver transplants and liver cancer. A liver transplant costs $500,000.

At least 4 million Americans are infected with hepatitis C.

HIV

Human Immunodeficiency Virus (HIV) is the virus that causes AIDS, a fatal disease.

Advances in treatment prolong the time before HIV becomes AIDS. The drug treatment can cost up to $6,000 per month.

16,000 of the 600,000 to one million needlestick injuries each year result in HIV exposure.

There are over 54 documented cases of HCWs with occupationally acquired HIV and at least 133 cases of possible transmissions of HIV.

Federal Legislation News:
EFFECTIVE DATE OF REVISED BLOODBORNE PATHOGENS STANDARDS: APRIL 18, 2001
ARE YOU COMPLIANT?
The Needlestick Safety and Prevention Act (HR 5178) authorizes federal OSHA to revise the 1991 Bloodborne Pathogens Standard (29CFR 1930:1030). This Act directs OSHA:

to revise the Bloodborne Pathogens standard to include new examples in the definition of engineering controls;
to require that Exposure Control Plans reflect how employers implement new developments in control technology;
to require employers to solicit input from employees responsible for direct patient care in the identification, evaluation, and selection of engineering and work practice controls;
and to require certain employers to establish and maintain a log of percutaneous injuries from contaminated sharps.

Click on following countries/organisations to see relevant info:

USA
W.H.O.
U.N.I.C.E.F.
EUROPE
FRANCE
UK
AUSTRALIA
CANADA

USA

- International sharps injury prevention {http://www.isips.org}
- Save Lives and Safe Needles - Needlestick Injuries {http://www.needlestick.org}

- "The Needlestick Safety & Prevention Act - HR 5178 - USA government and legislation { http://thomas.loc.gov/cgi-bin/query/z?c106:h5178: }

- Needle Injuries legislation USA
Senate, U.S. Government
http://www.senate.gov/search/index.html

The USA have amended their legislation on bloodborne pathogens to cover needle injuries and the use of safer devises. To see a copy of the
"Needlestick Safety and Prevention Act" search legislation from the 106th
Congress click here
{http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=106_cong_public_laws&docid=f:publ430.106}

- Preventing Needlestick Injuries in Health Care settings {http://www.cdc.gov/niosh/2000-108.html} by the Center for Disease Control and Prevention ( CDC ) {http://www.cdc.gov}

- Occupational Safety and Health Administration (OSHA) {http://www.osha-slc.gov/SLTC/needlestick/index.html}

- International Health Care Worker Safety Centre, University of Virginia (NGO)

http://www.med.virginia.edu/medcntr/centers/epinet/

The site is dedicated to prevention of the transmission of bloodborne
pathogens and the resources section includes information on exposure
statistics, devices and equipment, prevention checklist, U.S. needle and
bloodborne pathogen legislation and a comprehensive list of links
http://www.med.virginia.edu/medcntr/centers/epinet/links.html

- U.S. Department of Labor - Occupational Safety & Health Administration
{http://www.osha-slc.gov/SLTC/needlestick/index.html#Record. }

- American Nurses Association (ANA)
Dedicated needle injuries site contains information about needlestick
injuries, current legislation, and articles about safe needles {http://www.ana.org}

- American Hospital Association (ANA) {http://www.aha.org}

- Food and Drug Administration (FDA) on Pre Market Notification 510 k for medical needle devices {http://www.accessdata.fda.gov/scripts/cdrh/
cfdocs/cfTopic/topicindex/topindx.cfm?alpha=n}

- Needle Injuries Campaigns:

SEIU Nurse Alliance (part of Service Employees International Union)
Information about their campaign to reduce needle injuries http://www.nursealliance.org/care/needlestick.cfm

W.H.O.

- World Health Organization on vaccination safety (WHO)
{http://www.who.int/vaccinesaccess/injection_safety/
Injections_Safety/vital_to_Health/problem.htm}

U.N.I.C.E.F.

- UNICEF's "Global Alliance for Vaccines and Immunization" {http://www.unicef.org/gavi/}

EUROPE

- European Union - Agency for Safety and Health at Work on needle injuries and prevention
{http://europe.osha.eu.int/good_practice/healthcare/indexbykw.php?
kw=Needle }

There is no specific legislation at the European Union level regulating the
use of "safer devices" to prevent needle stick injuries comparable to that
introduced in the USA.

Needle stick injuries and safer needle devices are covered by two general
European Directives:

1/ Biological Agents Directive (Directive 2000/54/EC of 18 September 2000 on the protection of workers from risks related to exposure to biological agents at work) Covers the assessment and prevention of biological risks in the workplace
http://europa.eu.int/eur-lex/en/lif/dat/2000/en_300L0054.html
.

2/ Workplace Equipment Directive (Council Directive 89/655/EEC of 30 November 1989 concerning the minimum safety and health requirements for the use of work equipment by workers at work)
http://europa.eu.int/eur-lex/en/consleg/main/1989/en_1989L0655_index.html
Covers the use of suitable equipment regarding safety in the workplace.

The general hierarchy of control measures for all risks set in the
"Framework directive" article 6.2(5) is also relevant to the selection of
safer needle devices.
http://europa.eu.int/eur-lex/en/lif/dat/1989/en_389L0391.html This hierarchy includes combat risks at source, adapt to technical progress and replace the dangerous by the non-dangerous or less dangerous.

The European Commission Directorate General Employment and Social Affairs covers policy areas of occupational safety and health accident and the development of legislation (directives) in this area. You may find some relevant information on their website.
http://europe.eu.int/pol/socio/index_en.htm

The minimum requirements set in the directives are transposed into the
legislation in the individual Member States. The individual Member States may therefore have higher standards or more specific requirements in their national legislation. They may also have supporting guidelines and codes of practice.

The Agency has set up a separate health care sector subsite on its webpage here links to Member State information are given:
http://europe.osha.eu.int/good_practice/healthcare/

FRANCE

The French government has initiated a prevention programme (see the links to their information below)

Needle Injuries guidance and legislation
http://www.sante.gouv.fr/pdf/m5817.pdf

The French ministries of employment and health have been carrying out joint work to reduce the number of needlestick injuries and injuries from sharp objects in the health care sector. This includes information, training, research, and co-operation with manufacturers regarding product safety. This is a link to Lettre-circulaire DH/S12-DGS/V3 n?554 dated du 1er septembre 1998. It is a circular that provides background information and details of relevant legislation
Other needle stick information is given here
for example:
-Circulaire DGS.DH n?98/249 dated 20 April 1988 relative ? la pr?vention de la transmission d'agents infectieux v?hicul?s par le sang ou les liquides biologiques lors des soins dans les http://www.sante.gouv.fr /htm/pointsur/contamination/index.htm?tablissment de sant?
- Circulaire DGS.DH.DRT.DSS n?98/228 dated 9 April 1988 relative aux
recommandations de mise en oeuvre d'un traitement antir?troviral apr?s
exposition au risque de transmission du VIH
-Circulaire n?263 du 13 Octobre 1998 relative ? l'organisation de la
surveillance et de la pr?vention des infections nosocomiales.
Keywords: Biological hazards, infectious diseases, needle stick injuries,
legislation, good practice, health care workers

Grouped'Etude sur le Risque d'Exposition au Sang GERES (NGO)
Needle injuries statistics http://www.geres.org/ This site includes access to reports on accidents such as: rapport GERES sur les accidents exposant au sang et le risque de transmission de soignant ? patient. 4 novembre 1998

UNITED KINGDOM

Needle injuries campaigns:

http://www.saferneedlesnow.com
http://www.needlestickforum.net

"Hazards" Trade Union Journal
http://www.hazards.org/campaigns/needlesticks.htm
Brief introduction, information and links to trade union sites running
campaigns on needle injuries and link to ""Hazards UK needle stick campaign

UNISON trade union
Needle stick injuries subsite, includes a guide on safer needles.
http://www.unison.org.uk/polres/needle.htm

AVERT - AIDS Education and Research Trust (NGO)
Short guidelines on prevention of needle injuries and treatment in relation
to AIDS/HIV following an incident http://www.avert.org/needlestick.htm

UK Department of Health Links

http://www.medical-devices.gov.uk/
http://www.doh.gov.uk/
http://tap.ccta.gov.uk/doh/coin4.nsf/

AUSTRALIA

National Safety and Health Commission, Government Body
- Needle injuries
http://www.nohsc.gov.au/ohsinformation
/databases /topics/n/needlestick_injuries.htm

CANADA

CCOHS Government OSH Authority
Needle injuries and AIDS precautions guidelines. Short information sheet on precutions
http://www.ccohs.ca/oshanswers/diseases/aids/health_care2.html
.

Needle injuries guidelines. Short information sheet covering infection hazards from needle stick injuries, occurrence statistics broken down by activity and staff group and prevention
http://www.ccohs.ca/oshanswers/diseases/needlestick_injuries.html

HEPNET
The Hepatitis Information Network for HCW's working with Hepatitis patients risking infection
http://www.hepnet.com/hepc/hcvhlth.html