Sharps Injuries among Australian Healthcare Workers

Sharps Injuries are far too frequent among Australian healthcare workers (HWC)

Accidental sharps injuries (SI) via needles, sutures, etc, all carry a small but real risk of transmitting bloodborne diseases like HepB, HIV, etc., to the injured HCW.

In fact, Tarantola et al state there are 60 infectious diseases that can be transmitted by these injuries.

At the Australasian College of Infection Prevention and Control (ACIPC) 2016 conference, myself, Nicole Vaust and Jane Parker presented the results of a national survey we conducted among ACIPC members (with ACIPC and Ethics approval)

We asked members 9 questions on their institution’s 2014 occurrence of SI and mucocutaneous exposures (blood splashes to face, etc) – 307 hospitals from 6 states participated, making the survey one of largest in Australia – and we were surprised at the results.

Three out of every hundred HCW reported a sharps injury in 2014 (higher than USA rate); 51% of reported SI were nurses and 37% doctors; and 47% of all SI occurred during surgical procedures.

Extrapolating to Australia nationally, this means over 30,000 HCW sustain an SI annually – 80 per day!

Could it be that Australian HCW are not using safety engineered devices often enough? Or correctly?

What is clear is that this issue needs greater attention at state, perhaps federal legislative level – as it has in most developed countries.

click here for our poster

We will shortly submit our manuscript to the ACIPC Journal of Infection, Disease and Health – so watch this space.

A shared syringe – and $80mill bill

With social media and education outreach, major outbreaks of Bloodborne Pathogens (BBP) should be a thing of the past. Not so.

Alarm bells rang when 11 new HIV cases occurred in Nov-Jan in a small Indiana community – double that normally seen in a year .

This “handful of cases” from shared syringes among opioid drug users, had grown to 26 cases when reported in Feb by the Indiana State Department of Health, and by March had grown to 79 cases. By April the number had risen to 135 cases, 84% of whom were coinfected with HCV.

In a US CDC-Medscape Expert Commentary released this week, the number is now at 170 HIV cases, almost all HCV coinfected. The article states, “The lifelong medical care costs alone for treating the persons …will be more than $80 million“.

WHO in 2004 examined the alarming increase in BBP transmission among drug injectors and after a review of over 200 publications concluded that: the evidence for BBP reduction with needle and syringe exchange programs (NSEP) was overwhelming; NSEP need be country-wide; and any contrary legislation needs be repealed.

PS. Proudly, Australia and New Zealand were two of the first countries to use NSEPs nationally – and now via vending machines!

Interestingly, USA banned federal funding of NSEP in 1988, removed the ban in 2009, and reinstated the ban in 2011 (the legislation does not ban NSEPs; just federal funding of them). Opponents of federal support for NSEPs argue that it signals governmental acceptance of, and would facilitate the uptake of, illegal drug use. WHO says not so. Thankfully, in 2011, at least 221 non federal NSEPs operated in the US.

CDC recommends drug injectors be referred to “programs that provide access to sterile injection equipment.” A wise, evidence-based recommendation.

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