Background: Healthcare workers (HCWs) suffer more than 2 million occupational needle-stick injuries (NSIs) annually. Goal: To determine the global prevalence and causes of NSIs among HCWs. Methods: In this systematic review and meta-analysis, three databases (PubMed, Web of science, and Scopus) were searched for reports from January 1, 2000 to December 31, 2018. The random effects model was used to determine the prevalence of NSIs among HCWs. Hoy et al.’s instrument was employed to evaluate the quality of the included studies. Findings: A total of 87 studies performed on 50,916 HCWs in 31 countries worldwide were included in the study. The one-year global pooled prevalence of NSIs among HCWs was 44.5% (95% CI: 35.7, 53.2). Highest prevalence of NSIs occurred in the South East Asia region at 58.2% (95%, CI: 36.7, 79.8). By job category, prevalence of NSIs was highest among dentists at 59.1% (95% CI: 38.8, 79.4), Hypodermic needles were the most common cause of NSIs at 55.1% (95% CI: 41.4, 68.9). Conclusion: The current high prevalence of NSIs among HCWs suggests need to improve occupational health services and needle-stick education programs globally.

https://www.annalsofglobalhealth.org/articles/10.5334/aogh.2698/galley/2898/download/

Global Prevalence and Device Related Causes of Needle Stick Injuries among Health Care Workers: A Systematic Review and Meta-Analysis.

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 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.

https://bmjopen.bmj.com/content/bmjopen/4/7/e004767.full.pdf

Risk factors for bloodborne viral hepatitis in healthcare workers of Pakistan: a population based case-control study

Context: Needle stick injuries (NSIs) are wounds caused by needles in health care setup that accidentally puncture the skin and may result in exposure to blood or other body fluids. NSI is a major occupational health and safety issue faced by health care professionals globally. Nurses have the highest rate of needle stick injury among health care workers. Aims: To determine the prevalence of needle stick injuries (NSIs) among the nurses, to determine the association between NSI and selected variables like age, marital status, years in service, educational qualification and to assess the measures undertaken by the respondents after the NSI. Materials and Methods: A cross sectional study was conducted in a tertiary care hospital in Imphal among nurses from October to November 2011. Self-administered questionnaire was used for data collection. Descriptive statistics were used. Chi square test was used to see the association and a P-value of Results: The prevalence of NSI within the last one year was found to be 28.1% (N=86). Of them 49(46.5%) had two or more NSIs in the last one year. More than half of the NSIs occurred during intravenous (IV) injection, 16.3% during intramuscular (IM) injection and only 1.6% during recapping of the needle. Eighty three (96%) of them did not were gloves during NSI. Forty (46.5%) of them washed the injured part with water and soap as immediate measure. Thirty seven (43%) did not report it. Though 251(82%) knew about the free availability of Post Exposure Prophylaxis (PEP) in the hospital, only 5(5.7%) took PEP. Conclusion: Needle stick injury is an important occupational health hazard among the nurses. Reporting to the concerned authorities, screening after NSI and promotion of safety measures should be greatly encouraged.

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Prevalence of needle stick injuries among nurses in a tertiary care hospital and their immediate response

Background: Professional exposures of health care workers (HCW) to potentially infective blood and body fluids presents a serious health threat, including hepatitis B, hepatitis C and HIV transmission. This study was conducted to assess the risk for and reporting of needlestick injuries, sharp injuries and other occupational exposures of health care workers in a large healthcare center in Sarajevo. Methods: This cross-sectional survey was conducted in May 2013. The study target population included all hospital  health care workers who had a high potential for exposure.  The estimated sample size was 48 physicians, 132 nurses/technicians and 30 auxiliary personnel.  Results: During their career, 124 (63.3%) HCW reported exposures to blood and body fluids. In total, needle stick injuries  (66.1%) were the most common source of exposure, followed by contact with intact skin (12.1%) and cut with sharp object (11.3%). Only 43 (35.5%) reported any of these exposures to health authorities during their career. The odds of exposure to needle stick injuries and other occupational exposures to blood and bodily fluids were significantly higher among medical nurses/techicians (AOR=4.98, 95%CI=1.52-16,1) and auxillary (AOR=4.30, 95%CI=1.07-17.34) personnel when compared to physicians. HCW in the operation room, intervention ambulance and laboratory (AOR=3.73, 95%CI=1.43-9.72) had higher odds of exposure than workers in the ambulatory departments. Conclusions: Needlestick Injuries, Sharp Injuries  and other Occupational Exposures to Blood and Body Fluids among health care workers are underestimated hazard. Especialy, for HCW who work in operation room/interventional ambulance.  There is a need for preventive programs for HCW and further work on the establishment of an effective surveillance system. DOI: http://dx.doi.org/10.3126/ijosh.v4i1.9847

Needle Stick Injuries, Sharp Injuries and other Occupational Exposures to Blood and Body Fluids among Health Care Workers in a general hospital in Sarajevo, Bosnia and Herzegovina.

Background: Needle stick injury has been identified as the foremost health allied concern and the specialty of dentistry is not an exception. Its incidence can be reduced when a dental practitioner is completely proverbial to the standard cross-infection control measures. This study was intended to assess the knowledge, attitude and practices among the dental practitioners regarding Needle Stick Injuries and associated risk factors. Methods: This survey was carried out in the Oral Surgery Department, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Karachi. Dental practitioners of different job categories were conveniently approached by the BDS students. They all were provided with a structured and validated, self-administered questionnaire. Descriptive statistics and Chi-square test was applied with 5% level of significance. Results: All 100 (55 females and 45 males) practitioners agreed to participate in the study. Prevalence of Needle Stick Injury observed was 30% with no significant relationship with the demographic characteristics. Seventy-four percent of the participants were aware of the universal guidelines. Majority (88%) of the dental personnel believed that recapping of needles should be performed soon after use and 53% knew about needle-less safety devices. These injuries were experienced by 30% of the respondents, of which just 28% were reported. Conclusion: Dental practitioners were at high risk of getting Needle Stick Injuries in dental offices. Most of them had knowledge about it but there was lack of practice of universal precautions. Keywords: Needle Stick Injury, Blood Borne Diseases, Dental Practitioners, precaution, infection

Needle-stick injury: a rising bio-hazard.

Background: Needle-stick injury (NSI) is a major occupational health and safety issue faced by healthcare professionals globally. This study was aimed to assess the frequency and factors associated with NSIs in nurses of a tertiary health care facility in Lahore, Pakistan. It also focuses on safety measures adopted by these nurses after a needle stick injury. Methods : This cross-sectional descriptive study was conducted in Ghurki Trust Teaching Hospital, Lahore from October 2009 to January 2010. All nurses have participated in the study with a response rate of 99%. These responses were obtained via a pretested self-administered questionnaire. The data was analysed using SPSS-16. Percentages of the categorical variables were computed and represented in various statistical data presentation forms, for analysis and comparison. Chi-square test was applied as a test of significance with fixing the p value of 0.05 as significant. Results: Out of 77 nurses who participated in our study, only 33 (42%) nurses were aware of the occupational hazards of their profession when they joined nursing. Needle stick injury was reported by 40 (71.9%) of the nurses in last one year. About 17 (31.5%) were injured at the time of recapping the syringe. The availability of needle cutters in the hospital was reported by 75 (97.4%) nurses while only 46 (60%) of them had undertaken a sharp management training course. Approximately 50 (64.9%) nurses failed to use gloves while administering injections. After getting stuck by a contaminated needle 71 (92%) of the nurses cleaned the wound with a spirit swab, 67 (87%) washed the area with soap and water and 58 (75%) applied a readily available bandage. Only 38 (49%) went on to inform the higher officials about a needle stick injury. Fifty-seven (74%) of the nurses were vaccinated against HBV, and 56 (72.2%) of needle stick injured nurses proceeded for HBV screening, while 53 (68.6%) for HCV and 37(48.5%) for HIV. Conclusion: Needle stick injury is the most important occupational health hazard in nurses with alarmingly high rates. Reporting to the concerned authorities, screening of nurses after needle stick injury and promotion of safety measures against it should be greatly encouraged. Keywords: Needle stick injuries, Nurses, Pakistan

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Mirza Shaharyar Babar

Papers

Needle stick injuries in nurses at a tertiary health care facility