Occurrence of Needlestick and Injuries among Health-care Workers of a Tertiary Care Teaching Hospital in North India

ABSTRACT

Introduction: Occupational hazards such as accidental exposure to sharp, cuts, and splashes are common among health-care workers (HCWs).

Aims and Objectives: To determine the occurrence of self-reported occupational exposures to these hazards and to know the prevalent practices following the exposure. The second aim was to know the baseline antibody levels against hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) immediately after these accidents.

Methods: An observational prospective study was done in the HCWs of a tertiary care academic health organization of North India from January 2011 to December 2013. At the time of self-reporting of injury, a questionnaire was administered. Blood sample of HCWs and of the source, if identified, was collected for baseline HBV, HCV, and HIV serum markers. The exposed HCWs were followed up and repeat testing was done after 3–4 weeks for seroconversion up to 6 months.

Results: A total of 476 injuries were reported. Needlestick injury of fingers was the most common. Doctors were found to have the highest exposure rate (73.7%) distantly followed by nurses (19.1%). A significant number of the HCWs (125, 26.3%) vaccinated in past had hepatitis B surface antibody (anti-HBs) titers ≥10 mIU/mL (protection defined as anti-HBs level ≥10 mIU/ml). Only 44 sources were found to be seropositive (11 for HIV, 9 for HCV, and 24 for HBV). No seroconversion was seen in any of the exposed HCWs after 6 months.

Conclusions: The incidence of needlestick and sharp injuries is most often encountered in emergency wards. Anti-HBs titers were suboptimal in many of the HCWs requiring a booster dose of HBV vaccination.

Key words

Health-care workers - needlestick injury - occupational exposure - postexposure prophylaxis - splashes - underreporting

Publikationsverlauf

Artikel online veröffentlicht:
19. Februar 2020

• REFERENCES

• 1 Norsayani MY, Noor Hassim I. Study on incidence of needle stick injury and factors associated with this problem among medical students. J Occup Health 2003;45:172-8.
• 2 Alonso A. Cementing sharps safety in the European union: The importance of complying with the 2010 EU council directive on sharps injury prevention. J Nurs Care 2014;3:1-2.
• 3 Rogers B, Goodno L. Evaluation of interventions to prevent needlestick injuries in health care occupations. Am J Prev Med 2000;18 4 Suppl: 90-8.
• 4 Sepkowitz KA. Occupationally acquired infections in health care workers. Part I. Ann Intern Med 1996;125:826-34.
• 5 Lee JM, Botteman MF, Xanthakos N, Nicklasson L. Needlestick injuries in the United States. Epidemiologic, economic, and quality of life issues. AAOHN J 2005;53:117-33.
• 6 Cheng HC, Su CY, Yen AM, Huang CF. Factors affecting occupational exposure to needlestick and sharps injuries among dentists in Taiwan: A nationwide survey. PLoS One 2012;7:e34911.
• 7 Centers for Disease Control and Prevention: NIOSH Publications and Products. Preventing Needlestick Injuries in Health Care Settings (2000-108). Available from: http://www.cdc.gov/niosh/docs/2000-108/. [Last accessed on 2015 Jun 11].
• 8 Wilburn SQ. Needlestick and sharps injury prevention. Online J Issues Nurs 2004;9:5.
• 9 Singh S, editor. Standard operative manual: Hospital infection control. New Delhi: National AIDS Control Organization, Government of India; 1999.
• 10 Singhal V, Bora D, Singh S. Hepatitis B in health care workers: Indian scenario. J Lab Physicians 2009;1:41-8.
• 11 International Healthcare Worker Safety Center, University of Virginia. U.S. EPINet Sharps Injury and Blood and Body Fluid Exposure Surveillance Research Group. Sharps Injury Data Report; 2011. Available from: http://www.healthsystem.virginia.edu/pub/epinet/epinetdatareports.html#CitingEPINet. [Last accessed on 2015 Jun 11].
• 12 Sharma A, Gur R, Bhalla P. Study on prevalence of needle stick injury among health care workers in a tertiary care hospital in New Delhi: A two-year review. Indian J Public Health 2012;56:101-3.
• 13 Rele M, Mathur M, Turbadkar D. Risk of needle stick injuries in health care workers ߝ A report. Indian J Med Microbiol 2002;20:206-7.
• 14 Salelkar S, Motghare DD, Kulkarni MS, Vaz FS. Study of needle stick injuries among health care workers at a tertiary care hospital. Indian J Public Health 2010;54:18-20.
• 15 Ashat M, Bhatia V, Puri S, Thakare M, Koushal V. Needle stick injury and HIV risk among health care workers in North India. Indian J Med Sci 2011;65:371-8.
• 16 Prakash KP. Epidemiology of needle-stick injuries in Mangalore. J Evol Med Dent Sci 2012;1:128-36.
• 17 Sharma S, Gupta A, Arora A. Knowledge, attitude and practices on needle-stick and sharps injuries in tertiary care cardiac hospital: A survey. Indian J Med Sci 2010;64:396-401.
• 18 Jahan S. Epidemiology of needlestick injuries among health care workers in a secondary care hospital in Saudi Arabia. Ann Saudi Med 2005;25:233-8.
• 19 O'Connell T, Hayes B. Occupational sharps injuries in a Dublin teaching hospital. Ir Med J 2003;96:143-5.
• 20 Clarke SP, Sloane DM, Aiken LH. Effects of hospital staffing and organizational climate on needlestick injuries to nurses. Am J Public Health 2002;92:1115-9.
• 21 Mbaisi EM, Ng'ang'a Z, Wanzala P, Omolo J. Prevalence and factors associated with percutaneous injuries and splash exposures among health-care workers in a provincial hospital, Kenya, 2010. Pan Afr Med J 2013;14:10.
• 22 Wood AJ, Nadershahi NA, Fredekind RE, Cuny EJ, Chambers DW. Student occupational exposure incidence: Perception versus reality. J Dent Educ 2006;70:1081-8.
• 23 Sharma R, Rasania S, Verma A, Singh S. Study of prevalence and response to needle stick injuries among health care workers in a tertiary care hospital in Delhi, India. Indian J Community Med 2010;35:74-7.
• 24 Cervini P, Bell C. Brief report: Needlestick injury and inadequate post-exposure practice in medical students. J Gen Intern Med 2005;20:419-21.
• 25 Muralidhar S, Singh PK, Jain RK, Malhotra M, Bala M. Needle stick injuries among health care workers in a tertiary care hospital of India. Indian J Med Res 2010;131:405-10.
• 26 Jayanth ST, Kirupakaran H, Brahmadathan KN, Gnanaraj L, Kang G. Needle stick injuries in a tertiary care hospital. Indian J Med Microbiol 2009;27:44-7.
• 27 Hutin Y, Hauri A, Chiarello L, Catlin M, Stilwell B, Ghebrehiwet T, et al. Best infection control practices for intradermal, subcutaneous, and intramuscular needle injections. Bull World Health Organ 2003;81:491-500.
• 28 Singhal V, Bora D, Singh S. Prevalence of hepatitis B virus infection in healthcare workers of a tertiary care centre in India and their vaccination status. J Vaccines Vaccin 2011;2:2-4.
• 29 Floreani A, Baldo V, Cristofoletti M, Renzulli G, Valeri A, Zanetti C, et al. Long-term persistence of anti-HBs after vaccination against HBV: An 18 year experience in health care workers. Vaccine 2004;22:607-10.
• 30 Singru SA, Banerjee A. Occupational exposure to blood and body fluids among health care workers in a teaching hospital in Mumbai, India. Indian J Community Med 2008;33:26-30.