Every year, between 800,000 and 1 million health-care workers in the United States are injured by needles and other sharp medical implements, or sharps. Exposure to contaminated sharps puts workers at risk for contracting such blood-borne diseases as HIV and hepatitis B and C. In a recent study, a team of researchers found that introducing a comprehensive safety and education program at a community hospital led to a significant and sustained decrease in the overall injury rate of its personnel. The study appeared in the December issue of Infection Control and Hospital Epidemiology, published by the Vanderbilt University School of Medicine.

According to lead author Robyn R.M. Gershon, associate scientist, Environmental Health Sciences, School of Public Health, "A multifaceted approach incorporating training as well as safety devices such as anti-needlestick devices was found to be beneficial in reducing the overall number of injuries from sharps. The training component is extremely important, since it sends a message to employees that management is serious about their safety and health. Importantly, health-care workers are more likely to adopt safe work practices if they perceive a strong organizational commitment to safety."

Injury data were collected over a nine-year period, from 1990 to 1998, at a mid-sized, acute-care community hospital. In 1991, the hospital's senior administrators created an Anti-Needlestick and Sharps Injuries Task Force to develop and implement a comprehensive intervention program. The program included the introduction of a needleless intravenous catheter and a new comprehensive sharps disposal system, along with extensive safety training for all hospital employees. All workers experiencing sharps injuries were asked to complete a detailed exposure questionnaire as soon as possible following an incident.

The researchers evaluated the program's effectiveness by analyzing the pre- and post-intervention sharps injury rates and found that, following implementation of the intervention program, the overall rate of sharps injuries decreased by 70 percent from 1990 to 1998. Data were obtained on a total of 633 injuries for an average population of 2,300 employees. Injuries were most frequently reported by registered nurses and licensed practical nurses--the single largest occupational group at risk--followed by technicians and support staff.

For health-care workers, the risk of contracting HIV through a contaminated needle has been estimated at 0.3 to 0.4 percent; hepatitis B, at 10 to 35 percent; and hepatitis C, at 1.2 to 10 percent.