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PubMed1992

[Needlestick injuries in hospital personnel and the risk of hepatitis-B infection].

The risk of employees of the University Hospital of Basel acquiring virus hepatitis B following needle stick injuries (NSI) was evaluated prospectively. Over four years, 555 NSI were reported, resulting in a mean incidence of 48 NSI/1000 persons working/year. Of the injured, 455 (82%) had previously been vaccinated against hepatitis B, 32 (6%) were HBsAg and/or anti-HBc positive, and only 65 (12%) were at risk for HBV infection. The origin of 365 (66%) of the needles implicated in the NSI was identified, and of these 15 (4%) had been contaminated with HBsAg-positive blood. None of the 555 persons with NSI developed hepatitis. We conclude that the risk of HBV infection following NSI is low at our institution, but general measures need to be enforced to reduce the incidence of NSI in view of the potential risk that other infectious diseases may be transmitted by NSI.

Health Personnel↗
PubMed1994

Quantity of blood inoculated in a needlestick injury from suture needles.

We wanted to quantify the amount of blood inoculum present on several commonly used surgical and phlebotomy needles and to determine the effect of single or double gloving, the depth of needle penetration and needle size on inoculum volume. Nineteen, 22 gauge and 25 gauge phlebotomy needles, as well as the tapered suture needles from zero, 3-0 and 5-0 sutures and a cutting needle from a 4-0 suture were assessed. The needles were dipped into blood labeled with 125I-epidermal growth factor and then embedded 2 or 5 millimeters into an agarose gel. The volume of blood inoculum ranged from 133 to 683 nanoliters for the phlebotomy needles and from 35 to 366 nanoliters for the suture needles. Needles were then passed through none, one or two layers of surgical glove material before embedding the needles 5 millimeters into agarose gel. The use of one layer of surgical glove resulted in a significant (p < 0.001) decrease in inoculum from tapered suture needles, but not from the cutting needles. Two gloves were even more efficient (p < 0.001) than one glove at removing blood from all suture needles, including the cutting needle. However, surgical glove material did not significantly reduce the volume of blood inoculum transferred by the phlebotomy needles. The size of the needle and depth of penetration were found to have a significant influence on inoculum.

Blood↗
PubMedDate not supplied

[Update of the cost of needlestick injuries in hospital healthcare personnel].

OBJECTIVES: To update the mean cost of each hepatitis B, hepatitis C and HIV follow-up in health personnel accidentally exposed to blood and body fluids, to stratify the cost depending on the serological status of the source, and to identify the items that account for the main part of the cost. METHODS: A cost analysis was carried out. The postexposure program was modeled on a decision tree combining probabilities (percentage of each type of source depending on positivity for the three viruses and immunization status of the health worker against hepatitis B) and monetary costs (euros in 2002). Costs included salaries, laboratory, pharmacy (including postexposure prophylaxis), water, gas and electricity, cleaning, telephone, medical and office equipment, amortization and lost productivity. RESULTS: The mean cost was 388 euros, ranging from 1,502 euros (source positive for hepatitis C and HIV) to 172 euros (source negative for the three viruses). If the source was hepatitis B positive, the mean cost was 666 euros when the injured worker was not immunized and was 467 euros if the worker was immunized. Serologic tests and postexposure prophylaxis accounted for the main part of the cost. CONCLUSIONS: The high cost suggests the need for appropriate risk evaluation to avoid unnecessary follow-ups. The model used allows the cost of each potentially avoidable episode to be determined and could be used in any hospital to perform an economic evaluation of new preventive devices.

Costs and Cost Analysis↗
PubMed1985

Needlecaps to prevent needlestick injuries.

Hospital employees are at risk for numerous possible complications of accidental needlesticks. The mechanisms of such accidents suggest that many are preventable. This article presents a simple but novel revision of the needlecap which facilitates resheathing of a used needle. With routine use the hospital environment could be made safer for virtually all employees at almost no additional cost. Ultimate hospital savings could be significant through prevention of injury.

Accidents, Occupational↗