McCormick RD, Meisch MG, Ircink FG, Maki DG, et al.
The American journal of medicine. Date of publication 1991 Sep 16;volume 91(3B):301S-307S.
1. Am J Med. 1991 Sep 16;91(3B):301S-307S. doi: 10.1016/0002-9343(91)90386-c.
Epidemiology of hospital sharps injuries: a 14-year prospective study in the
pre-AIDS and AIDS eras.
McCormick RD(1), Meisch MG, Ircink FG, Maki DG.
Author information:
(1)Infection Control Department, University of Wisconsin Hospitals, University
of Wisconsin Medical School, Madison 53792.
The world pandemic of acquired immunodeficiency syndrome (AIDS) has focused
enormous attention on the problem of accidental sharps injuries sustained by
health care workers (HCWs) and the risk of occupationally acquired infection by
human immunodeficiency virus (HIV). At the 1980 Conference, we reported a 4-year
epidemiologic study (1975-1979) of sharps injuries in HCWs at our hospital.
Using the same reporting system and analyses, we now report the epidemiology of
sharps injuries in our center during the current AIDS era (1987-1988) and assess
trends over the 14-year period. Despite greatly increased institutional efforts
to prevent sharps injuries, the annual incidence has increased more than
threefold (60.4 to 187.0/1,000 HCWs), reflecting better reporting and increased
exposure. Reported injuries by house officers have increased ninefold. Adjusting
for inflation, the direct costs of sharps injuries has increased sevenfold
($5,354 to $37,271/year). Environmental service HCWs (305.8 sharps injuries per
1,000 employees) now have the highest incidence in our center, followed by
nursing personnel (196.5/1,000) and laboratory personnel (169.9/1,000), but as
in 1975-1979, two thirds of all injuries occur in nursing personnel. Although
phlebotomy team members have a very low risk per procedure (1/26,871 draws),
their annual incidence is extraordinarily high, 407.0/1,000. Injuries continue
to occur mainly during disposal of waste, linen, or used procedure trays (19.7%
of all injuries), administration of parenteral injections or infusion therapy
(15.7%), surgery (16.0%), blood drawing (13.3%), or recapping of used needles
(10.1%). Making disposal units available at every bedside has reduced injuries
from needle disposal two-fold since 1975-1979. With consistent application of a
stringent postexposure protocol, and wide acceptance of the hepatitis B vaccine,
we have had no sharps injury-related infections during the past 3 years. These
data indicate the increasing risk, complexity and cost of sharps injuries in
HCWs and the need for more innovative--ideally, technology-based--approaches to
prevention. Certain groups of HCWs are at very high risk. Comprehensive
postexposure protocols that are uniformly applied can provide substantial
protection to exposed HCWs.
DOI: 10.1016/0002-9343(91)90386-c
PMID: 1928183 [Indexed for MEDLINE]
