Needle-stick injuries

Discuss Occupational Safety and Health Administration (OSHA) guidelines concerning needle stick injuries and precautions. 

The needle stick log will help both employees and employers track all needle sticks to help identify problem areas. The log must be maintained to protect the confidentiality of the injured employee. In addition, employers must have a written Exposure Control Plan that is updated annually. During the annual review, inquiries must be made about new or prospective safer options. If new safer devices are available, they should be adopted for use in the agency. The new guidelines will help reduce needle stick injuries among health care workers and others who handle medical sharps. Safety engineered devices such as self-sheathing needles and needleless systems can be used. 

HIV infection Health care workers exposed to blood after needle-stick injury Tenofovir/emtricitabine lopinavir/ritonavir Good... 

Hernandez, M.E., Brngnera, M., Pnynelo, T., Barrera, JJVI., Sanchez Tapias, J.M., Rodes, J. Risk of needle-stick injuries in the transmission of hepatitis C virus in hospital personnel. X Hepatol. 1992 16 ... 

Risk of cross-contamination from needle-stick injury. 

Protective clothinq and equipment, avoiding needle stick injuries, decontamination, nandwashing, exposure procedures, and waste disposal. 

A woman taking metoprolol 50 mg daily and felodipine 5 mg daily for hypertension developed bilateral leg oedema, orthostatic hypotension, and other symptoms including dizziness and fatigue, 3 days after starting HAART following a needle-stick injury. The antiretroviral therapy included zidovudine, lamivudine, and nelfinavir 2 g daily. Antihypertensive treatment was stopped and the adverse effects abated within 3 days. The patient was then successfully switched to a diuretic-based regimen without recurrence of oedema. ... 

These things go on for months and months before anything is done. .. This creates a feeling ofapathy, that there is no point in filling in a needle-stick injury form, ora blood splash form. 

Occupational Safety and Health Administration (OSHA) recordable cases, which include work-related injuries and illnesses that result in one or more of the following death, loss of consciousness, days away from work, restricted work activity or job transfer, medical treatment (beyond first aid), significant work-related injuries or illnesses that are diagnosed by a physician or other licensed heath care professional (these include any work-related case involving cancer, chronic irreversible disease, a fracture or cracked bone, or a punctured eardrum) additional criteria include any needle-stick injury or cut from a sharp object that is contaminated with another person s blood or other potentially infectious material, any case requiring an employee to be medically removed under the requirements of an OSHA health standard, and tuberculosis infection as evidenced by a positive skin test or diagnosis by a physician or other licensed health care professional after exposure to a known case of active tuberculosis. 

Focussing on worker outcomes, Mark et al. (2007) reported a direct influence of safety culture on workers back injuries, but not on needle-stick injuries, in a... 

Reassuringly, early prospective studies of HCWs exposed to infectious material in the workplace showed that the risk of contracting HIV infection occupationally was very low. However, the first report of nosocomial infection from patient to provider was published in 1984 [27]. It described an acute febrile illness in a HCW who had experienced a percutaneous needle-stick injury with blood derived from an AIDS patient. In 1986, HIV seroconversion was reported following a superficial needle-stick injury of a finger [28]. 

Using injection vials and needle-free devices, as far as possible, to minimise needle-stick injuries. If sharps cannot be avoided, their use should be minimised [18], see also Sect. 26.10... 

Reduce occupational needle-stick injuries among hospital-based healthcare workers... 

Hepatitis B, HIV-AIDS from needle-stick injuries Viral and bacterial infections Enzyme produced inflammation of alveoli Hepatitis B, HIV-AIDS from skin abrasion... 

Methods and engineering innovations for preventing needle stick injuries... 

A number of veterinary vaccines contain components that are pathogenic in humans and which could conceivably cause disease, although the vast majority are specific to the animals they infect. An example of a disease that infects both animals and humans is rabies, and rabies vaccines are commercially and widely available. However, the problem is overcome by inactivation of the virus to produce a product that is safe for both the vaccinated animal and for those who administer it. However, as Table 14.1 indicates, some products are available that may cause disease in humans if used improperly or should accidental injection or a needle stick injury occur. Clearly, the results of human contamination and infection are microbiological and not toxicological. Nevertheless, it is worth examining these briefly for the sake of completeness and to emphasise that user safety is not the sole domain of pharmaceutical products. 

In contrast to orf, brucellosis infection has developed in humans following self-injection with live brucella vaccine. In the USA, the Centers for Disease Control and Prevention (CDC) received reports of 26 cases through passive surveillance and 21 of these had suffered needle stick injuries with contaminated needles used for animal vaccination, 4 had received conjunctival spray exposure and one individual had contamination through an open wound. There were no cases of brucellosis in these subjects. There is currently insufficient data to determine if the strain involved can cause systemic brucellosis in humans. " Self-injection with Mycobacterium paratuberculosis bacterin (Johne s disease bacterin) produced only minor local reactions. 

The majority of adverse reactions involving vaccines and other injectable products were minor needle stick injuries. 

Veterinary medicinal products are widely used in sick companion and farm animals and, on the basis of the data reviewed here from the UK and the USA, the main adverse effects in humans appear to be needle stick injuries or other accidents involving self-injection. Adverse events, including those arising from the toxicity of the drug, either systemic or local, do occur, but considering the millions of doses used world wide, and especially in the two countries examined here, it must be concluded that they are relatively rare. 

Gordon CA. Reducing needle-stick injuries with the use of 2-octyl cyanoacrylates for laceration repair. J Am Acad Nurse Pract. 2001 13 10-12. 

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