Effectiveness of measures to prevent needlestick injuries among ...

Preface
Preface
It has long been recognized that needlestick and other injuries from sharp objects
place healthcare workers at risk of infection. The most common pathogens carried in
body fluids are hepatitis B virus (HBV), hepatitis C virus (HCV), and the human immu-
nodeficiency virus (HIV).
Infections caused by occupational exposures are costly in terms of human suffering,
the social-economic impact, and the financial responsibilities borne by accident insur-
ance institutions. In recognition of these burdens, prevention measures have been the
focus of hazard reduction for health care professionals. For example, German em-
ployers have been obligated to provide free HBV immunization for as long as an ef-
fective vaccination has been available, since 1982. The legislation mandating free
HBV immunization was originally part of accident prevention regulation 103 “Health
and Welfare”, and in 1999 was incorporated into the “Biological Agents Ordinance”
(Biostoffverordnung). Not all eligible employees agree to be vaccinated. Unfortunately,
there are no effective vaccines currently available to protect against HCV and HIV.
Therefore, additional preventive measures that focus on technical changes to equip-
ment must also be implemented.
Safety engineered sharp devices have been available in the US since the late 1990s,
and their use was formalized into law by the “Needlestick Safety and Prevention Act”
of 2000. Similarly, the use of safety engineered sharps was mandated in Germany by
the Technical Rule 250, “Biological Agents in Health Care and Welfare Facilities”
(TRBA 250). The TRBA 250 was developed by the Committee on Biological Agents
(Ausschuss für Biologische Arbeitsstoffe, ABAS) of the German Federal Ministry of
Economics and Labour, in cooperation with the expert committee on Health Care and
Welfare of the Federation of Institutions for Statutory Accident Insurance and Preven-
tion (HVBG). In paragraph 4.2.4 it is demanded that spike, sharp or breakable
devices should be replaced by suitable devices or methods which have no or low risk
of needlestick injuries. The TRBA 250 further stipulates that model or evaluation pro-
jects demonstrating equipment effectiveness must be considered when devices are to
be introduced into a workplace.
Report „Needlestick injuries“ 11