Effectiveness of measures to prevent needlestick injuries among ...

1 Introduction
1 Introduction
Although the extent of tissue damage to health care workers injured while using sharp
medical equipment, especially needles and intravenous (IV) equipment, is generally
minor, a more serious problem, and the impetus behind the development of needle-
stick injury (NSI) prevention programs, arises from the risk of infection by blood-borne
pathogens subsequent to NSI. The pathogens of greatest concern that may be trans-
mitted by NSI are hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency
virus (HIV). While other blood borne pathogens (BBP), including, for example, Hepati-
tis G; Herpes Simplex 1; Group A Streptococcus; and Human Parvovirus B19 may also
be transmitted by NSI, they are less common [1 to 7]. Because of these potentially
serious consequences of NSI, ongoing surveillance and tracking of injuries and any
subsequent infections are crucial for identifying high-risk groups or activities, and
for planning health care services for health care workers (HCW) who may become
infected.
In the United States of America (USA), the growth of NSI prevention programs corre-
lated with the growth of awareness of the HIV epidemic in the mid-1980s [8]. The
United States Centers for Disease Control and Prevention (CDC) issued its first set of
guidelines on needlestick safety in 1983; the revised version, issued in 1987, became
the so-called “Universal Precautions” in which health care and emergency services
providers were instructed to treat all body fluids as if they were infective [8; 9]. The
Occupational Safety and Health Administration (OSHA) lagged several years behind
CDC in recognizing the risks associated with NSI, issuing the first blood borne patho-
gens (BBP) standard in 1991. These regulations were designed to protect health care
workers from risks of occupational exposure to BBP by investing employers with the
responsibility of evaluating the effectiveness of existing risk control measures, and of
identifying and evaluating new technologies that might prove to be more effective at
reducing the risk of NSI occurrence [10]. The 1999 version of the OSHA BBP standard
reiterated and emphasized employers’ responsibility to review the efficacy of their in-
fection control plans annually, to keep informed about newly developed engineering
controls, and to use the most advanced system that could be feasibly adopted by their
institution [10]. In parallel with the implementation of increasingly specific regulatory
Report „Needlestick injuries“ 13