Effectiveness of measures to prevent needlestick injuries among ...

3 Descriptive epidemiology of NSI
involved in NSI might be altered if calculations accounted for frequency of use each
type of equipment.
NSI are most likely to occur during use, with the second highest rate associated with
recapping used needles and disposing of used sharps (Table 7, see page 93). These
activities are all amenable to engineering controls and/or safety training aimed at
reducing the NSI rate. Of note, the US Occupational Safety and Health Administration
(OSHA) disallowed recapping beginning in 1992, with 29 CFR 1910.1030.
Bearing in mind that surveillance data are only available for hospitals, Table 8 (see
page 94) shows that NSI were most likely to occur in patient rooms and operating
rooms, locations where sharps were most likely to be used. Not included in these data
were estimates for HCW employed in outpatient settings or nursing homes; home
health care providers; emergency first responders; dentists and dental technicians;
or others employed in non-hospital settings.
Limited NSI surveillance or survey data for individual or small groups of hospitals
were available for several other European countries (Denmark, Greece, Sweden, and
Switzerland) but are not shown in the tables because they do not represent national
data. The patterns of NSI occurrence, including the relative distribution by occupatio-
nal group, location, type of equipment and activity during NSI, were generally similar
to the national patterns noted in the surveillance data described in tables 4 to 8:
Nurses and physicians uniformly reported the most injuries, and the nurses’ generally
exceeded physicians’ reports by at least a factor of two [25; 26; 28; 30]. NSI tended
to occur most frequently in patient rooms [26; 28; 30], and needles were the most
frequently involved type of equipment [25; 26; 28; 30]. The high rate of NSI due to
recapping or improper disposal of used needles suggests that a large proportion of
reported events were avoidable [25; 26; 28; 30].
Additional data were available based on a survey of hospital-employed physicians in
Denmark by Nelsing et al. [31]. About 30 % of respondents practiced surgical special-
ties, and this subgroup reported higher rates of NSI compared to their colleagues in
non-surgical specialties: There were 6 to 8 NSI per person-year at risk among general
surgeons, orthopedic surgeons and neurosurgeons, versus 3.1 and 1.3 NSI per per-
son-year among internists and anesthesiologists, respectively. Overall, the surgical
Report „Needlestick injuries“ 26