HealthManagement, Volume 14 - Issue 4, 2014

One of the most common and serious risks to healthcare workers is an infection result­ing from a sharp or needlestick injury. In Europe, approximately 8 million healthcare workers are at risk of these injuries. Even though data on the frequency of needle­stick injuries differ greatly between dif­ferent hospitals, as well as between dif­ferent units of the same hospital, they all show that needlestick injuries happen con­tinuously in the daily work of healthcare workers. It has been estimated that more than one million such injuries occur in the healthcare facilities across the European Union each year. Alarmingly though, approx­imately 50% are unreported.


Underreporting is one of the major causes of the biased low priority that needlestick injuries have received so far. The extent of this phenomenon has simply been under­estimated. Yet, needlestick injuries put the healthcare workers at risk of serious infec­tion from any one of more than 30 poten­tially dangerous pathogens, including HIV, hepatitis B and hepatitis C.


Another reason why needlestick injuries have been a low priority so far is that in some EU countries, including the Czech Republic, no data are available on a national level. Data collection is carried out sporadically and mostly on the level of a single hospital.


For example, France, Switzerland and Germany give us a clearer indication of the scale of the problem. In France, a survey conducted by the French Group for the Prevention of Occupational Infections in Healthcare Workers found 29,132 cases of occupational exposures to blood and bodily fluids in 2010. Eight out of ten acci­dents were the result of percutaneous inju­ries, mainly needlestick. What is significant here is that 43.3% of these could have been avoided through the observance of stand­ard precautions.


In Switzerland and Germany, the focus has centred on the costs of needlestick inju­ries. A Swiss occupational health physi­cian, Esther Graf-Deuel, estimated that the average cost of a needlestick injury ranges from EUR 355 (for a non-infectious patient) to EUR 3,464 (for an HIV-infected source patient).


According to other research done by Prof. Andreas Wittmann from the University of Wuppertal, the cost of one needlestick injury is EUR 487, of which approximately EUR 150 is not covered by the obligatory accident insurance and must be carried by the employer. Based on the estimated 500,000, needlestick injuries that take place in Germany each year, Prof. Wittman concludes that these injuries cost Germany approximately EUR 47 million per year.


These, as well as numerous other inde­pendent studies conclude that, overall, short and long-term benefits, including economic savings, can be achieved by investing in safer working practices and medical devices to prevent needlestick injuries.


Eliminating the unnecessary use of sharps by implementing changes in prac­tice and on the basis of the results of the risk assessment, providing medical devices incorporating safety-engineered protection mechanisms.


Acknowledging this wealth of research and recommendations made by experts, the European Union decided to act, and in 2010 it adopted the Directive 2010/32/EU on the prevention of sharps injuries in the hospital and healthcare sector. The Directive provides for “eliminating the unnecessary use of sharps by implementing changes in practice and on the basis of the results of the risk assess­ment, providing medical devices incorporating safety-engineered protection mechanisms.”


A report by the European Parliament explains why a mandatory obligation to implement pre­vention and protection measures was chosen by the European legislators. “While the exist­ing legislation [laws such as the Labour Code, Act on Protection of Public Health, Health and Safety at Work Directives] should, theo­retically, address the risk of needlestick inju­ries, in practical terms, this has not been the case. Guidelines, awareness campaigns and other non-legislative initiatives can only make a partial contribution; they should be used in addition to directives.”


The strategy is, therefore, clear; minimise the risk of exposure to sharp objects among healthcare workers by requiring healthcare providers to take suitable prevention and protection steps. Use of safety-engineered devices, vaccination and proper information and training for staff are essential measures to ensure compliance with this strategy and the Directive 2010/32/EU.


And what is your organisation doing to prevent these occupational accidents?