A new report launched today (11 December 2014) by Public Health England (PHE)
warns that healthcare workers continue to be at risk of exposure to
bloodborne viruses through occupational sharps injuries, despite the
fact that safety-engineered devices to prevent these injuries are now
Occupational exposures to a bloodborne virus (BBV) that were reported to PHE
increased among healthcare workers from 373 in 2004 to 496 in 2013.
Over this 10-year period, approximately 30% of exposures involved a
source patient infected with HIV; 54% involved hepatitis C (HCV), and 9%, hepatitis B (HBV).
Of these exposures 81% were sustained by doctors, nurses and healthcare
assistants and 65% occurred during clinical procedures. Seventy-eight
percent of exposures involved a percutaneous needlestick injury, the
majority of which were sharps injuries involving a hollow-bore needle.
The report, presented at the 5th Prevention of Occupational Infections, Treatment and Reporting Strategies (POINTERS)
Conference in Cardiff City Hall, comes after the EU Sharps Directive in
2010 and the UK Sharps Regulations in 2013, which state that safe
working conditions must be created for healthcare workers to help reduce
the risk of sharps injury. ‘Safe working conditions’ can range from
working hours that reduce tiredness among healthcare workers, to the
provision of safety devices to reduce the risk of a needlestick injury
before, during or after use, and appropriate training to staff
performing clinical procedures.
Between 2004 and 2013, 9 healthcare workers were infected with HCV
following occupational exposure in England, Wales and Northern Ireland.
Eight of the nine healthcare workers received antiviral therapy, of
whom 7 are known to have achieved viral clearance.
The report also finds that HBV immunisation programmes across England, Wales and Northern Ireland are effectively protecting healthcare workers from HBV infection, with no new cases reported. Furthermore, 97% of healthcare workers exposed to HIV who commenced post-exposure prophylaxis (PEP) did so within 72 hours of exposure, and no HIV infections to healthcare workers have been reported.
Dr Fortune Ncube, Head of the BBV Department at PHE said:
It is a disappointment that we still continue to see injuries to
healthcare workers occurring after the procedure, in the period prior to
and during disposal. These injuries are entirely preventable.
Despite this, we are encouraged that there have been no new HIV infections in healthcare workers and that the immunisation programme for HBV is effective in preventing HBV
infections in healthcare workers. We want to remind all healthcare
employers to comply with the regulations regarding safer working
conditions and to provide safety devices to healthcare workers in an
effort to reduce sharps injuries and protect them from infection.
Jill Holmes, Infection Prevention Control Nurse Specialist and
Infection Control Society representative on the Safer Needles Network
Safety-engineered devices are not fool proof. Unless they are used
correctly, these devices will not be effective or prevent sharps
injuries. It is vital that healthcare providers train new and existing
staff in their correct use.
It is also essential for all staff to remember
the importance of basic sharps safety, such as never, ever re-sheathing a
used needle, always taking the sharps bin to the point of use, and
never filling above the fill line. Safe use and handling of sharps must
be embedded into everyday practice.
Notes to Editors
The eye of the needle is a report on healthcare workers’ exposures to bloodborne viruses such as hepatitis B, hepatitis C and HIV while at work. Read the full 2014 report.
Additional key findings from data submitted to the significant
occupational exposures surveillance system between 2004 and 2013
- 4830 significant occupational exposures to a BBV were reported among healthcare workers; the annual number of exposures increased from 373 in 2004 to 496 in 2013
- of healthcare workers reporting a significant occupational exposure, 1 in 2 was exposed to HCV, 1 in 3 to HIV, and 1 in 10 to HBV
- seven in ten (71%, 3396/4766) exposures involved a percutaneous
needlestick injury, the majority of which were sharps injuries involving
a hollowbore needle; the annual number of percutaneous injuries
increased by 22% over the 10-year period from 283 to 344, whereas
mucocutaneous exposures increased by 61%, from 90 to 145
- two-thirds (65%, 2490/3816) of exposures occurred in wards, operating theatres and Accident and Emergency (A&E) departments; the annual number of exposures increased over time both in operating theatres and A&E but declined in wards
- four in five (81%, 3926/4830) exposures were sustained by doctors,
nurses and healthcare assistants; among all occupational groups,
two-thirds (65%, 2288/3494) of exposures occurred during clinical
- of healthcare workers exposed to HBV
for whom immunisation status was known (data limited to the period from
2009 to 2013), 96% (300/313) were known responders to the HBV vaccine; no HBV seroconversions have been reported
- occupational exposures to HIV are well managed; 97% (580/598) of healthcare workers exposed to HIV who commenced post-exposure prophylaxis (PEP) did so within 72 hours of exposure; 89% (535) commenced PEP within 24 hours; no HIV seroconversions have been reported
- between 2004 and 2013, there have been 9 reported HCV seroconversions
More information on the 5th POINTERS conference.
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