Needlestick injury

Needlestick injury
Classification and external resources
ICD-10	W46
ICD-9-CM	E920.5
DiseasesDB	31976
MeSH	D016602
[]

A needlestick injury, percutaneous injury, or percutaneous exposure incident is the penetration of skin by a needle or other sharp object, which was in contact with blood, tissue, or other body fluid before the exposure. Occupational needlestick injuries primarily affect healthcare workers, who make up 80% of needlestick injuries in the United States. Various other occupations are also at increased risk of needlestick injury, including law enforcement, laborers, tattoo artists, food preparers, and agricultural workers. Though the acute physiological effects of a needlestick injury are generally negligible, these devices can transmit blood-borne diseases, placing those exposed at increased risk of contracting infectious diseases, such as hepatitis B (HBV), hepatitis C (HCV), and the human immunodeficiency virus (HIV). Among healthcare workers and laboratory personnel worldwide, more than 25 blood-borne viruses have been reported to be caused by needlestick injuries.

It is estimated that half of all occupational needlestick injuries are not reported. Additionally, an unknown number of occupational needlestick injuries are reported by the affected employee, yet due to organizational failure, institutional record of the injury does not exist. Increasing recognition of the unique occupational hazard posed by needlestick injuries, as well as the development of efficacious interventions to minimize the largely preventable occupational risk, encouraged legislative regulation in the US, causing a decline in needlestick injuries among healthcare workers.

Needlestick injuries are a common event in the healthcare environment. When drawing blood, administering an intramuscular or intravenous drug, or performing any procedure involving sharps, accidents can occur and facilitate the transmission of blood-borne diseases. Injuries also commonly occur during needle recapping or via improper disposal of devices into an overfilled or poorly located sharps container. Lack of access to appropriate personal protective equipment, or alternatively, employee failure to use provided equipment, increases the risk of occupational needlestick injuries. Needlestick injuries may also occur when needles are exchanged between personnel, loaded into a needle driver, or when sutures are tied off while still connected to the needle. Needlestick injuries are more common during night shifts and for less experienced people; fatigue, high workload, shift work, high pressure, or high perception of risk can all increase the chances of a needlestick injury. During surgery, a surgical needle or other sharp instrument may inadvertently penetrate the glove and skin of operating room personnel; scalpel injuries tend to be larger than a needlestick. Generally, needlestick injuries cause only minor visible trauma or bleeding; however, even in the absence of bleeding the risk of viral infection remains.

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