Clinical, economic, and humanistic burden of needlestick injuries in healthcare workers

Abstract

IntroductionNeedlestick injuries (NSIs) from a contaminated needle put healthcare workers (HCWs) at risk of becoming infected with a blood-borne virus and suffering serious short- and long-term medical consequences. Hypodermic injections using disposable syringes and needles are the most frequent cause of NSIs.ObjectiveTo perform a systematic literature review on NSI and active safety-engineered devices for hypodermic injection.MethodsMEDLINE, EMBASE, and COCHRANE databases were searched for studies that evaluated the clinical, economic, or humanistic outcomes of NSI or active safety-engineered devices.ResultsNSIs have been reported by 14.9%–69.4% of HCWs with the wide range due to differences in countries, settings, and methodologies used to determine rates. Exposure to contaminated sharps is responsible for 37%–39% of the worldwide cases of hepatitis B and C infections in HCWs. HCWs may experience serious emotional effects and mental health disorders after a NSI, resulting in work loss and post-traumatic stress disorder. In 2015 International US$ (IntUS$), the average cost of a NSI was IntUS$747 (range IntUS$199–1,691). Hypodermic injections, the most frequent cause of NSI, are responsible for 32%–36% of NSIs. The use of safety devices that cover the needle-tip after hypodermic injection lowers the risk of NSI per HCW by 43.4%–100% compared to conventional devices. The economic value of converting to safety injective devices shows net savings, favorable budget impact, and overall cost-effectiveness.ConclusionThe clinical, economic, and humanistic burden is substantial for HCWs who experience a NSI. Safety-engineered devices for hypodermic injection demonstrate value by reducing NSI risk, and the associated direct and indirect costs, psychological stress on HCWs, and occupational blood-borne viral infection risk.

Needlestick injuries: a density-equalizing mapping and socioeconomic analysis of the global research

“…Health-care workers have the highest risk of experiencing needlestick injuries, but also other occupations are endangered (King and Strony 2019;Mona et al 2019). When injured, the individual clinical, psychological and economic burden can be substantial (Cooke and Stephens 2017).…”

Novel approaches for the design, delivery and administration of vaccine technologies

“…Prime among these limitations is the effect pain and fear of needles has on patient compliance and ultimately vaccination rates [8]. This report also showed that needle-stick injuries were responsible for 37-39% of global hepatitis B and C infections in health-care workers [15]. A further major concern, for developed but especially developing countries, is the spread of blood-borne pathogens as a consequence of needle reuse or needle-stick injuries [10,11].…”

“…However, the many drawbacks and limitations of needle and syringe delivery are beginning to make it look like a rather out-dated approach. It is clear that in the intervening 18 years improved training and working practices have reduced these levels, but a more recent report still showed that 14·9-69·4% of health-care workers have reported needle-stick injuries, with the wide range due to differences in practices between countries [15]. In the United Kingdom and United States, infants may have received up to 23 prophylactic inoculations for 10 different pathogens by the age of 18 months [9].…”

“…In 2000, approximately half of all US physicians and 77% of nurses experienced needle-stick injuries, which led to 16 000 hepatitis C, 66 000 hepatitis B and 1000 HIV infections [13,14]. It is clear that in the intervening 18 years improved training and working practices have reduced these levels, but a more recent report still showed that 14·9-69·4% of health-care workers have reported needle-stick injuries, with the wide range due to differences in practices between countries [15]. This report also showed that needle-stick injuries were responsible for 37-39% of global hepatitis B and C infections in health-care workers [15].…”

“…It is clear that in the intervening 18 years improved training and working practices have reduced these levels, but a more recent report still showed that 14·9-69·4% of health-care workers have reported needle-stick injuries, with the wide range due to differences in practices between countries [15]. This report also showed that needle-stick injuries were responsible for 37-39% of global hepatitis B and C infections in health-care workers [15]. It is no surprise that when faced with this iatrogenicity, researchers have looked to develop alternative approaches that might allow vaccination without the use of a needle.…”