Needlestick/sharps injuries and HIV exposure among health care workers. National estimates based on a survey of U.S. hospitals.
Exposure to HIV in the workplace is a major concern for health care workers. The greatest risk for bloodborne pathogen transmission is associated with percutaneous injuries involving hollow-bore needles contaminated with patient blood. Limited data are available about how many sharps injuries (SIs) and needlesticks (NSs) occur in the United States, with estimates ranging from 100,000 to 1 million injuries per year. We conducted a survey of 100 infection control practitioners located at randomly selected U.S. hospitals to assess the number of SIs or NSs occurring during 1990; 65 (65%) responded. The mean number of NS/SIs reported was 45, with a mean of 1.1 known HIV-related NS/SIs. The underreporting rate was estimated to be 18.5%. Assuming that the hospitals provided exact numbers of injuries and were representative of the approximately 5,100 U.S. hospitals, then about 252,000 NS/SIs were reported in U.S. hospitals in 1990 (95% CI = 193,000-312,000). If the under-reporting rate was 33% to 66%, then the point estimate for the total number of NS/SIs ranges from 378,000 to 756,000. Similar extrapolation involving the reported number of NS/SIs contaminated with blood from an HIV-infected patient yields an estimate of 5,610 exposures in 1990 (95% CI = 1,300-8,300). The number of U.S. hospital workers sustaining NS/SIs with potential exposure to HIV appears to be considerable. Efforts to reduce the risk of bloodborne pathogen transmission from NS/SIs are warranted.
HIV/AIDS Clinic and Programs, Health-Partners St. Paul-Ramsey Medical Center, USA.
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D015982:Bias; D003430:Cross-Sectional Studies; D018563:Disease Notification / Q000706:statistics & numerical data; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D015994:Incidence; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data*; D016602:Needlestick Injuries / Q000453:epidemiology*; D009784:Occupational Diseases / Q000453:epidemiology*; D010348:Patient Care Team / Q000706:statistics & numerical data*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology