title: An outbreak of needlestick injuries in hospital employees due to needles piercing infectious waste containers.
abstract: OBJECTIVE
  To investigate the cause of an outbreak of needlestick injuries (NSIs) in hospital employees.
  
  
  METHODS
  A 700-bed university hospital.
  
  
  METHODS
  Outbreak investigation, laboratory evaluation of a medical waste disposal device, cost analysis.
  
  
  METHODS
  Employee health department records were reviewed of workers suffering sticks from needles piercing fiberboard-contaminated material containers (CMCs). A laboratory evaluation of needle-puncture resistance properties of the CMCs was performed using a testing apparatus. The cost of a hospital waste disposal program using fiberboard CMCs was compared with the cost of a program using rigid plastic (polypropylene) boxes.
  
  
  RESULTS
  During 40 months of surveillance in 1986 and from 1989 to 1991, only one NSI had occurred from a needle piercing a CMC. During 9 months in 1993, 13 NSIs occurred due to needles piercing CMCs (P < .001). No clinical illness resulted from the NSIs. The outbreak was halted by a temporary change to plastic (polypropylene) boxes for sharps disposal ($4.92 to $23.33/cu ft) until receipt of a box with a newly designed solid fiberboard liner ($1.25/cu ft). CMC liners used during the epidemic had a mean needle puncture resistance of 527 g, as compared with 660 g for liners used before the outbreak (P < .001). The new solid fiberboard liner has a mean puncture resistance of 1,765 g. A program of waste disposal using fiberboard CMCs was found to cost approximately one-seventh the cost of a program using plastic boxes for disposal of infectious waste.
  
  
  CONCLUSIONS
  A program for infectious waste disposal using fiberboard CMCs can be safe and cost-effective if appropriate standards for puncture resistance are met.
authors.affiliation: University of Virginia Health Sciences Center, Charlottesville 22908, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Anglim
authors.forename: J E
authors.initials: JE
authors.lastname: Collmer
authors.forename: T J
authors.initials: TJ
authors.lastname: Loving
authors.forename: K A
authors.initials: KA
authors.lastname: Beltran
authors.forename: B J
authors.initials: BJ
authors.lastname: Coyner
authors.forename: K
authors.initials: K
authors.lastname: Adal
authors.forename: J
authors.initials: J
authors.lastname: Jagger
authors.forename: N J
authors.initials: NJ
authors.lastname: Sojka
authors.forename: B M
authors.initials: BM
authors.lastname: Farr
mesh_terms: D003264:Containment of Biohazards / Q000191:economics / Q000295:instrumentation; D003365:Costs and Cost Analysis; D004196:Disease Outbreaks; D005069:Evaluation Studies as Topic; D017721:Hospital Costs; D006785:Hospitals, University; D006801:Humans; D017744:Medical Waste Disposal / Q000191:economics / Q000295:instrumentation; D016602:Needlestick Injuries / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D010969:Plastics; D015397:Program Evaluation / Q000191:economics; D014768:Virginia / Q000453:epidemiology
chemical_list: D017744:Medical Waste Disposal; D010969:Plastics