Percutaneous injuries in anesthesia personnel.
Anesthesia personnel are at risk for occupationally acquired blood-borne infections from human immunodeficiency virus, hepatitis viruses, and others after percutaneous exposures to infected blood or body fluids. The risk is greater after an infected, blood-contaminated, percutaneous injury, especially from a hollow-bore blood-filled needle, than from other types of exposures. Few data are available on the specific occupational hazards to anesthesia personnel from needles and other sharp devices. Fifty-eight percutaneous injuries (PIs) from anesthesia personnel in nine hospitals were analyzed. Thirty-nine of 58 PIs were from contaminated devices (all needles), and 19 were from uncontaminated devices or of unknown contamination status. Forty-three percent of contaminated percutaneous injuries (CPI) were classified as moderate (some bleeding) or severe (deep injury with profuse bleeding), and most were to health-care workers' hands. Fifty-nine percent of CPI were potentially preventable. Eighty-seven percent of CPI were from hollow-bore needles, and 68% of these were potentially preventable. The largest categories of devices causing CPI were needle on syringe, intravenous (i.v.) or arterial catheter needle-stylet, suture needle, and standard hollow-bore needle for secondary i.v. infusion. Most CPI occurred between steps of a multistep procedure (8%), were recapping related (13%), or occurred at other times after use (41%). No CPI were reported from use of needlestick-prevention safety devices. The devices and mechanisms of injury identified in this study provide specific data that may lead to prevention strategies to reduce the risk of PI.
Greene
E S
ES
Department of Anesthesiology, Albany Medical College, New York 12208, USA.
Berry
A J
AJ
Arnold
W P
WP
Jagger
J
J
D000776:Anesthesiology / Q000706:statistics & numerical data*; D017848:Blood-Borne Pathogens; D002406:Catheterization, Peripheral / Q000295:instrumentation; D004866:Equipment Contamination; D006678:HIV; D006230:Hand Injuries / Q000453:epidemiology; D006470:Hemorrhage / Q000453:epidemiology; D006518:Hepatitis Viruses; D006801:Humans; D007262:Infusions, Intravenous / Q000295:instrumentation; D007275:Injections, Intravenous / Q000295:instrumentation; D009339:Needles; D016602:Needlestick Injuries / Q000453:epidemiology* / Q000517:prevention & control; D009518:New York / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000517:prevention & control; D016273:Occupational Exposure; D011482:Protective Devices; D012307:Risk Factors; D013536:Suture Techniques / Q000295:instrumentation; D013594:Syringes