Costs of needlestick injuries and subsequent hepatitis and HIV infection.
BACKGROUND
Physicians, nurses and other healthcare workers (HCWs) are at risk of bloodborne pathogens infection from needlestick injuries, but costs of needlesticks are little studied.


METHODS
We used the cost-of-illness and incidence approaches. We used the perspective of the medical provider (medical costs) and the individual (lost productivity). Data on needlesticks, infections from hepatitis B and C (HBV, HCV) and human immune-deficiency (HIV) among HCWs, as well as data on per-unit costs were culled from research literature, Centers for Disease Control and Prevention reports, and Bureau of Labor Statistics reports. We also generated estimates based upon industry employment and scenarios for source-patients. These data and estimates were combined with assumptions to produce a model that generated base-case estimates as well as one-way and multi-way probabilistic sensitivity analyses. Future costs were discounted by 3%.


RESULTS
We estimated 644,963 needlesticks in the healthcare industry for 2004 of which 49% generated costs. Medical costs were $107.3 million of which 96% resulted from testing and prophylaxis and 4% from treating long-term infections (34 persons with chronic HBV, 143 with chronic HCV, and 1 with HIV). Lost-work productivity generated $81.2 million, for which 59% involved testing and prophylaxis and 41% involved long-term infections. Combined medical and work productivity costs summed to $188.5 million. Multi-way sensitivity analysis suggested a range on combined costs from $100.7 million to $405.9 million.


CONCLUSIONS
Detailed methodology was developed to estimate costs of needlesticks and subsequent infections for hospital-based and non-hospital-based health care workers. The combined medical and lost productivity costs comprised roughly 0.1% of all occupational injury and illness costs for all jobs in the economy. We did not account for lost home production or pain and suffering costs, however, nor did we estimate benefit/cost ratios of specific interventions to reduce needlesticks.
Leigh
J Paul
JP
Center for Healthcare Policy and Research and Department of Public Health Sciences, University of California, Davis, CA 95616-8638, USA. pleigh@ucdavis.edu
Gillen
Marion
M
Franks
Peter
P
Sutherland
Susan
S
Nguyen
Hienh H
HH
Steenland
Kyle
K
Xing
Guibo
G
D017281:Cost of Illness; D015658:HIV Infections / Q000191:economics* / Q000453:epidemiology / Q000635:transmission; D006282:Health Personnel; D006509:Hepatitis B / Q000191:economics* / Q000453:epidemiology / Q000635:transmission; D006526:Hepatitis C / Q000191:economics* / Q000453:epidemiology / Q000635:transmission; D006801:Humans; D015994:Incidence; D016602:Needlestick Injuries / Q000191:economics*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology