title: The Snowman: A model of injuries and near-misses for the prevention of sharps injuries.
abstract: BACKGROUND
  Sharps injuries (SI) and other blood/body fluid exposures (BBFE) present bloodborne pathogen risks for home healthcare (HHC) workers. While SI and BBFE are sufficiently frequent in HHC to be serious public health concerns, even moderately large surveys can still have insufficient power to identify risk factors. In this study, a new conceptual model for using near-misses for SI and BBFE was developed and its utility in statistical analyses of SI and BBFE risk factors was evaluated.
  
  
  METHODS
  A survey of HHC nurses (n = 787) and aides (n = 282) gathered data on the numbers of SI, BBFE, and near-misses in the past year. Questions focused on the circumstances leading up to the SI, BBFE, and near-misses. After evaluating the hypothesis that near-misses and events lie along the same causal pathway, we combined these outcomes to estimate their association with an important risk factor: employment status.
  
  
  RESULTS
  There were similar frequencies of risk factors for the events SI, BBFE, and their near-misses, suggesting that they may share common causal pathways. Combined data on events and near-misses confirmed our hypothesis that part-time and temporary HHC aides were at higher risk than full-timers.
  
  
  CONCLUSIONS
  Analyses combining injuries and near-misses may be useful in risk factor investigations.
authors.affiliation: Department of Work Environment, University of Massachusetts Lowell, USA. hyun.kim@mssm.edu
authors.forename: Hyun
authors.initials: H
authors.lastname: Kim
authors.forename: David
authors.initials: D
authors.lastname: Kriebel
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Quinn
authors.forename: Letitia
authors.initials: L
authors.lastname: Davis
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000328:Adult; D017848:Blood-Borne Pathogens; D001826:Body Fluids; D004651:Employment; D005260:Female; D018576:Home Health Aides; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D016602:Needlestick Injuries / Q000517:prevention & control*; D009726:Nurses; D016273:Occupational Exposure / Q000517:prevention & control* / Q000706:statistics & numerical data*; D012307:Risk Factors; D011795:Surveys and Questionnaires