title: Incidence of ambulatory care visits after needlestick and sharps injuries among healthcare workers in Taiwan: a nationwide population-based study.
abstract: Healthcare professionals have a high risk of needlestick and sharps injuries (NSIs), which have a high potential for disease transmission. Ambulatory care follow up is essential, but is usually overlooked. This study aimed to investigate the annual and cumulative (age-, sex-, and subtype-specific) incidences of ambulatory care visits after NSIs. This study was also designed to evaluate the incidences of blood-borne diseases associated with NSIs among Taiwanese health professionals in Taiwan between 2004 and 2010. Data were obtained from the National Health Insurance Research Database, which contains anonymized records representing approximately 99% of the Taiwan population. A total of 4443 nurse healthcare workers (NHCWs) and 3138 non-nurse healthcare workers (NNHCWs), including physicians, medical technologists, and other health professionals were included in this longitudinal study. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The Mantel-Haenszel method was used to adjust for sex, age, and type of affiliation. Results showed that the annual incidence of ambulatory care visits of NHCWs increased from 0.7% in 2004 to 1.9% in 2010; this incidence was significantly higher than that of NNHCWs (from 0.3% in 2004 to 0.5% in 2010) in any yearly comparison (p < 0.05). The sex-adjusted 7-year cumulative incidence rate was 3.23 (95% CI = 1.23-8.45) in males and 3.92 (95% CI = 2.70-5.69) in females (p < 0.05). The age-adjusted 7-year cumulative incidence rate was 2.74 (95% CI = 1.99-3.77) and 2.14 (95% CI = 1.49-3.07) in subjects ≤ 30 and ≥31 years old, respectively (p < 0.0005). The affiliation-adjusted 7-year cumulative incidence rate was 1.89 (95% CI = 1.21-2.94) in medical centers and 3.33 (95% CI = 2.51-4.41) in nonmedical centers (p < 0.01). In conclusion, NSIs increased steadily from 2004 to 2010 in Taiwan with NHCWs having higher NSIs incidences than NNHCWs. A routine ambulatory care visit after NSIs can prevent blood-borne transmission, especially for NHCWs. Educational programs may be helpful for reducing the incidence of NSIs and increasing ambulatory care visit ratios after NSIs.
authors.affiliation: Institute of Pharmaceutical Science and Technology, Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Shyang-Guang
authors.initials: SG
authors.lastname: Wang
authors.affiliation: Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Chin-Tun
authors.initials: CT
authors.lastname: Hung
authors.affiliation: Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Li
authors.affiliation: Department of Food Science and Technology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Lu
authors.affiliation: Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Shu-Chuan
authors.initials: SC
authors.lastname: Chang
authors.affiliation: Institute of Pharmaceutical Science and Technology, Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Horng-Mo
authors.initials: HM
authors.lastname: Lee
authors.affiliation: Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Lee-Wen
authors.initials: LW
authors.lastname: Pai
authors.affiliation: Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Fu-I
authors.initials: FI
authors.lastname: Lai
authors.affiliation: Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Huang
authors.affiliation: Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan. Electronic address: ycchung@ctust.edu.tw.
authors.forename: Yueh-Chin
authors.initials: YC
authors.lastname: Chung
mesh_terms: D000328:Adult; D000367:Age Factors; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D003141:Communicable Diseases / Q000209:etiology; D003710:Demography; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006306:Health Surveys / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D016602:Needlestick Injuries / Q000150:complications / Q000453:epidemiology*; D009726:Nurses / Q000706:statistics & numerical data; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: Ambulatory care visit; Epidemiology; Healthcare worker; Incidence; Needlestick and sharps injuries