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Increase in hep C, B and HIV exposure from sharps injuries

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Nursing staff continue to be at risk of exposure to bloodborne viruses from sharps injuries, with figures showing a rise in staff reporting these incidents.

This is despite the availability of safety-engineered devices and new rules promoting their use, noted Public Health England in its Eye of the Needle report.

It found the number of staff exposed to bloodborne viruses via sharps injuries increased by a third from 373 in 2004 to 496 in 2013. Around 80% of the 4,830 incidents reported over the period involved doctors, nurses and healthcare assistants.

“All healthcare employers [should] provide safety devices to healthcare workers”

Fortune Ncube

More than half of these exposures were to patients with hepatitis C, while around a third involved HIV and 9% hepatitis B.

The increase comes in spite of the introduction of UK Sharps Regulations in 2013, which legally requires employers to ensure safe working conditions that reduce the risk of sharps injury.

These conditions include shift patterns that reduce tiredness for healthcare workers, providing safety devices to minimise the risk of a needlestick injury before, during or after use, and appropriate training.

The report was presented yesterday at this year’s Prevention of Occupational Infections, Treatment and Reporting Strategies conference in Cardiff.

It found that from 2004 to 2013, nine workers in England, Wales and Northern Ireland became infected with hepatitis C following exposure at work. Eight of these staff members received therapy, with seven achieving viral clearance.

Almost all (97%) of those exposed to HIV who commenced post-exposure prophylaxis treatment did so within 72 hours and no workers reported contracting HIV infections.

Of those exposed to hepatitis B, none reported contracting the virus. Of the 313 staff who reported their immunisation status, 96% had had the hepatitis B vaccine.

“It is essential for all staff to remember the importance of basic sharps safety”

Jill Holmes

Fortune Ncube, head of the bloodborne virus department at PHE, said it was disappointing that workers continued to experience “entirely preventable” sharps injuries.

“We want to remind all healthcare employers to comply with the regulations regarding safer working conditions and to provide safety devices to healthcare workers in an effort to reduce sharps injuries and protect them from infection,” he said.

“Despite this, we are encouraged that there have been no new HIV infections in healthcare workers and that the immunisation programme for hepatitis B is effective,” he added.

Hepatitis C

Hepatitis C

Jill Holmes, an infection prevention control nurse specialist and member of the Safer Needles Network, warned that safety-engineered devices were not “fool proof” and urged healthcare providers to train staff in their use.

“It is also essential for all staff to remember the importance of basic sharps safety, such as never, ever re-sheathing a used needle, always taking the sharps bin to the point of use, and never filling above the fill line,” she said.

Safe use and handling of sharps must be embedded into everyday practice,” said Ms Holmes.

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