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Evaluating and Controlling Exposure

Studies show that as many as one-third of all sharps injuries occur during disposal. Nurses are particularly at risk, as they sustain the most needlestick injuries. The Centers for Disease Control and Prevention (CDC) estimates that 62 to 88 percent of sharps injuries can be prevented simply by using safer medical devices. The following references provide information regarding possible solutions for bloodborne pathogens and needlestick hazards.

Please Note: Articles/references that are dated before April 18, 2001 may not reflect the changes of the new Bloodborne Pathogens Standard but still provide relevant, general information.

Engineering Controls

Engineering controls are defined in OSHA's Bloodborne Pathogens standard as controls that isolate or remove the bloodborne pathogens hazard from the workplace [29 CFR 1910.1030(b)]. The standard states "Engineering and work practice controls shall be used to eliminate or minimize employee exposure" [29 CFR 1910.1030(d)(2)(i)]. This means that if an effective and clinically appropriate safety-engineered sharp exists, an employer must evaluate and implement it.

Control Programs
Text Version of Chart - Bar graph with injury rate/per 100 procedures on the left (from 0 to 7) and percentage of blunt needles used on the right (from 0 - 60), during a given year/month from 1993 (April-June, July-Sep, and Oct-Dec) to 1994 (Jan-Mar and Apr-Jun) across the bottom. The Injury rate starts less than 6 in 1993 (April-Jun) with almost zero percent blunt needles used. The injury rate rises slightly to 6 in 1993 (July-Sep) with even less percent blunt needles used than previous period. In 1993 (Oct-Dec), the injury rate stays near 6 with the percent of blunt needles used rising slightly above both of the previous two periods. In 1994 (Jan-Mar), the injury rate drops significantly just above 1 with the percent of blunt needles used increasing to above 30. From 1994 (Apr-June), the injury rate drops slightly to at or below 1 with the percent of blunt needles used increasing to near 55.

Figure 1. Rate of injury associated with the use of curved suture needles during gynecologic surgical procedures and percentage of suture needles used that were blunt, by quarter—three hospitals, New York City hospitals, April 1993–June 1994

Text Version

Safer Needle Devices
  • Selected EPA-registered Disinfectants. Environmental Protection Agency (EPA), (January 9, 2009). Includes lists of EPA registered anti-microbial products to assist in choosing the appropriate decontaminant.
Post-exposure Evaluation

According to the NIOSH Alert Preventing Needlestick Injuries in Health Care Settings, it is estimated that 600,000 to 800,000 needlestick injuries (NSIs) and other percutaneous injuries (PIs) occur annually among health care workers. PIs are caused by sharp objects such as hypodermic needles, scalpels, suture needles, wires, trochanters, surgical pins, and saws. Additional exposure incidents include splashes and other contact with mucous membranes or non-intact skin. Post-exposure management is an integral part of a complete program for preventing infection following exposure incidents.

The following references provide useful information about the management of occupational exposure incidents to blood or other potentially infectious materials.

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