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 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.
Checklist for Sharps Injury Prevention (PDF). The University of Virginia, International Health Care Worker Safety Center. Provides a checklist intended to help facilities comply with the sharps safety requirements of OSHA's Bloodborne Pathogens Standard.
Safety in Surgery. The University of Virginia International Healthcare Worker Safety Center, (2008). Resources to reduce exposure risk and improve healthcare workers safety in surgical settings.
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
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.
Safety Device List. The University of Virginia Health System, International Healthcare Worker Safety Center, (2003). Provides a list of devices designed to prevent percutaneous injury and exposure to bloodborne pathogens in the health care setting.
Selected EPA-registered Disinfectants. Environmental Protection Agency (EPA), (2009, January 9). Includes lists of EPA registered anti-microbial products to assist in choosing the appropriate decontaminant.
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.
HIV Testing. Centers for Disease Control and Prevention (CDC). This page discusses HIV testing, new testing techniques as well as provides information regarding rapid testing and how the tests can be implemented in different settings and research on the effectiveness and possible uses of the tests.
EPINet. The University of Virginia, International Healthcare Worker Safety Center. The Exposure Prevention Information Network (EPINet) system provides standardized methods for recording and tracking percutaneous injuries and blood and body fluid contacts. EPINet consists of a Needlestick and Sharp Injury Report, a Blood and Body Fluid Exposure Report, and software for entering, accessing, and analyzing the data from the forms.
All other documents, that are not PDF materials or formatted for the web, are available as Microsoft Office® formats and videos and are noted accordingly. If additional assistance is needed with reading, reviewing or accessing these documents or any figures and illustrations, please also contact OSHA's Directorate of Technical Support and Emergency Management at (202) 693-2300.
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