Nursing staff are the employees most frequently injured from needlesticks (Exposure Prevention Information Network (EPINet)). Data show needlestick injuries occur most frequently in patient rooms.
Exposure to blood and other potentially infectious materials (OPIM) from needlestick injuries due to:
- Unsafe needle devices
- Improper handling and disposal of needles
Requirements under OSHA's Bloodborne Pathogens Standard, 29 CFR 1910.1030
- Use safer needle devices and needleless devices to decrease needlestick or other sharps exposures. See Safer Needle Devices section.
- Proper handling and disposal of needles and other sharps according to the Bloodborne Pathogens Standard can help prevent needlestick injuries.
Use engineering controls (e.g., safer needle devices) and work practice controls (e.g., altering the way a task is performed to reduce chance of injury such as prohibiting recapping of needles by a two-handed technique) to eliminate or minimize exposures to bloodborne pathogens. [29 CFR 1910.1030(c), 29 CFR 1910.1030(d)].
- Examples of engineering controls:
- Safer needles/other sharps devices.
- Blunt-tip suture needles.
- Needleless IV connectors.
- Proper containers for sharps.
- Non-glass capillary tubes. OSHA, FDA and NIOSH warn healthcare workers about the hazards from breakage of glass capillary tubes and sanction using non-glass capillary tubes.
- The risk of sharps injuries must be eliminated or minimized. Follow the applicable provisions of the standard. For example:
- Contaminated needles and other contaminated sharps must be discarded immediately or as soon as feasible into appropriate containers, as required by the standard. [29 CFR 1910.1030(d)(4)(iii)(A)(1)]
- Sharps containers shall be easily accessible and located as close as is feasible to the immediate area where sharps are used or can be reasonably anticipated to be found. [29 CFR 1910.1030(d)(4)(iii)(A)(2)(i)]
- Contaminated needles and other contaminated sharps must not be bent, recapped, or removed except as noted in 29 CFR 1910.1030(d)(2)(vii)(A) and (d)(2)(vii)(B). Shearing or breaking contaminated needles is prohibited. [29 CFR 1910.1030(d)(2)(vii)]
- Do not allow sharps containers to overfill. Replace sharps containers routinely. [29 CFR 1910.1030(d)(4)(iii)(A)(2)(iii)]
OSHA requires employers to ensure that the biosafety officer or other responsible person conducts an exposure determination to determine the exposure of workers to blood or OPIM throughout the hospital setting. [29 CFR 1910.1030(c)(2)(i)].
- Workbook for Designing, Implementing, and Evaluating a Sharps Injury Prevention Program. Centers for Disease Control and Prevention (CDC).
- CDC: Emergency Sharps Information, also provides immediate access to treatment protocols following blood exposures involving HIV, HBV and HCV, including the Clinicians' Post Exposure Prophylaxis Hotline (PEPline) at 1-888-448-4911.
- Bloodborne Infectious Diseases: HIV/AIDS, Hepatitis B, and Hepatitis C. National Institute for Occupational Safety and Health (NIOSH) Workplace Safety and Health Topic.
- B. Stringer, T. Haines. "Hands-free technique: preventing occupational exposure during surgery." Journal of Perioperative Practice 16.10 (October 2006): 495.
- Blunt-Tip Surgical Suture Needles Reduce Needlestick Injuries and the Risk of Subsequent Bloodborne Pathogen Transmission to Surgical Personnel: FDA, NIOSH and OSHA Joint Safety Communication. U.S. Food and Drug Administration (FDA), (May 30, 2012).
- Use of Blunt-Tip Suture Needles to Decrease Percutaneous Injuries to Surgical Personnel (PDF). OSHA and the National Institute for Occupational Safety and Health (NIOSH) Publication No. 2008-101, (October 2007). Supersedes NIOSH Publication 2007–132.
Take precautions with respect to all contaminated sharps, not just needles. "Contaminated Sharps" means any contaminated object that can penetrate the skin including, but not limited to, needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wires. [29 CFR 1910.1030(b)]
Exposure to blood and OPIM through contaminated sharps, such as:
- I.V. Connectors that use needle systems.
- Disposable razors that could be contaminated.
Follow requirements of the Bloodborne Standard (29 CFR 1910.1030) with respect to all "contaminated sharps." For example:
- Implement engineering and work practice controls to eliminate or minimize exposure to bloodborne pathogens [29 CFR 1910.1030(c), 29 CFR 1910.1030(d)].
- Dispose of contaminated sharps immediately or as soon as feasible into appropriate containers, as required by the standard. [29 CFR 1910.1030(d)(4)(iii)(A)(1)]
- Protecting Yourself When Handling Contaminated Sharps. OSHA Fact Sheet, (January 2011).
- Also see Healthcare-wide Hazards - Needlesticks/Sharps Injuries.