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Needle-free systems


50 45 40 35 30 25 20 15 10 5 0

48.9% 43.5% 40.2% 39.7% 32.7% 31.4% 28.6% 24.0% 23.9% 19.7% 18.7% 31.4%

implement and support the new legislation. l

References 1. Ridzon R CC, DeMaria A. Simultaneous transmission of human immunodeficiency virus and hepatitis C virus from a needlestick injury. N Engl J Med 1997; 336:919–22.

2. Prüss-Üstün A, Rapiti E, Hutin Y. Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers. Am J Ind Med 2005;48:482–90.

3. Phillips EK, Conaway MR, Jagger JC. Percutaneous injuries before and after the Needlestick Safety and Prevention Act. N Engl J Med 2012;366:670–1.

Figure 1: Number of reported needlestick injuries in different medical departments of the University Hospital Frankfurt, Germany

% 25 20.5% 20 15 11.4% 10 5 0

Overall (HBV, HCV, HIV)

HIV HCV HBV co-infections

Figure 2: Prevalence of blood-borne viruses among the index patients at the University Hospital Frankfurt, Germany. During the study period overall, 86.5% (449/519) of the index patients were tested for HIV, HBV and HCV

physician after the incident.7,12 Consistent

reporting of NSI is, however, an essential prerequisite for providing appropriate treatment and taking post-exposure prophylactic measures in a timely fashion.

Council Directive 2010/32/EU makes demands on local, national and European-wide systems and assumes that a complete recording of all NSI is crucial to minimise the occupational hazards. The management of NSI ought to be given high priority and all healthcare institutions should have processes for reporting and managing NSI 24 hours a day and 365 days a year.8

Why is the Directive important? Due to the severe occupational hazards of NSI, preventing NSI should be in everybody’s interest. Despite the wide introduction of safety devices at the University Hospital Frankfurt, Germany

almost every day at least one NSI is reported by our HCWs (for example 519 needlestick injuries occurred between October 2010 and April 2012). During the study period, testing for blood-borne pathogens among the index patients of the University Hospital Frankfurt was performed in 86.5% (449/519) of patients; overall, 20.5% of the index patients were infected with a blood-borne pathogen (Fig. 2). One case of HCV transmission occurred in a physician,13

two initial diagnoses (active

hepatitis B and hepatitis C infection) among index patients were made during the observation period.14

These results

clearly point out a serious risk for occupational infections.

It is our hope that the new EU Directive will minimise the severe health risks caused by NSI. The legislator, the employers and the occupational health physicians should make every effort to

9.8% 3.6% 4.2%

4. Tomkins SE. Occupational transmission of hepatitis C in healthcare workers and factors associated with seroconversion: UK surveillance data. J Viral Hepat 2012;19:199–204.

5. Voide C. Underreporting of needlestick and sharps injuries among healthcare workers in a Swiss University Hospital. Swiss Med Wkly 2012;142: w13523.

6. Council Directive 2010/32/EU of 10 May 2010 implementing the Framework agreement on prevention from sharp injuries in the hospital and healthcare sector concluded by HOSPEEM and EPSU. Official Journal of the European Union 2010;134:66–72.

7. Wicker S et al. Needlestick injuries among Healthcare workers: Occupational hazard or avoidable hazard? Wien Klin Wochenschr 2008; 120:486–92.

8. Henderson DK. Management of needlestick injuries – A house officer who has a needlestick. JAMA 2012;307:75–84.

9. Louie T. Occupational hazards. N Engl J Med 2005;353:757–9.

10. Worthington MG, Ross JJ, Bergeron EK. Posttraumatic stress disorder after occupational HIV exposure: two cases and a literature review. Infect Control Hosp Epidemiol 2006;27:215–7.

11. Howsepian AA. Post-traumatic stress disorder following needle-stick contaminated with suspected HIV-positive blood. Gen Hosp Psychiatry 1998;20:123–4.

12. Wicker S, Rabenau HF. A review of the control and prevention of needlestick injuries. Eur Infec Dis 2011;5:60–3.

13. Himmelreich H et al. Early diagnosis of hepatitis C transmission after needlestick injury [Frühzeitige Diagnose einer Hepatitis C-Übertragung nach Nadelstichverletzung – article in German]. Der Unfallchirurg 2012; Epub ahead of print 8 September 2012.

14. Wicker S et al. Blood examinations after needlestick injuries. Benefits for healthcare workers and indexpatients. [Blutuntersuchungen nach Nadelstichverletzungen: Vorteile für Mitarbeiter und Indexpatienten – article in German]. Zahnärztliche Mitteilungen 2011; 101, Nr. 24 A, 46–8.



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