Case study: Needlestick — how to prevent needlestick injuries effectively

State Health Office Baden-Württemberg (Landesgesundheitsamt)

University Hospital of Heidelberg (Universitätsklinikum)

Statutory Accident Insurance for the Health Care Sector (BGW)

Statutory Accident Insurance for the Public Services Baden-Württemberg (UKBW)

Freiburg research centre for occupational and social medicine (FFAS)

Number of needlestick injuries can be as high as one per worker per year. Consequences of a single needlestick injury can be severe or even fatal. The most common risk are Hepatitis B and C and HIV infections. In 2004 there were 218 occupational hepatitis and eight HIV infections recognised in Germany. Health-care facilities do not invest in safety instruments although safety equipment were estimated to causes additional costs of EUR 63 per worker a year while each needlestick accident costs around EUR 480. By a two-year on-the-job intervention study, the organisations wanted to assess how needlestick injuries could be prevented efficiently.

Three groups were formed of workers in 18 departments. Group 1 kept on working with conventional instruments without any additional training. Group 2 were given special advice. Group 3 were also given special advice before the study and, additionally, the workers were required to work only with safety instruments for 12 months whenever possible. At the start and the end questionnaires were filled by workers about accidents and prevention measures during the previous 12 months. Safety containers of Group 3 were checked periodically to determine whether the safety instruments were used and disposed of correctly.

A comparison of the data from the questionnaires showed a drop in the number of needlestick injuries before and during the study among all three groups. This could be attributed to short-term sensitising effects among all workers. Only in Group 3 was a statistically significant reduction of needlestick injuries below the long-term accident rates. All registered accidents to workers of Group 3 happened when they were working with conventional instruments. Not a single accident with a safety instrument was registered. Acceptance of the new needles grew with the time in use and users’ experience in handling them.