Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Feb;110(5):61-7.
doi: 10.3238/arztebl.2013.0061. Epub 2013 Feb 1.

The management of needlestick injuries

Heiko Himmelreich  1 , Holger F Rabenau, Matthias Rindermann, Christoph Stephan, Markus Bickel, Ingo Marzi, Sabine Wicker
Affiliations

The management of needlestick injuries

Heiko Himmelreich et al. Dtsch Arztebl Int. 2013 Feb.

Abstract

Background: An estimated 1 million needlestick injuries (NSIs) occur in Europe each year. The Council Directive 2010/32/EU on the prevention of NSIs describes minimum requirements for prevention and calls for the implementation of local, national and Europe-wide reporting systems. The Directive is to be implemented by all EU member states by 11 May 2013. The purpose of this study was to assess (and improve) the procedures for the reporting and treatment of needlestick injuries in a German tertiary-care hospital.

Methods: We carried out a prospective observational study of the NSI reporting system in the hospital over a period of 18 months and determined the incidence of NSIs, the prevalence of blood-borne pathogens among index patients, the rate of initiation of post-exposure prophylaxis, and the rate of serological testing of the affected health care personnel.

Results: 519 instances of NSI were reported to the accident insurance doctor over the period of the study, which consisted of 547 working days. 86.5% of the index patients underwent serological study for hepatitis B and C (HBV and HCV) and for the human immune deficiency virus (HIV); this resulted in two initial diagnoses (one each of active hepatitis B and hepatitis C) in the index patient. 92 of 449 index patients, or one in five, was infected with at least one blood-borne pathogen. HIV post-exposure prophylaxis was initiated in 41 health care workers. One case of hepatitis C virus transmission arose and was successfully treated. Other than that, no infection was transmitted.

Conclusion: Complete reporting of NSIs is a prerequisite for the identification of risky procedures and to ensure optimal treatment of the affected health care personnel. The accident insurance doctor must possess a high degree of interdisciplinary competence in order to treat NSI effectively.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Frankfurt am Main University Hospital’s procedure for reporting to accident insurance doctor and follow-up care for needlestick injuries (NSIs) *1HCV: if positive for anti-HCV, perform HCV PCR test to determine viral load of index patient *2HBV: anti-HBs test at 6 weeks if affected employee’s HBV immunity is insufficient at time of NSI and booster immunization therefore administered AID: accident insurance doctor; ER: emergency room; HCV: hepatitis C virus; HBV: hepatitis B virus; PCR: polymerase chain reaction; PEP: postexposure prophylaxis; STIKO: Standing Committee on Vaccination Recommendations (Ständige Impfkommission); BC: Blood count; AST: aspartate aminotransferase; ALT: alanine aminotransferase
Figure 2
Figure 2
Distribution of reported needlestick injuries (n = 519) by professional group
Figure 3
Figure 3
Distribution of reported needlestick injuries (n = 519) by specialty
Figure 4
Figure 4
Distribution of reported needlestick injuries (n = 519) by category of injury
Figure 5
Figure 5
Tolerability of HIV postexposure prophylaxis in 41 employees following work-related blood contact
See this image and copyright information in PMC

Comment in

  • Index patient's details are important.
    Teterin W. Teterin W. Dtsch Arztebl Int. 2013 Jun;110(23-24):420. doi: 10.3238/arztebl.2013.0420a. Dtsch Arztebl Int. 2013. PMID: 23837087 Free PMC article. No abstract available.
  • In reply.
    Wicker S, Marzi I. Wicker S, et al. Dtsch Arztebl Int. 2013 Jun;110(23-24):420. doi: 10.3238/arztebl.2013.0420b. Dtsch Arztebl Int. 2013. PMID: 23837088 Free PMC article. No abstract available.

References

    1. Europäische Agentur für Sicherheit und Gesundheitsschutz am Arbeitsplatz (OSHA-EU) Vermeidung von Verletzungen durch scharfe/spitze Instrumente am Arbeitsplatz. Available at. http://osha.europa.eu/de/sector/healthcare/prevention-sharp-injuries-wor.... Last accessed on 27 October 2012.
    1. Henderson DK. Management of needlestick injuries: a house officer who has a needlestick. JAMA. 2012;307:75–84. - PubMed
    1. Wicker S, Gottschalk R, Rabenau HF. Risk of needlestick injuries from an occupational medicine and virological viewpoint. Dtsch Arztebl. 2007;104(45):A 3102–A 3107.
    1. Ridzon R, Gallagher K, Ciesielski C, et al. Simultaneous transmission of human immunodeficiency virus and hepatitis C virus from a needle-stick injury. N Engl J Med. 1997;336:919–922. - PubMed
    1. Richtlinie 2010/32/EU des Rates vom 10. Mai 2010 zur Durchführung der vom HOSPEEM und EGÖD geschlossenen Rahmenvereinbarung zur Vermeidung von Verletzungen durch scharfe/spitze. Amtsblatt der Europäischen Union L134/66. Instrumente im Krankenhaus- und Gesundheitssektor.