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Needlestick Injury in Hospital Personnel: A Multicenter Survey From Central Italy

Published online by Cambridge University Press:  21 June 2016

Francesco Albertoni
Affiliation:
Latium Region Epidemiology Unit, Rome, Italy
Giuseppe Ippolito*
Affiliation:
AIDS Unit, Lazzaro Spallanzani Hospital, Rome, Italy
Nicola Petrosillo
Affiliation:
Frosinone General Hospital, Rome, Italy
Lorenzo Sommella
Affiliation:
University Hospital Agostino Gemelli, Rome, Italy
Vincenzo Di Nardo
Affiliation:
Rieti General Hospital, Rome, Italy
Carlo Ricci
Affiliation:
Tivoli Civic Hospital, Rome, Italy
Elisabetta Franco
Affiliation:
Institute of Hygiene, Tor Vergata University, Rome, Italy
Carlo A. Perucci
Affiliation:
Latium Region Epidemiology Unit, Rome, Italy
Elisabetta Rapiti
Affiliation:
Latium Region Epidemiology Unit, Rome, Italy
Gennaro Zullo
Affiliation:
S. Filippo Hospital, Rome, Italy
*
Unita Operativa AIDS, Ospedale L. Spallanzani, Vie Portuense 292, 00149 Rome, Italy

Abstract

Objectives:

To assess the rate of needlestick injury in hospital personnel in an Italian region. To identify risk factors potentially amenable to correction.

Design:

Hospital workers undergoing hepatitis B prevaccination testing in 1985 through 1986 were interviewed regarding needlestick injury in the previous year, job category, area of work, years of employment, and other pertinent information.

Setting:

Of the 98 public hospitals of the Latium region, 68 participated in the survey: 32 of 55 with less than 200 beds, 20 of 25 with 200 to 300 beds, 11 of 13 with 400 to 900 beds, and all of the 5 with more than 1,000 beds.

Participants:

All healthcare workers providing direct patient care or environmental services as well as student nurses were invited by the hospital directors to undergo hepatitis B prevaccination testing and vaccination, if eligible.

Results:

Of 30,226 hospital workers of the 68 participating hospitals, 20,055 were interviewed (66.3%): 47.7% of the 7,172 doctors, 71% of the 14,157 nurses, 55.9% of the 2,513 technicians, and 71.9% of the 6,384 ancillary workers. Needlestick injury was recalled by 29.3%; the rates were 54.9%, 35.3%, 33.8%, 26.5%, 18.7%, and 14.7% in surgeons, registered and unskilled nurses, physicians, ancillary workers, and technicians, respectively. The recalled injury rate was 39.7% and 34.0% in surgical and intensive care areas; in infectious diseases, it was 16.7%. Bates were lower in hospitals with 200 to 300 beds (25.6%). The needlestick injury rate declined from 32% in those with less than 5 years of employment to 28% in those with more than 20 years (p<.01). Prevalence of HBV infection was higher in student nurses and young workers recalling a needlestick exposure (14.3% and 15.8%, respectively), versus 10.1% and 12.8% in those not exposed (p<.01 and <.05, respectively).

Conclusions:

Parenteral exposure to bloodborne infectious agents is a relevant risk among healthcare workers in our region, particularly in defined job categories and hospital areas (surgeons, nurses, surgical, and intensive care areas). Immunization and educational efforts should be made along with better designs of devices to reduce the risk of infection.

Type
Brief Report
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

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References

1. Leibowitz, S, Greenwald, L, Cohen, I, et al. Serum hepatitis in a blood bank worker. JAMA. 1949;140:13311333.CrossRefGoogle Scholar
2. Needlestick transmission of HTLV-III from a patient infected in Africa. Lancet. 1984;2:13761377.Google Scholar
3. McCray, E, The Cooperative Needlestick Surveillance Group. Occupational risk of the acquired immunodeficiency syndrome among health care workers. N Engl J Med. 1986;314:11271132.CrossRefGoogle Scholar
4. Gerberding, JL, Bryant-LeBlanc, OE, Nelson, K, et al. Risk of transmitting the human immunodeficiency virus, cytomegalovirus and hepatitis B virus to health care workers exposed to patients with AIDS and AID&elated conditions. J Infect Dis. 1987;156:18.CrossRefGoogle Scholar
5. Fahey, BJ, Schmitt, JM, Saah, AJ, Lane, HC, Henderson, DK. Assessment of risk for occupatdonal/nosocomial transmission of human immunodeficiency virus type I in health care workers. Presented at the 5th International Conference on AIDS; Montreal, Canada; June 4-9, 1989.Google Scholar
6. Marcus, R, The Cooperative Needlestick Surveillance Group. Health-care workers exposed to patients infected with human immunodeficiency virus (HIV), United States. Presented at the 5th International Conference on AIDS; Montreal, Canada; June 4-9, 1989.Google Scholar
7. Ippolito, G, Puro, V, The Italian Study Group on Occupational Risk of HIV Infection. Efficacy of HIV transmission after at-risk exposures in health care settings: the Italian multicentric study. Presented at the 7th International Conference on AIDS; Florence, Italy; June 16–21, 1991.Google Scholar
8. Seef, LB, Wright, EC, Zimmerman, HJ, et al. Type B hepatitis after needlestick exposure: prevention with hepatitis B immune globulin. Final report of the Veterans' Administration Cooperative Study. Ann Intern Med. 1978;88:285293.CrossRefGoogle Scholar
9. Grady, GF, Lee, VA, Prince, AM, et al. Hepatitis B immune globulin for accidental exposures among medical personnel: final report of a multicenter controlled trial. J Infect Dis. 1978;138:625638.CrossRefGoogle ScholarPubMed
10. McCormick, RD. Maki, DG Epidemiology of needlestick injuries in hospital persdnnel. Am J Med. 1981;70:928932.CrossRefGoogle Scholar
11. Hadler, SC, Doto, IL, Maynard, JE, et al. Occupational risk of hepatitis B infection in hospital workers. Infect Control. 1985;6:2431.CrossRefGoogle ScholarPubMed
12. Albertoni, F, Di Nardo, V, Ippolito, G, et al. Regionwide survey of HBV markers in hospital workers in Latium, Italy. Presented at the 2nd International Conference of the Hospital Infection Society; London, England; September 2-6, 1990.Google Scholar
13. Albertoni, F Ippolito, G, Perucci, CA, The Latium Hepatitis Prevention Group. Strategies of hepatitis B vaccination at regional level. In: Coursaget, P, Tong, MJ eds. Progress in Hepatitis B Immunization, Collogue INSERM. London, England: John Libbey Eurotext; 1990;194:429436.Google Scholar
14. Dean, AD, Dean, JA, Burton, AH, Dicker, RC. Epi Info, Version 5: A Word Processing, Database and Statistic Program for Epidemiology on Micro-Computers. Stone Mountain, Ga: USD, Inc.; 1990.Google Scholar
15. Ruben, FL, Norden, CW, Rockwell, K, Hruska, E. Epidemiology of accidental needle-puncture wounds in hospital workers. Am J Med Sci. 1983;286:2630.CrossRefGoogle ScholarPubMed
16. Mansour, AM. Which physicians are at high risk for needlestick injuries? Am J Infect Control. 1990;18:208210.CrossRefGoogle ScholarPubMed
17. Ippolito, G, Cadrobbi, P, Carosi, G, et al. Risk of occupational exposure to HIV infected body fluids and transmission of HIV-1 among health care workers: a multicentre study. Presented at the 5th International Conference on AIDS; Montreal, Canada; June 4-9, 1989.Google Scholar
18. McCormick, RD, Meisch, MG, Ircink, FG, Maki, DG. Epidemiology of hospital sharp injuries: a 14-year prospective study in the pre-AIDS and AIDS eras. Am J Med. 1991;91 (suppl 3B):301307.CrossRefGoogle Scholar
19. Mangione, CM, Gerberding, JL, Cummings, SR Occupational exposure to HIV: frequency and rates of underreporting of percutaneous and mucocutaneous exposures by medical house staff. Am J Med. 1991;90:8590.CrossRefGoogle Scholar
20. Tandberg, D, Stewart, KK, Doezema, D. Under-reporting of contaminated needlestick injuries in emergency health care workers. Ann Emerg Med. 1991;20:6670.CrossRefGoogle ScholarPubMed
21. Centers for Disease Control. Recommendations for prevention of HIV transmission in health care settings. MMWR. 1987;36(suppl S-2):118.Google Scholar
22. Dienstag, JL, Ryan, DM. Occupational exposure to hepatitis B virus in hospital personnel: infection or immunization? Am J Epidemiol. 1982;115:2639.CrossRefGoogle ScholarPubMed
23. Jagger, J, Pearson, RD. Universal Precautions: still missing the point on needlesticks. Infect Control Hosp Epidemiol. 1991;12:211213.CrossRefGoogle ScholarPubMed
24. Petrosillo, N, Albertoni, F, Balocchini, E, et al. Immunogenicity of yeast derived HB vaccine in risk groups from central Italy. Presented at the 1990 International Symposium on Viral Hepatitis and Liver Disease; Houston, Texas, April 4-8, 1990.Google Scholar