Prevalence and risk factors of needle stick and sharp injury among tertiary hospital workers, Vientiane, Lao PDR

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Abstract

Objectives:

Health care workers (HCWs) face risks of needle stick and sharp injuries (NSIs). Most NSIs occur in developing countries, however, no epidemiological study on NSIs is publicly available in Lao PDR. The objective of this study is to identify the prevalence and risk factors of NSIs among HCWs in Lao PDR.

Methods:

This cross-sectional study was designed to determine the prevalence and risk factors of NSIs among four tertiary hospitals in Vientiane, Lao People's Democratic Republic.

Results:

Six months before the survey, 11.4% (106/932) of hospital staff had experienced NSIs, while 42.1% did in their entire career. Key protective factors of NSIs among nurses included adequate availability of needles, syringes, and sharp equipment ( p = 0.042; odds ratio [OR], 0.47) and attendance to educational or refresher courses on safety regarding NSIs ( p = 0.038; OR, 0.50). As an on-site practice, single-handed recapping was prevalent (46.7%, 257/550) among participants.

Conclusions:

The result showed that high rates of NSIs persist among HCWs. The findings of this research call for comprehensive health and injection safety programs for HCWs involved in clinical practice.

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Most cited references 18

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Needle stick injuries among nurses in sub-Saharan Africa.

Maritta Jaakkola, A Nsubuga (2005)

Despite a heavy burden of HIV/AIDS and other blood borne infections, few studies have investigated needle stick injuries in sub-Saharan Africa. We conducted a cross-sectional study at Mulago national referral hospital in Kampala, Uganda, to assess the occurrence and risk factors of needle stick injuries among nurses and midwives. A total of 526 nurses and midwives involved in the direct day-to-day management of patients answered a questionnaire inquiring about occurrence of needle stick injuries and about potential predictors, including work experience, work load, working habits, training, and risk behaviour. A 57% of the nurses and midwives had experienced at least one needle stick injury in the last year. Only 18% had not experienced any such injury in their entire career. The rate of needle stick injuries was 4.2 per person-year. Multiple logistic regression analysis showed that the most important risk factor for needle stick injuries was lack of training on such injuries (OR 5.72, 95% CI 3.41-9.62). Other important risk factors included working for more than 40 h/week (OR 1.90, 95% CI 1.20-3.31), recapping needles most of the time (OR 1.78, 95% CI 1.11-2.86), and not using gloves when handling needles (OR 1.91, 95% CI 1.10-3.32). The study showed a high rate of needle stick injuries among nurses and midwives working in Uganda. The strongest predictor for needle stick injuries was lack of training. Other important risk factors were related to long working hours, working habits, and experience.

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Standard Precautions: Occupational Exposure and Behavior of Health Care Workers in Ethiopia

Ayalu Reda, Shiferaw Fisseha, Bezatu Mengistie … (2010)

Background Occupational exposure to blood and body fluids is a serious concern for health care workers, and presents a major risk for the transmission of infections such as HIV and hepatitis viruses. The objective of this study was to investigate occupational exposures and behavior of health care workers (HCWs) in eastern Ethiopia. Methods We surveyed 475 HCWs working in 10 hospitals and 20 health centers in eastern Ethiopia using a structured questionnaire with a response rate of 84.4%. Descriptive statistics and multivariate analysis using logistic regression were performed. Results Life time risks of needle stick (30.5%; 95% CI 26.4–34.6%) and sharps injuries (25.7%; 95% CI 21.8–29.6%) were high. The one year prevalence of needle stick and sharps injury were 17.5% (95% CI 14.1–20.9%) and 13.5% (95% CI 10.4–16.6%) respectively. There was a high prevalence of life time (28.8%; 95% CI = 24.7–32.9%) and one year (20.2%; 95% CI = 16.6–23.8%) exposures to blood and body fluids. Two hundred thirteen (44.8%) HCWs reported that they were dissatisfied by the supply of infection prevention materials. HCWs had sub-optimal practices and unfavorable attitudes related to standard precautions such as needle recapping (46.9%) and discriminatory attitudes (30.5%) toward HIV/AIDS patients. Conclusion There was a high level of exposure to blood and body fluids among HCWs. We detected suboptimal practices and behavior that put both patients and HCWs at significant risk of acquiring occupational infections. Health authorities in the study area need to improve the training of HCWs and provision of infection prevention equipment. In addition, regular reporting and assessment of occupational exposures need to be implemented.

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Blood-borne viruses in health care workers: prevention and management.

E Delarocque-Astagneau, E Bouvet, D Abiteboul … (2011)

Three pathogens account for most cases of occupationally acquired blood-borne infection: hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The highest proportion of occupational transmission is due to percutaneous injury (PI) via hollow-bore needles with vascular access. We briefly review prevention and management of blood-borne pathogens in health care workers (HCWs) in developed countries. HCW compliance with standard precautions is necessary for prevention of PI. Safety-engineered devices are now being increasingly promoted as an approach to decreasing the rate of PI. Prevention of HBV transmission requires HCW immunization through vaccination against HBV. In non-vaccinated HCWs (or HCWs with an unknown antibody response to vaccination) exposed to an HbsAg-positive or an untested source patient, post-exposure prophylaxis with HBV vaccine, hepatitis B immunoglobulin or both must be started as soon as possible. Although no available prophylaxis exists for HCV, it is crucial to identify HCV exposure and infection in health care settings and to consequently propose early treatment when transmission occurs. Following occupational exposure with potential for HIV transmission, use of antiretroviral post-exposure prophylaxis must be evaluated. Patients need to be protected from blood-borne pathogen-infected HCWs, and especially surgeons performing exposure-prone procedures (EPPs) with risk of transmission to the patient. However, HCWs not performing EPPs should be protected from arbitrary administrative decisions that would restrict their practice rights. Finally, it must be emphasized that occupational blood exposure is of great concern in developing countries, with higher risk of exposure to blood-borne viruses because of a higher prevalence of the latter than in developed countries, re-use of needles and syringes and greater risk of sustaining PI, since injection routes are more frequently used for drug administration than in developed countries. Copyright © 2011 Elsevier B.V. All rights reserved.

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Author and article information

Journal

Journal ID (nlm-ta): J Occup Health

Journal ID (iso-abbrev): J Occup Health

Title: Journal of Occupational Health

Publisher: Japan Society for Occupational Health

ISSN (Print): 1341-9145

ISSN (Electronic): 1348-9585

Publication date (Electronic): 13 September 2017

Publication date (Print): 20 November 2017

Volume: 59

Issue: 6

Pages: 581-585

Affiliations

[1 ] National Center for Global Health and Medicine

[2 ] Graduate School of Medicine, The University of Tokyo

[3 ] Teikyo University Graduate School of Public Health

[4 ] Faculty of Postgraduate Studies, University of Health Sciences

[5 ] Reproductive Health and Research, World Health Organization

Author notes

Correspondence to: C. Matsubara, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan (e-mail: c-matsubara@ 123456it.ncgm.go.jp )

Article

Publisher-manuscript ID: 17-0084-FS

DOI: 10.1539/joh.17-0084-FS

PMC ID: 5721280

PubMed ID: 28904259

SO-VID: 954f89a3-bd1c-4271-9023-febf9f404717

License:

Journal of Occupational Health is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view the details of this license, please visit ( https://creativecommons.org/licenses/by-nc-sa/4.0/).

Prevalence and risk factors of needle stick and sharp injury among tertiary hospital workers, Vientiane, Lao PDR

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China Occupational Medicine

Most cited references 18

Needle stick injuries among nurses in sub-Saharan Africa.

Standard Precautions: Occupational Exposure and Behavior of Health Care Workers in Ethiopia

Blood-borne viruses in health care workers: prevention and management.

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