Needlestick injuries among health care workers: occupational hazard or avoidable hazard?

Making Our Hospitals a Safe Workplace: Hazard Identification and Risk Assessment at a Tertiary-Level Public Hospital in Eastern India

BACKGROUND

Hospitals are complex places with a large number of employees, patients, furniture, equipment, etc. Healthcare workers (HCWs), patients, or the general public are vulnerable to injuries and illness due to unseen hazards at the workplace. This study aims to identify the hazards and assess the risks at a hospital to ensure safety for HCWs, patients, and the public and generate awareness about the same. It helps in reducing the financial obligation of the institution due to the treatment of illnesses of staff, absenteeism, and service disruption and slows down manpower turnover. Hazard Identification and Risk Assessment (HIRA) helps reduce human errors and promote safe behavior.

OBJECTIVE

This study aims to identify and study the hazards in a hospital, assess the risks associated with the hazards, and recommend methods to reduce or eliminate the hazards based on the outcomes of the study.

METHODOLOGY

An observational study was conducted at a 1000-bed tertiary-level teaching public sector hospital in eastern India. A checklist was used for direct observation, conducting staff interviews, and document reviews. A risk scoring tool was used, and hazards were ranked as per the risk score.

RESULTS

Thirty-eight hazards were identified in the study and classified under the categories of natural, physical, chemical, biological, ergonomic, psychological, and safety. The fire risk and occurrence of cyclones had the highest risk scores.

CONCLUSIONS

The study identified hazards through direct observations, record reviews, and staff interviews. These findings can guide the prioritization of areas requiring necessary action in risk reduction, ensuring a safe workplace for healthcare workers (HCWs), patients, and the public. They can also help the institution shift from a reactive approach to a proactive method for HCW safety.

Sharps Injuries Among Medical Trainees and Attending Physicians

PURPOSE

Sharps injuries are a particularly concerning occupational hazard faced by physicians and are largely preventable. This study compared the proportion and rate of sharps injuries among medical trainees with those among attending physicians by sharps injury characteristics.

METHOD

The authors used data reported to the Massachusetts Sharps Injury Surveillance System from 2002-2018. Sharps injury characteristics examined were department where injury occurred, device, purpose or procedure for which device was used or intended, presence of sharps injury prevention feature, who was holding the device, and how and when the injury occurred. Global chi-square was used to assess differences in the percent distribution of sharps injury characteristics between physician groups. Joinpoint regression was used to evaluate trends in injury rates among trainees and attendings.

RESULTS

From 2002-2018, 17,565 sharps injuries among physicians were reported to the surveillance system, 10,525 of which occurred among trainees. For attendings and trainees combined, sharps injuries occurred most in operating and procedure rooms and most often involved suture needles. Significant differences in sharps injuries were found between trainees and attendings with respect to department, device, and intended purpose or procedure. Sharps without engineered sharps injury protections accounted for approximately 4.4 times as many injuries (13,355, 76.0%) as those with protections (3,008, 17.1%). Among trainees, sharps injuries were highest in the first quarter of the academic year and decreased over time, while sharps injuries among attendings had a very slight, significant increase.

CONCLUSIONS

Sharps injuries are an ongoing occupational hazard faced by physicians, particularly during clinical training. Further research is needed to elucidate the etiology of the observed injury patterns during the academic year. Medical training programs need to implement a multipronged approach to prevent sharps injuries, including increased use of devices with sharps injury prevention features and robust training on safe handling of sharps.

Needlestick and sharps injuries at a German university hospital: epidemiology, causes and preventive potential - a descriptive analysis

OBJECTIVES

To analyze the number, epidemiology and circumstances of needlestick and sharps injuries (NSSI) and exposures to body fluids and to identify further preventive measures to improve the occupational safety of health care workers (HCW).

MATERIAL AND METHODS

Setting: German university tertiary-care referral center. Retrospective study based on injury documentation sheets of the hospital's staff and faculty health service and, if given, on reports by continuity doctors and by the accident and emergency department in January 2014-June 2016.

RESULTS

Altogether, 567 injuries were registered with a significant decrease of cases over the study period. The majority of accidents occurred in the operating theater (35%). Stress, time pressure, overstrain, carelessness and distraction were found to be the main reasons for injuries. At least 30% of the cases were preventable, mainly by wearing personal protective equipment (PPE), by proper disposal of an item and by early replacement of overfilled sharps containers (SC). In 20% of the cases involving an item, the injury was caused by a safety-engineered device (SED). Almost one-third of these injuries were attributable to an improper use of the SED.

CONCLUSIONS

Despite many efforts made to reduce their number, NSSI still occur. Health care workers and students should be offered regular trainings to be sensitized to this topic and to learn the appropriate use of SED. Moreover, organizational measures must be taken, such as the provision of suitable PPE and safe SC. Strategies need to be established to improve the working conditions and reduce the stress level of HCW. Int J Occup Med Environ Health. 2022;35(5):497-507.

Causes of Needlestick and Sharps Injuries When Using Devices with and without Safety Features

Safety-engineered devices (SEDs) have been developed to protect healthcare personnel (HCP) from needlestick and sharps injuries (NSIs). The aim of this study was to analyze NSIs associated with SEDs and non-SEDs among HCP in hospitals, medical offices and care facilities. Records from online questionnaires on NSIs were used. Causes of NSIs were compared for SED use and healthcare setting. A sample of 835 files was included. Injuries with SEDs accounted for 35.0% of all NSIs, whereas the proportions were higher in medical offices and lower in care facilities. NSIs in nurses were more often associated with SEDs than NSIs in physicians. NSIs from intravenous needles were associated with SEDs in more than 60% of cases in hospitals and medical offices and in about 30.0% of cases in care facilities. In contrast, suturing was associated with every fourth NSI in hospitals, of which fewer than 10.0% were associated with SEDs. In care facilities, SEDs were involved in 36.1% of NSIs during subcutaneous injections. NSIs during disposal accounted for 29.2% of total NSIs, of which 36.1% were associated with SEDs. Frequent reasons for SED-associated NSIs were technical problems, unexpected patient movement and problems during disposal. Our analysis shows that many NSIs are associated with SEDs. Continuous training is necessary in the handling and disposal of SEDs.

Determinants of Occupational Safety Culture in Hospitals and other Workplaces-Results from an Integrative Literature Review

Background: The aim of the present study was to obtain an overview of occupational safety culture by assessing and mapping determinants in different workplaces (hospital workplaces and workplaces in construction, manufacturing, and other industry sectors) using an already established theoretical framework with seven clusters developed by Cornelissen and colleagues. We further derived implications for further research on determinants of occupational safety culture for the hospital workplace by comparing the hospital workplace with other workplaces. Methods: We conducted an integrative literature review and searched systematically for studies in four research databases (PubMed, Web of Science, CINAHL, and PsycINFO). The search was undertaken in 2019, and updated in April 2020. Results of the included studies were analyzed and mapped to the seven clusters proposed by Cornelissen and colleagues. Results: After screening 5566 hits, 44 studies were included. Among these, 17 studies were conducted in hospital workplaces and 27 were performed in other workplaces. We identified various determinants of an occupational safety culture. Most studies in hospital and other workplaces included determinants referring to management and colleagues, to workplace characteristics and circumstances, and to employee characteristics. Only few determinants in the studies referred to other factors such as socio-economic factors or to content relating to climate and culture. Conclusions: The theoretical framework used was helpful in classifying various determinants from studies at different workplaces. By comparing and contrasting results of studies investigating determinants at the hospital workplace with those addressing other workplaces, it was possible to derive implications for further research, especially for the hospital sector. To date, many determinants for occupational safety culture known from workplaces outside of the healthcare system have not been addressed in studies covering hospital workplaces. For further studies in the hospital workplace, it may be promising to address determinants that have been less studied so far to gain a more comprehensive picture of important determinants of an occupational safety culture in the hospital sector.

Needlestick prevention devices: data from hospital surveillance in Piedmont, Italy-comprehensive analysis on needlestick injuries between healthcare workers after the introduction of safety devices

OBJECTIVE

Needlestick and sharps injuries (NSIs) involving healthcare workers (HCWs) are worldwide under surveillance since long time; the implementation of the European Directive 32/2010 regarding the mandatory use of safety-engineered devices (SEDs) seems to have reduced the number of these accidents. Our surveillance investigated the frequency and the modality of SED-related NSIs in the Piedmont region to verify changes in the epidemiology of these events.

METHODS

We analysed the exposure records of NSIs, device usage data and structural data of 42 acute care hospitals and compared conventional and safety devices. We calculated the accident rates per 100 000 needles and, as a measure of SED efficacy, the relative risk between the use of safety and non-safety devices with a 95% CI. We also described the dynamics of the NSIs and the most involved professional groups of HCWs, procedures and devices.

RESULTS

Total and specific device accident rates for 100 000 needles were lower with the use of SEDs. In 2015-2016, there were 1640 NSIs, with a decreasing absolute number during the observation period; 18% were SEDs related. Half of the total accidents with SEDs occurred in the patient's room, and nurses were involved in 78% of the cases. The most involved devices were the butterfly needles and peripheral venous catheters, and the most involved procedures were venous sampling (40%) and phlebotherapy (16%). The exposures occurred mostly during the procedure, and 45% of the SED-related injuries occurred during the disposal of the device; 92% of the SEDs involved had a manual activation mechanism.

CONCLUSION

In agreement with the results of other European studies, our results show that SEDs reduce the risk of percutaneous exposure of HCWs, but in introducing SEDs, we must select those with a higher level of safety (with a passive activation mechanism) and improve the healthcare staff training programmes.

Do training and needle-safety devices prevent needlestick injuries? A systematised review of the literature

This systematised review was undertaken to appraise research on the effects of training and the use of needle-safety devices (NSDs) on the prevention of needlestick injuries (NSIs) among health workers, focusing on a European perspective. A literature search from 2007 to 2017 was performed, which identified six studies that investigated the introduction of training and NSDs and their affect on NSIs. The six chosen studies identified that training, as well as the adoption of NSDs, has an impact on preventing NSIs. However, further information is required on the content and mode of delivery of training and on which types of NSDs are most effective at preventing injuries. This will help healthcare workers to understand and implement the most effective strategies to prevent injuries. This article provides a critique of the research approaches used in the six studies.

Seroprevalence of anti-HBc, risk factors of occupationally acquired HBV infection and HBV vaccination among hospital staff in Poland: a multicenter study

BACKGROUND

Due to numerous blood exposures hospital staff are at risk of acquiring hepatitis B virus (HBV) infections. This study aimed at estimating prevalence of HBV, associated risk factors and HBV vaccination among Polish health care workers (HCWs).

METHODS

A cross-sectional sero-survey was conducted (October 2016-January 2018) in 10 randomly selected hospitals from two provinces: of low and high incidence of HBV, with the use of an anonymous, self- administered questionnaire. Blood samples were screened for hepatitis B core antibodies (anti-HBc) with enzyme immunoassay.

RESULTS

Of the 306 participating HCWs, 88.6% were females, 69.9% nurses (mean age 47.8 ± 9.0 years). HBV vaccination was reported by 94.2%, participants (4.7% with 2 doses, 58.1% with 3 doses, 37.2% took a booster), but of these 75.1% reported no post-immunization serology. The sero-prevalence of anti-HBc was 12.1% (95%CI 8.4-15.7%); only 11.1% had ever screened themselves for HBV infection. Out of 37 anti-HBc positive HCWs, 29 reported being vaccinated for HBV; 10.5% vaccinated HCWs were anti-HBc positive. Regarding other occupational risk factors, 27.8% had experienced a sharp injury (SI) in the last year, 80.0% of incidents were not reported. The use of safety devices (SD) was 86.3%; 35.9% participants used to recap a needle. Older age (OR = 4.24), lack of HBV vaccination (OR = 7.42), working at the province of high HBV incidence in the general population (OR = 2.69) were each predictors of participant's HBV infection.

CONCLUSIONS

High anti-HBc seroprevalence was found in hospital staff with older generation particularly constituting a risk group. Unsatisfactory vaccination coverage and the use of SDs, needle recapping and under-reporting of SIs were main modifiable risk factors regarding HBV infection. The study provides evidence of the protective role of HBV vaccine, as well as the possible effect of HBV incidence in the general population on HCW's anti-HBc seropositivity. Universal vaccination, followed by strict policies to confirm immunity, better compliance with infection-control practices and widespread implementation of SDs should be enforced to protect hospital staff from occupationally acquired HBV infections.

Do safety engineered devices reduce needlestick injuries?

BACKGROUND

Needlestick injuries (NSIs) are one of the most common health hazards facing healthcare workers (HCWs) across the globe. Needles with safety engineered devices (SEDs) have been developed to minimize the risk of exposure to blood-borne infections, such as hepatitis B virus, hepatitis C virus and human immunodeficiency virus, associated with NSIs.

AIM

To assess the effect of the introduction of SEDs in preventing NSIs among HCWs at Jeroen Bosch Hospital, the Netherlands.

METHODS

The incidence rates of reported NSIs before and after the introduction of SEDs were compared. All HCWs who reported an NSI with an SED were interviewed in order to understand the underlying causes of the NSIs.

FINDINGS

Despite the introduction of SEDs, the incidence of NSIs increased from 1.9 per 100 HCWs before the introduction of SEDs to 2.2 per 100 HCWs after the introduction of SEDs. The registration of reported SED-related NSIs showed a significant decrease in the number of NSIs related to injection needles and blood sugar needles, while an unexpected significant increase in NSIs with nadroparin calcium needles and infusion needles was found. The most common causes reported for NSIs were unsafe disposal of the needles and problems with the safety feature.

CONCLUSION

The application of SEDs has not led to a reduction in NSIs. The majority of NSIs caused by a needle with an SED can be prevented by stimulation of safe needle disposal, proper use of SEDs, and provision of feedback to manufacturers to keep improving product design.

Risk Reduction of Needle Stick Injuries Due to Continuous Shift from Unsafe to Safe Instruments at a German University Hospital

This study assessed protective effects of a continuous introduction of safe instruments in terms of reduction of needle stick injuries. The retrospective study analyzed correlations between the increasing proportion of safe instruments and a reduction of the incidence of needle stick injuries linked to such instruments in a German university hospital over 5 years. Incidents declined about 17.6% from 80.3 incidents per 1000 employees to 66.2, associated with an increase in the proportions of injuries due to instruments without protective mechanisms such as scalpels or hypodermic needles by 12.2%. For injuries due to venipuncture cannulae in various surgical and internal medicine departments, there was a negative association between the proportion of safe instruments and the incidence of injuries. For injection needles, portacath needles, and lancets in selected internal medicine departments, the number of injuries also dropped during this study interval. However, there was no clear-cut association with the percentage of safe instruments. This observational study suggests a correlation between the implementation of use of safe instruments and the reduction of needle stick injuries in a case of a graduated implementation. However, the effects are much less pronounced than in previous interventional studies.

Effectiveness of Intensive Interactive Classes and Hands on Practice to Increase Awareness about Sharps Injuries and Splashes among Health Care Workers

BACKGROUND

Occupational exposure to sharps and splashes pose a major hazard among health care workers (HCWs); so knowledge and awareness regarding sharps/splashes by blood and potentially infectious body fluids (BBF) is a must. Hence, the study was done to assess the extent of knowledge of the staff and using awareness classes and hands on practice as a model to increase awareness as well as prevention.

MATERIALS AND METHODS

This prospective interventional cohort study, using before - after trial, was conducted in a Level I trauma care centre. All cadres of HCWs were enrolled randomly into 5 different groups of 15 each. This study was conducted in 2 phases - interactive classes and hands on practice (Phase I) and questionnaire assessment and work area observation (phase II). This was repeated twice and the final outcome was analysed. A systematic level of grading was used to assess the improvement.

RESULTS

It was observed that Group 1 (doctors) and group 2 (nurses) had the maximum knowledge about such exposures and its prevention compared to the other groups (groups 3, 4 and 5) during the initial assessment (Phase I). The remaining groups showed a major improvement after the 2(nd) assessment, though their knowledge was poor in the beginning. Groups 1and 2 showed 32% and remaining groups showed a 25% improvement in voluntary reporting after the second assessment (Phase II).

CONCLUSION

Awareness classes and hands on practice are indeed useful in generating knowledge about sharps/ splashes. Certain incentives given at right time can improve it further.

Incidence of percutaneous injury in Taiwan healthcare workers

Reporting of percutaneous injuries (PIs) to the Chinese Exposure Prevention Information Network (EPINet) became mandatory for all public and tertiary referral hospitals in Taiwan in 2011. We have estimated the number of microbially contaminated PIs and the national PI incidence using a retrospective secondary data analysis approach to analyse 2011 data from the Chinese EPINet to determine the types of PI, mechanisms of occurrence and associated risks. The results revealed a national estimate of PIs between 6710 and 8319 in 2011. The most common incidents for physicians were disposable syringes, suture needles, and disposable scalpels; while for nurses they were disposable syringes, intravenous catheters, and lancets. About 13·0% of the source patients were seropositive for hepatitis B virus (HBV) surface antigen, 13·8% were seropositive for hepatitis C virus (HCV), and 1·1% seropositive for human immunodeficiency virus (HIV). From these results we estimate that annually 970 full-time healthcare workers (HCWs) would be exposed to HBV, 1094 to HCV, and 99 to HIV. This study improves our understanding of the mechanisms and risks of PIs and informs the development of more efficient preventive measures to protect HCWs from such injuries.

[Risk estimation of blood-borne infections by emergency room personnel]

BACKGROUND

Emergency department personnel are at risk of occupational exposure to blood-borne pathogens. Previous studies have shown that the prevalence of human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV) virus infections among trauma patients is higher compared to the general population.

OBJECTIVES

The aim of the study was to investigate the compliance rates of trauma team members in applying standard precautions, knowledge about the transmission risk of blood-borne infections and perceived risk of acquiring HIV, HBV and HCV.

METHODS

An anonymous questionnaire was distributed to 100 trauma team members including physicians, nurses and medical students from different medical departments (e.g. surgery, radiology, anesthesia and internal medicine).

RESULTS

The results of the questionnaire showed that trauma team members had insufficient knowledge of the risk of blood-borne pathogens, overestimated the risk of HCV infection and underused standard precautions during treatment of emergency trauma patients.

CONCLUSION

Further educational measures for emergency department personnel are required to increase the knowledge of occupational infections and compliance with standard precautions. Every healthcare worker needs to be sufficiently vaccinated against HBV. In the case of injury awareness of all measures of post-exposure prophylaxis is of utmost importance for affected personnel.

Sharps injuries in the operating room

OBJECTIVES

We aimed to identify who sustains needlestick and sharps injuries, under what circumstances and what actions are taken to minimize the risk and in response to intraoperative NSSIs.

METHODS

The cross-sectional study was conducted in 2013 on 215 operation room personnel in 14 hospitals of the Hormozgan province, Iran.

RESULTS

Two hundred and fifty appropriate responders completed the questionnaire (86 %). Anaesthesia 59 (27.4 %) and operation room technicians 55 (25.6 %) sustained the greatest numbers of NSSIs over the past year. Awareness of local protocols was significantly worse in the residents group. The commonest reasons for noncompliance with NSSIs local protocols were not sure of the local protocols 44 (20.4 %) and prolonged operation so unable to leave operation table 37 (17.3 %).

CONCLUSIONS

A revision of the local protocol to reduce the time it takes to complete may improve compliance. Education is of paramount importance in making health care workers aware of this issue. The application of safety devices led to a reduction in NSSIs and reduces the risk of blood borne infection as well.

Needlestick and sharps injuries among medical undergraduate students

BACKGROUND

Needlestick and sharps injuries (NSIs) can cause a transmission of bloodborne diseases. In this study, injury rate, accident mechanisms, and targets for preventive strategies were investigated at a major university hospital hosting different medical study programs.

METHODS

In 2009 and 2010, cross-sectional anonymous surveys were carried out among medical undergraduate students. Furthermore, all NSIs reported to the accident insurer from 2007 to 2010 were analyzed. This spans the comprehensive introduction of safety instruments in the university hospital in 2008.

RESULTS

The online survey was completed by 1,214 students in 2009 and 917 students in 2010. Results show an injury rate of 21.4% per year (mean value). Accidents are mostly related to vein puncture, surgical procedures, and instrument disposal. Comparing 2 parallel medical programs, the educational curriculum using objective structured clinical examinations, which are associated with significantly lower NSI incidences. The rate of under-reporting is 53% (mean value). Analysis of the injury reports made to the accident insurer showed a 50% decrease in NSIs surrounding the introduction of safe instruments.

CONCLUSION

Undergraduate medical students are at high risk of NSIs. Safe instruments and university instructions can prevent NSIs. Reporting procedures should be part of medical undergraduate training.

Reduction of needlestick injuries in healthcare personnel at a university hospital using safety devices

Background

Healthcare personnel (HCP) is exposed to bloodborne pathogens through occupational risk factors. The objective of this study was to compare the incidence of needlestick injuries (NSIs) before and after the introduction of safety devices in all departments of our hospital.

Methods

Data was extracted from mandatory needlestick report forms of the hospital’s Occupational Health Service. Serological results of patients and healthcare personnel (HCP) were reviewed in the laboratory information system.

Results

In 2007, the year before the introduction of safety devices, 448 needlestick injuries were self-reported, corresponding to an annual rate of 69.0 NSIs per 1 000 full-time HCP. The highest incidence was observed among medical staff in the surgery department and internal medicine with 152 (33.9%) and 79 (17.6%) NSIs, respectively. Of all occupational groups, nurses (36.2%) had the highest risk to sustain NSIs. In 2008 safety devices were introduced across the hospital, e.g. peripheral venous catheter, hypodermic needle and stapling system for wound sealing providing active or passive protection. In 2009, the year after introduction of safety devices, only 350 NSIs were reported, the annual rate of NSIs decreased to 52.4 per 1 000 full-time HCP. Thus an overall reduction of 21.9% for NSIs was achieved when safer devices were applied. The number of NSIs was reduced by even 50% for blood withdrawal, for use of peripheral venous catheters and application of hypodermic needles.

Conclusion

The application of safety devices led to a reduction of NSIs and significantly reduces the risk of bloodborne infections.

Sharps injuries: the risks and relevance to plastic surgeons

Surgeons are at risk for injury in the operating room daily. Because of the ubiquity of occupational hazards, injuries remain prevalent and expensive. Although occupational hazards can include musculoskeletal conditions, psychosocial stress, radiation exposure, and the risk of communicable diseases, sharps injuries remain the most common among surgeons in practice and the most frequent route of transmission of blood-borne pathogens. Therefore, increased attention to the health, economic, personal, and social implications of these injuries is essential for appropriate management and future prevention.

[Blood-borne infections and the pregnant health care worker. Risks and preventive measures]

Due to the increasing proportion of women in health care, as well as changes in working conditions (implementation of safety devices, minimally invasive/endoscopic procedures) the question arises whether the applicable laws and regulations for the protection of working mothers are outdated and should be updated.Individual risk analysis, as well as the inclusion of the pregnant health care worker in the decision-making process with regard to continuation or modification of the work practice serves as a protection of the expectant mother and unborn child and allows a continuation of the occupational activities.

Underreporting of blood and body fluid exposures among health care students and trainees in the acute care setting: a 2007 survey

BACKGROUND

It has been estimated that more than 8 million health care workers (HCWs) in the United States may be exposed to blood and body fluids via sharp and mucocutaneous exposures.

METHODS

An anonymous questionnaire was distributed among 505 HCWs. The target sample population included all the medical students; nursing professionals; dental professionals; and residents in internal medicine, emergency medicine, surgery, and obstetrics and gynecology at the University of Illinois Medical Center, Chicago, Illinois, a metropolitan tertiary care and referral center for Northern Illinois and Northwest Indiana. The sample was limited by the number of HCWs who were available to take the survey. The number and the characteristics of occupational exposures and reporting practices were recorded and compiled. Subsequently, a review of the English literature was performed using PubMed to analyze reasons for underreporting. Secondary and tertiary articles were located based on findings from the initial searches.

RESULTS

One hundred three of 455 (22.6%) HCWs reported a sharps exposure during their career, including their student years; thirty-four (33.0%) of these were not reported. One hundred five of 455 (23.1%) HCWs reported a mucocutaneous exposure during their career; 87 (82.9%) of these were not reported. The most common year of exposure was the intern year. The most common reason for not reporting was the belief that the exposure was not significant, followed by the combination of believing the exposure was not significant and being too busy.

CONCLUSION

Underreporting of blood and body fluid exposures is common because of a belief that most exposures are not significant. More education of HCWs is needed to change this perspective.

Occupational exposures to bloodborne viruses among German dental professionals and students in a clinical setting

PURPOSE

Exposures to bloodborne pathogens pose a serious risk to dental healthcare workers (DHCW). Despite improved methods of preventing exposures like needlestick injuries (NSI), occupational exposures still continue to occur. The purpose of this study was to evaluate the incidence of occupational exposures to patient body fluids among German DHCW, to assess the rate of reporting of such incidents, and to evaluate the association of various factors with these exposures.

METHODS

Data was obtained through an anonymous questionnaire.

RESULTS

Our study confirms that occupational skills are an important factor concerning NSI. It turned out that dental students (0.74 NSI p. a.) had nearly twice the number of NSI compared with dentists with more or less than 10 years working experience (0.42, 0.49 NSI p. a., respectively, P < 0.0001). Overall, 54.3% (n = 144/265) of respondents had sustained at least one NSI in their professional life. Only 28.5% of injured dental students and DHCW reported all of their NSI, the main reason (19.1%) for not reporting NSI was little or no perception of risk on behalf of the respondent. One-fourth of respondents were not wearing a mask and 55.6% were not wearing protective goggles during their last occupational exposures.

CONCLUSIONS

Occupational exposure to blood or body fluids is a common problem among DHCW and dental students. Measures must be adopted by official institutions, public health service, occupational health association and universities in order to reverse this situation.