Factors Associated with Occupational Needle Stick and Sharps Injuries among Hospital Healthcare Workers in Bale Zone, Southeast Ethiopia

Needle Stick Injury Among Healthcare Workers in a Tertiary Care Setting in Dehradun, Sub-Himalayan Region: A Four-Year Record-Based Study

INTRODUCTION

Needlestick injuries (NSIs) represent a significant occupational health risk in healthcare settings. These injuries, caused by contaminated sharps such as needles, vials, and scalpel blades, can lead to percutaneous exposure to infectious materials. Despite the severity of NSIs, they often go unreported, highlighting a critical gap in occupational safety protocols.

AIMS

This study aimed to investigate the occurrence of NSIs among healthcare workers (HCWs) by sex, profession, and working areas. It also sought to explore the underlying reasons for these injuries and the factors contributing to their underreporting.

METHODOLOGY

Adhering to the RECORD guidelines (Reporting of studies Conducted using Observational Routinely Collected Data), this record-based study involved a retrospective analysis of reported NSIs. Data were collected from voluntary reports by HCWs who experienced NSIs or exposure to potentially infectious materials such as blood and body fluids. Statistical analysis was conducted using IBM SPSS Statistics for Windows, Version 16 (Released 2007; IBM Corp., Armonk, New York) and Microsoft Excel 2010 (Microsoft Corporation, Redmond, Washington).

RESULTS

Data from 142 participants indicated a higher proportion of females experiencing NSIs compared to males, with rates of 57.7% pre-COVID and 60.6% during COVID. There were notable shifts in NSI rates across professions, with increases observed among staff nurses and ward attendants/helpers. Analysis of injury circumstances revealed a decrease in sampling procedure-related injuries but an increase during intravenous procedures and biomedical waste segregation. Injuries occurring on the right-hand index finger decreased from 52.1% pre-COVID to 31% during COVID, while those on the left-hand index finger increased from 19.7% pre-COVID to 39.4% during COVID. Statistically significant associations were found between the injury site and the place of occurrence (p=0.021). Healthcare professionals commonly cleansed the site with disinfectants and used personal protective equipment (PPE) kits, with increased PPE usage noted during the COVID-19 pandemic. These findings emphasize the evolving dynamics of NSIs among HCWs and underscore the importance of tailored preventive measures during pandemics.

The Epidemiology of Needlestick and Sharp Injuries Among Healthcare Workers in a Secondary Care Hospital in Saudi Arabia: A Retrospective Study

Introduction Needlestick and sharp injuries (NSI) continue to pose a significant risk for healthcare workers (HCWs) at their workplace. The incidence rate of NSI in hospitals depends on multiple risk factors. This study aimed to analyze the epidemiological characteristics of NSI among HCWs and the risk factors influencing NSI rates and to provide further direction for NSI prevention in secondary care hospitals. Methods This study included all the NSI cases reported by HCWs in King Abdul Aziz Hospital, Makkah from 2005 to 2017. All the cases were recorded in the Exposure Prevention Information Network (EPINet™) database (International Healthcare Worker Safety Center, University of Virginia, Charlottesville, USA). The study was executed by using data loaded in the EPINet™ Program, the hospital electronic recording system Medica Plus, and analyzed by the Statistical Package for the Social Sciences program (SPSS Inc. Released 2007. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). Results During the period of study, 524 NSI cases were reported. The mean incidence rate per 100 occupied beds with 95% CI was 25.43 (22.05-28.81) and a statistically insignificant decline in NSI incidence rate was observed from 2005 to 2017. The maximal annual incidence rate (35.63 per 100 occupied beds) was registered in 2010 and the minimal value (14.84 per 100 occupied beds) in 2013. Injuries were mainly reported in patient rooms/wards (30.2%) and most frequently by nurses (56.1%). The mean of incident reporting within 24 hours was 74.0, 95% CI (67.19-80.73). This rate showed a statistically significant (p=0.01) increasing trend of 5.0% per annum. The mean of identified source patients - 83.5, 95% CI (79.13- 87.23) - possessed an annual 2.1% rise during 2005-2017 which was statistically insignificant (p=0.7). Cases occurred after the use/before disposal of items in 45.0% of cases and during the use of items in 44.7%. Hollow-bore needles caused injuries in 46.5% of incidents. Blood sample taking - 23.2% and IV or arterial line insertion/removal/manipulation (19.1%) - presented exposure-prone procedures posing the highest risk. Conclusions The results of this study revealed a high rate of NSI in the hospital. NSI rate in hospitals was impacted by a group of related risk factors, particularly, the location of risk (patient room/ward, intensive care unit (ICU), and emergency room (ER) depending on job intensity, the kind and frequency of exposure-prone procedures (blood sample taking, IV or arterial line insertion/removal/manipulation) and handling of hollow-bore and solid needle connected to the main healthcare professional group at risk (nurses). Future direction in NSI prevention requires a complex approach of continuous staff education along with the usage of devices with safety features.

Magnitude of occupational exposure to sharp injuries among nurses working in South Gondar zone public hospitals, Northcentral Ethiopia: institution-based cross-sectional study

OBJECTIVE

This study aimed to determine the magnitude of occupational exposure to sharp injuries and identify its associated factors among nurses.

DESIGN

Institution-based cross-sectional study design was conducted from 1 to 30 November 2022.

ANALYSIS

The collected data were entered into EpiData V.4.2; then, exported to Stata V.14 for analysis. Variables with a p value of <0.05 at 95% CI were considered significantly associated with occupational exposure to sharp injuries.

SETTING

The study was conducted in South Gondar zone public hospitals.

PARTICIPANTS

Nurses working in South Gondar zone public hospitals.

RESULTS

Of the total respondents, 213 (56.65%) were between the ages of 25 and 34 with the mean±SD of age 30.22±6.63 years. Similarly, 202 (53.72%) of the respondents were women. This study finding showed that the magnitude of occupational exposure to sharp injuries among nurses was 52.39% (95% CI: 47.92% to 56.37%). Moreover, this study finding showed that year of service >10 years (adjusted OR (AOR)=2.35, 95% CI: 1.21 to 4.57), lack of infection prevention training (AOR=1.85, 95% CI: 1.09 to 3.45), job-related stress (AOR=2.24, 95% CI: 1.27 to 3.89) and presence of contaminated sharps at the workplace (AOR=2.76, 95% CI: 1.67 to 4.72) were significantly associated with occupational exposure to sharp injuries among nurses.

CONCLUSIONS

Generally, this study finding reported that the magnitude of occupational exposure to sharp injuries among nurses was high. This study finding also showed that years of service >10 years, lack of infection prevention training, job-related stress and the presence of contaminated sharps at the workplace were independent predictors of occupational exposure to sharp injuries among nurses. Hence, all the concerned bodies should strengthen regular provision of infection prevention training to nurses at all levels. Nurses should practice proper use of safety box more than ever in order to avoid the presence of contaminated needles and other sharp materials at the workplace.

Exposure to needle stick injuries among health care workers in hemodialysis units in the southwest of Iran: a cross-sectional study

BACKGROUND

Needle stick injury (NSI) is the most common cause of infection with blood-borne pathogens (BBP) among healthcare workers (HCWs). This study aimed to assess the prevalence of NSI and it's contributing factors among HCWs of hemodialysis (HD) units in southwest Iran.

METHODS

A cross-sectional study was performed in 13 HD centers in Shiraz, Iran. A total of 122 employees were enrolled in our study. We used self-administrated questionnaires to collect data about demographics, experiences regarding NSIs, and general health status. The statistical tests used in this study were Chi-square and Independent T-test. A P-value < 0.05 is considered significant.

RESULTS

The mean age of the study population was 36.1 ± 7.8 years (72.1%: women). Exposure to NSIs was reported by 23.0% of them at least once during the previous six months. NSI prevalence was significantly higher among those with higher age (p = 0.033), work experience > 10 years (p = 0.040), and those who graduated earlier (p = 0.031). The intravenous injection was the most common procedure leading to NSI, and being in a hurry was the most common cause. The average general health was 3.7 ± 3.2, higher among those not exposed to NSI (p = 0.042).

CONCLUSION

NSI is a prevalent hazard in HCWs of HD units. The high rate of NSI and unreported cases, besides the lack of adequate information, indicates the necessity of implementing protocols and strategies for improving the safety of this personnel. It is difficult to compare the result of this study with those performed among HCWs in other settings; hence, further studies are needed to determine whether HCWs of these units are more exposed to NSIs.

Occupational-Related Injuries and Associated Risk Factors Among Healthcare Workers Working in Developing Countries: A Systematic Review

Background

Occupational-related diseases or illnesses account for an estimated 2.4 million deaths worldwide every year. Currently, occupational hazards threaten healthcare workers' (HCWs) lives, safety, and well-being. Therefore, providing the prevalence and major causes of occupational-related diseases may enable injury reduction and the creation of safer working environments, which are important for providing higher quality services. The current study aimed to determine the prevalence of occupational-related injuries and associated risk factors among HCWs, particularly in developing countries.

Methods

The articles published in English were retrieved using a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings (MeSH), and keywords in electronic databases (SCOPUS/Science Direct, Web of Science, DOAJ, PubMed/MEDLINE, CINAHL, and Google Scholars). Using Joanna Briggs Institute critical appraisal tools, a quality assessment was conducted to determine the articles' relevance. In addition, the relevant articles were identified through a series of assessment and evaluation stages.

Results

About 721 studies were searched using electronic databases, of which 36 articles included 139,578 HCWs. The average prevalence of occupational-related injuries among HCWs in the career and previous last year accounted for 60.17%, ranged from 32% to 87.8% and 39.16%, ranged from 1.14% to 87%, respectively. The current study found that sex and hours worked, stress at work, occupation, age, training in infection prevention, use of universal precautions, recapping needles, ward work experience, staffing and resource adequacy, awareness, outdated guidelines, and previous exposure to sharp injury were statistically associated with occupational-related injuries.

Conclusions

This study revealed that 39% and 60% of HCWs experienced occupational-related injuries in the last year and during their career, respectively. Therefore, the appropriate measures must be taken to reduce the burden of occupational-related injuries by following standard precautions or occupational health and safety measures.

Animal care professionals' practice towards zoonotic disease management and infection control practice in selected districts of Wolaita zone, Southern Ethiopia

Veterinary practices or activities expose professionals to occupational hazards, including infection with zoonotic diseases, during contact with animals. To assess animal care professionals' practice towards zoonotic disease management and infection control practices (ICPs) in selected areas of the Wolaita zone, a cross-sectional survey was conducted using a structured questionnaire survey. A total of 287 animal care professionals were registered by the Wolaita zone livestock and fishery office and working in nine different districts of the Wolaita zone. Of these, 135 animal care professionals working across nine different districts of the Wolaita zone were interviewed in the current study. The survey showed that about 55% (74/135) of respondents were animal health assistants, and about 84% (114/135) of the professionals were males. In terms of utilization of ICP, about 72% of professionals routinely wash their hands before eating and drinking in their workplace. However, approximately 7% of professionals sometimes eat or drink at the workplace. Additionally, almost 32% of the professionals always wash their hands between patient contacts. In the survey, approximately 49% of veterinarians said they sterilized and reused disposable needles. When dealing with an animal suspected of carrying a zoonotic infection, nearly 25% of experts isolate or quarantine diseased animals, and only about 25% of the experts remove their personal protective equipment (PPE) before interacting with other animals. Approximately 62% of responders said they used outwear (PPE) when carrying out surgery and 28% when performing a necropsy. Nearly 39% of veterinarians reported using gloves and gowns when assisting with parturition or handling conception products, and around 36% of practitioners utilized proper PPE when handling blood samples. Our findings show that the veterinary community in the Wolaita Zone's selected sites needs to be educated about ICPs regularly. A better understanding of the risk of zoonotic disease exposure, as well as alternatives for reducing this risk and liability problems, may encourage the use of infection control measures. Successful partnerships across multiple professional sectors should use a One Health approach that includes stakeholders from the human, animal, and environmental categories.

Sero-Prevalence of HBV and its Associated Factors Among Healthcare Providers in Public Health Facilities in Eastern Ethiopia

Background:

Healthcare providers are in high occupational risk of Hepatitis B virus infection than that of the general population because of the high risk of occupational exposure to patients’ body fluids and accidental sharp injuries. There are no large facility-based studies conducted on the prevalence of HBV infection and its associated factors among health care providers in eastern Ethiopia.

Objective:

This study aimed at investigating the seroprevalence of Hepatitis B Virus and its associated factors among the healthcare providers in public health facilities in eastern Ethiopia.

Methods:

A facility-based cross-sectional study was conducted among 438 randomly selected healthcare providers in eastern Ethiopia from March to June 2018. Pretested structured questionnaire was used to collect data on socio-demographic characteristics and other risk factors. In addition, a 2.5 ml blood was collected and the serum was analyzed for Hepatitis B surface antigen using the Instant Hepatitis B surface antigen kit. Data were entered using Epidata version 3.1 and analyzed using SPSS statistical packages version 22. Descriptive summary measures were used. Bivariate and multivariable logistic regression was conducted at 95% CI. An association at P-value <.05 was considered statistically significant.

Results:

A total of 438 (92.02% response rate) health care providers have participated in this study. The prevalence of hepatitis B virus infection was 9.6%. There were no significant differences in the HBV infection rates among healthcare providers with respect to socio-demographic characteristics (P-value >.05). After adjusting for some variables, the following variables remained statistically significantly associated with HBsAg positive result in the multivariable analysis: exposure to body fluids (AOR = 3.0; 95% CI [1.25, 7.05]), history of needle stick injury (AOR = 4.70; 95% CI [2.10, 10.55]), history of operation/surgery (AOR = 4.88, 95% CI [1.43, 16.62]), history of multiple sexual partner (AOR = 7.48; 95% CI [2.08, 26.96]), and being unvaccinated (AOR = 6.09; 95% CI [2.75, 13.51]).

Conclusion:

This study showed a high prevalence of HBV infection among health care providers in eastern Ethiopia. This is significant because health professionals may be at increased risk of chronic complications and may also be source of infection for their clients and general population during their healthcare practice. Management commitment that should focus on occupational safety and health promotions is necessary.

Burden and Transmission Risks of Viral Hepatitis in Southern Ethiopia: Evidence Needed for Prevention and Control Measures

BACKGROUND

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are significant causes of liver-associated morbidity and mortality for millions of people globally. Ethiopia is one of the viral hepatitis-endemic countries with no national strategy for surveillance and limited data. As such, this study aimed to investigated the extent and associated risk factors of HBV and HCV among community members in southern Ethiopia.

METHODS

A community-based cross-sectional study was conducted from January 2020 to August 2020. A structured questionnaire was used to collect behavioral and sociodemographic data. Serum samples were collected and assayed for seromarkers of HBV (HBsAg, anti-HBc, and anti-HBs) and HCV (anti-HCV) using ELISAs. In HBsAg-positive samples, HBV DNA was further quantified using RT-PCR. Data were entered into EpiData 3.1 and analyzed using SPSS 21.0. Descriptive statistics and logistic regression analysis were employed.

RESULTS

The study included 693 participants. Seromarkers for HBsAg, anti-HCV, anti-HBc, and anti-HBs were found to be 9.5%, 1.4%, 31.1%, and 14.3%, respectively. In 66 HBsAg positives, 57 (86.4%) had quantifiable HBV DNA. Prevalence of current HBV infection (HBsAg+, anti-HBc+, anti-HBs-) and lifetime exposure (positive for either HBsAg or anti-HBc) to HBV were 8.7% and 31.9%, respectively, and 63.1% of participants were vulnerable or had no evidence of prior HBV infection (HBsAg-, anti-HBc-, anti-HBs-). On multivariate logistic regression analysis, multiple sexual contacts, family history of hepatitis infection, alcohol consumption, and khat chewing were significantly associated with HBV. The seroprevalence of HBV was relatively high in this study area.

CONCLUSION

This study showed high prevalence of HBV infection, but low prevalence of HCV. This indicates that HBV is a major health problem in this community. Population-based surveillance, care, and treatment, as well as behavioral change and education programs, should be enhanced to minimize risk exposure.

Occupational blood exposure beyond needle stick injuries: hospital-based cross-sectional study among healthcare workers in governmental hospitals of Northern Ethiopia

Background

Occupational blood exposure is one of the major public health problems that healthcare workers (HCWs) are encountering. Most previous occupational blood exposure studies are delimited to needle stick injury, which could underestimate the real level of blood exposure. On the other hand, others deal with crude blood and body-fluids exposure, which possibly overestimate the magnitude of blood exposure. Therefore, this study aimed at determining the prevalence of occupational blood exposure and identifying associated factors among HCWs in the Southern Tigrai zone governmental hospitals of Northern Ethiopia considering all the potential means of blood exposure (needle stick injury, sharp medical equipment injury, and blood splash) while excluding blood-free body-fluids.

Methods

A hospital based cross-sectional study design was employed to gather data from randomly selected HCWs in three governmental hospitals from February to March, 2020. A multivariable logistic regression model was used to identify the independent factors associated with the outcome variable.

Results

From the total of 318 HCWs, 148 (46.5 %) were exposed to blood at least once in their lifetime. Working for more than 40 h per week (AOR= 9.4; 95 % CI: 7.61, 11.41), lack of adequate personal protective equipment (PPE) (AOR=3.88; 95 % CI: 1.64, 5.42), Hepatitis B virus vaccination (AOR=0.54; 95 % CI: 0.12,0.78), recapping used needle sticks (AOR=3.18; 95 % CI: 1.28, 8.83), and lack of infection prevention and patient safety (IPPS) training (AOR=13.5; 95 % CI: 8.12,19.11) were detected to significantly increase the likelihood of occupational blood exposure.

Conclusions

As nearly half of the HCWs were exposed to blood, reducing work load below 40 h per week by employing additional staff members, supplying adequate PPE, avoiding recapping of used needle sticks, and providing IPPS training for the HCWs should be practiced.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-07167-9.

Sharps injuries and splash exposures among healthcare workers in Arab countries: protocol of a systematic review and meta-analysis

INTRODUCTION

Sharps injuries, including needlestick injuries and splash exposures, constitute serious occupational health problems for healthcare workers, carrying the risk of bloodborne infections. However, data on such occupational incidents and their risk factors in healthcare settings are scarce and not systematically summarised in the Arab countries.The aim of this study is to conduct a systematic review and meta-analysis to review published literature about sharps injuries and splash exposures of healthcare workers in Arab countries, with the objectives to determine the incidence and/or prevalence of these events, their identified risk factors and the applied preventive and postexposure prophylactic measures.

METHODS AND ANALYSIS

The protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines. A comprehensive presearch developed in January to March 2021 in the database PubMed will be followed by a systematic search of six, core medical and health science databases: PubMed, EMBASE, Scopus, CINAHL, Web of Science and Africa-Wide Information in May 2021. The search will be performed without any filters or restrictions for publication years. Covidence systematic review tool will be used for document management, blinded screening and study selection. Two reviewers will independently screen the records, extract data and conduct risk of bias assessment. Results will be synthesised narratively in summary tables, and, if findings allow, meta-analysis will be conducted on the incidence and/or prevalence of sharps injuries and splash exposures, and on the effect size of risk factors.

ETHICS AND DISSEMINATION

The systematic review methodology does not require ethics approval due to the nature of the study design based only on published studies. The results of the systematic review will be published in a peer-reviewed journal, disseminated to stakeholders and made publicly available.

PROSPERO REGISTRATION NUMBER

CRD42021242416.

Prevalence and associated factors of needle stick and sharps injuries among healthcare workers in northwestern Ethiopia

Background

Needle stick and sharp injuries (NSSIs) are a common problem among healthcare workers (HCWs). Although the factors related to NSSIs for HCWs are well documented by several studies in Ethiopia, no evidence has been reported about the magnitude of and factors related to NSSIs in hospitals in northwestern Ethiopia.

Methods

An institution-based cross-sectional study was carried out from January to March 2019 among 318 HCWs in three randomly-selected hospitals of the eight hospitals found in South Gondar Zone. Sample sizes were proportionally allocated to professional categories. Study participants were selected by systematic random sampling methods using the monthly salary payroll for each profession as the sampling frame. Data were collected using a self-administered questionnaire. The outcome of this study was the presence (injured) or absence of NSSIs during the 12 months prior to data collection. A binary logistic regression model with 95% confidence interval (CI) was used for data analysis. Variables from the bi-variable analysis with a p-value ≤ 0.25 were retained into the multivariable analysis. From the multivariable analysis, variables with a p-value less than 0.05 was declared as factors significantly associated with NSSIs.

Main findings

The prevalence of NSSIs was 29.5% (95% CI: 24.2–35.5%) during the 12 months prior to the survey. Of these, 46.0% reported that their injuries were moderate, superficial (33.3%) or severe (20.7%). About 41.4% of the injuries were caused by a suture needle. Factors significantly associated with NSSIs were occupation as a nurse (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.18–4.26), disposal of sharp materials in places other than in safety boxes (AOR = 3.93, 95% CI: 2.10–5.35), recapping of needles (AOR = 2.27, 95% CI: 1.13–4.56), and feeling sleepy at work (AOR = 2.24, 95% CI: 1.14–4.41).

Conclusion

This study showed that almost one-third of HCWs had sustained NSSIs, a proportion that is high. Factors significantly associated with NSSIs were occupation as a nurse, habit of needle recapping, disposal of sharp materials in places other than in safety boxes and feeling sleepy at work. Observing proper and regular universal precautions for nurses during daily clinical activities and providing safety boxes for the disposal of sharp materials, practicing mechanical needle recapping and preventing sleepiness by reducing work overload among HCWs may reduce the incidence of NSSIs.

A comparison of knowledge and practices of universal precautions among public sector health care workers in Ugu north sub-district, KwaZulu-Natal, South Africa (2010-2014)

Background

Annually, there are a high number of needlestick injuries (NSIs) among health care workers (HCWs) globally. The knowledge and practice of HCWs of universal precautions (UPs) play an important role in determining the risk of an NSI. The objective of this study was to compare the knowledge and practices of UPs among HCWs with NSIs with HCWs without NSIs, in Ugu north sub-district in KwaZulu-Natal (KZN), South Africa, between 2010 and 2014.

Methods

A study among HCWs having an NSI (n = 100) between 2010 and 2014 compared with controls (n = 200) was conducted in 2016–2017 at a district hospital and 11 primary health care facilities in Ugu north sub-district, KZN, South Africa. Health care workers’ knowledge and practices of UPs were assessed by using a standardised questionnaire. Knowledge and practice responses were scored, and means and standard deviations (SDs) were calculated. Total scores of knowledge and practices were categorised into acceptable and unacceptable, and a binary logistic model was used to identify independent factors associated with being a case. The accepted level of significance was 0.05.

Results

The majority of the participants were nurses (n = 233; 77.7%) and female (n = 227; 75.7%). Control HCWs had better practice scores for UPs (86.13%; SD: 16.57) compared with cases (82.43%; SD: 19.98). The logistic regression analysis showed that the HCWs with acceptable knowledge and unacceptable practice were more likely to have had an NSI (odds ratio [OR]: 5.8; 95% confidence interval [CI]: 1.4–24.0).

Conclusion

There were significant differences between cases and controls with respect to knowledge and practice of UPs that are important findings for workplace health and safety and HCW training.

What were the changes during the COVID-19 pandemic era concerning occupational risks among health care workers?

BACKGROUND

Accidental exposure to percutaneous needle stick and sharp injuries (NSSIs) and blood and other body fluids is the unintended contact with risky medical instruments or patient secretions during a medical intervention. During the COVID-19 pandemic, the significance of occupational injuries in healthcare professionals was revealed once again. To assess the occupational injuries, we compared rates, distribution and type of exposure to blood and body fluids and NSSIs of health care workers for 2019 (pre-pandemic era) and 2020 (pandemic era) years, respectively.

MATERIAL AND METHODS

Our study included data collected by the 'Hospital Infection Control Committee' for the years 2019-2020. Data collected using the active surveillance method were analyzed retrospectively.

RESULTS

During 2019 (pre-pandemic period) and 2020 (pandemic period), 112 (27.65%₀) and 82 (21.4%₀) NSSIs reported, respectively. Of the exposed HCWs in 2019 (pre-pandemic period), 16.8%₀ (14) were doctor, 53.6%₀ (60) were nurse and 47.4%₀ (14) were intern doctors. In the 2020 (pandemic period), NSSIs were observed most frequently in nurses and cleaning staff, 50.24%₀ and 33.64%₀, respectively. Concerning the total percentage of exposure to blood and other body fluids, a slight increase was revealed from 1.48%₀ to 2.62%₀ in 2019 and 2020, respectively. A significant decrease in exposure rate was reported among the doctors between the pre-pandemic and pandemic era; 3.6%₀ and 1.19%₀ at 2019 and 2020, respectively. A significant increase in exposure rate was reported among the nurses between pre-pandemic and pandemic era; 0.8%₀ and 6.89%₀, respectively.

CONCLUSION

In conclusion, the exposure to NSSIs during the pandemic period decreased; however, there was no severe difference at pre-pandemic and pandemic periods concerning exposure to blood and body fluids. Well-designed training and awareness programs can be effective in preventing exposure to NSSIs and blood and other body fluids and exposure to respiratory acquired viruses.

Needle-stick and sharps injuries: awareness, prevalence and risk factors of a global problem in healthcare workers at Tanta University Hospitals, Egypt

Objectives. This study aimed to assess the level of awareness, prevalence and risk factors of needle-stick and sharps injuries (NSSIs) in Tanta University Hospitals, Egypt to develop a well-established preventive strategy. Methods. A total of 662 healthcare workers (HCWs), including nurses and physicians, who attended work during the last 6 months of 2019 were included. Data were collected on a structured questionnaire distributed during their working time. Results. Of 662 participating HCWs, 486 were nurses and 176 were physicians. Good awareness (86.1 and 83.1%) of the participants about safe injection policy and sharp disposal after use was observed. Nurses showed a significantly higher percentage of poor awareness score (79.1%) than physicians (20.9%). NSSIs in our hospitals reached 60.4%. Nurses (67.9%) had higher risk of NSSIs than physicians (39.8%; p < 0.001). NSSIs were significantly less likely to occur for HCWs who were aware of safe injection and sharp disposal policies. NSSIs were frequent with specimen collection (16.4%), injections (15.5%) and sharp disposal (14.6%). Only 110 (27.5%) have reported their injuries. Conclusion. A comprehensive program that addresses institutional, behavioral and device-related factors that contribute to the occurrence of NSSIs and reporting systems is needed.

Epidemiology and risk factors of needlestick injuries among healthcare workers in Iran: a systematic reviews and meta-analysis

BACKGROUND

Occupational contact with blood and body fluids poses a significant risk to healthcare workers. The aim of this systematic review is to investigate the epidemiology and risk factors affecting needlestick injuries (NSI) in healthcare personnel in Iran.

METHODS

In March 2020, researchers studied six international databases such as Medline/PubMed, ProQuest, ISI/WOS, Scopus, Embase, and Google Scholar for English papers and two Iranian databases (MagIran and SID) for Persian papers. Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess quality of studies. The method of reporting was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.

RESULTS

A total of 43 articles were included in the analysis. Results showed that females (OR = 1.30, 95 % CI 1.06-1.58, P value = 0.009), younger age (OR = 2.75, 95 % CI 2.27-3.33, P value < 0.001, rotated shift workers (OR = 2.16, 95 % CI 1.47-3.15, P value < 0.001), not attending training courses (OR = 1.30, 95 % CI 1.07-1.56, P value = 0.006), working in the surgery ward (OR = 1.83, 95 % CI 1.33-2.50, P value < 0.001), less work experience (OR = 1.43, 95 % CI 1.04-1.95, P value = 0.025) apposed a greater risk factors for NSI among healthcare workers.

CONCLUSION

Based on the results of this review, factors such as young age, less work experience, work shift, and female gender are considered as strong risk factors for NSI injury in Iran. Preventive measures including education programs can reduce the burden of NSI among healthcare personnel.

Risk Factors of Needlestick and Sharp Injuries among Health Care Workers at Sanglah Tertiary Hospital

Background: Needlestick and sharp injuries (NSIs) remain one of the main occupational hazards among health care workers (HCWs) that lead to blood-borne pathogen exposure. Purpose: This study examined the risk factors for NSIs among HCWs at a tertiary referral hospital in Bali. Methods: A case-control study was conducted at Sanglah General Hospital, Bali, involving 171 HCWs, divided into 81 cases and 90 control subjects. The sample was selected using a simple random sampling technique. Data were collected using questionnaires and analyzed using multiple logistic regression. Results: The majority of respondents had experienced NSIs once, in the morning shift, and had affected an individual’s hands. The most frequent activity leading to NSIs was giving an injection and most of the situations causing NSIs involved accidental self-action, and recapping needles. Factors associated with the incidence of NSIs were work career or experience of <5 years (p < 0.01; adjusted odds ratio [AOR]=5.04; 95% confidence interval [CI] = 2.04–12.42), non-compliance with working procedures (p = 0.01; AOR = 2.47; 95%CI= 1.26–4.82), female HCWs (p = 0.03; AOR = 2.21; 95% CI = 1.01–4.55), and unsafe workplace conditions (p = 0.04; AOR = 2.23; 95% CI = 1.01–4.92). Conclusion: Personal and environmental factors such as gender, work experience, compliance with working procedures, and workplace conditions are among the risk factors for NSIs. Occupational health and safety policies and programs focusing on the relevant factors, accompanied by adequate supervision, are necessary to reduce the risk of NSIs occurring.

Needlestick and sharps injuries in an Indonesian tertiary teaching hospital from 2014 to 2017: a cohort study

OBJECTIVE

Needlestick and sharps injuries among healthcare workers (HCWs) pose significant occupational health problems. We aim to provide incidence and other epidemiological aspects of needlestick and sharp injuries (NSSIs) among HCWs in a tertiary teaching hospital in Indonesia, to inform the evaluation of NSSIs prevention programme.

METHODS

A cohort study was conducted at Cipto Mangunkusumo Hospital in Jakarta. We analysed data of the sharps injury programme at the hospital between January 2014 and December 2017. Incidence of NSSIs was calculated per 1000 person-years (1000-PY).

RESULTS

Over the 4-year period, a total of 286 NSSIs were reported. The mean NSSIs incidence rate for 4 years was 13.3/1000-PY, peaking in 2015 (15.5/1000-PY) then decreasing afterward. Most NSSIs were experienced by nurses (42.7%), but the highest incidence was among midwives (18.9/1000-PY), followed by nurses, medical students and medical doctors (15.2/1000-PY, 12.6/1000-PY and 11.8/1000-PY, respectively). The devices causing the highest proportion of NSSIs were hollow-bore needles (66.8%), followed by suture needles (14.3%) and solid needles (10.8%). 9.4% of NSSIs were related to insulin pen injection. Of all the incidents, 31.3% occurred during surgical procedures, 25.9% during blood collections, 14.3% during administering injection of drugs and 13.3% during waste cleaning.

CONCLUSION

In conclusion, this study showed varied incidences of NSSI among different occupations, with the highest among midwives and nurses. Many unsafe work practices still continue, which is of utmost concern. We suggest opportunities for prevention including training and cultivating safer workplace practices.

Sharps injuries prevention among healthcare providers in surgical, medical and pediatric wards of a public hospital in Jimma Zone: a best practice implementation project

BACKGROUND

Sharps injuries are a serious public health problem that healthcare providers face and constitute a major risk for the transmission of blood-borne infections. Prevention of sharps injuries in hospitals requires that healthcare providers comply with universal precautions.

OBJECTIVES

The aim of this study was to assess and improve the compliance of healthcare providers with protocols based on best available evidence for prevention of sharps injuries in medical, surgical and pediatric wards of the hospital.

METHODS

A three-phase clinical audit was carried out using the online JBI Practical Application of Clinical Evidence System and Getting Research into Practice Program. Six audit criteria based on available evidence were used. Phase 1 of the project was the baseline audit, phase 2 the implementation of the best practice, and phase 3 the follow-up audit. Data were collected through observation, interview and resource inventory.

RESULTS

The postintervention compliance report showed maximum improvement in compliance in criterion 1 (sharps containers are not filled above the mark that indicates the bin is full) and criterion 2 (sharps containers are positioned out of the reach of children at a height that enables safe disposal by staff). Between the baseline and postintervention audits, the compliance rate for these criteria improved by more than half (criterion 1) and by nine-fold (criterion 2) (from 38 to 100% and 0 to 93%, respectively). During baseline, two nurses reported experiencing sharps injuries, noting that they think it is not important to report the injury if the patient is negative for HIV, and when they do not know where to report it, regardless. At the postintervention audit no injuries were reported.

CONCLUSION

The best practice recommendations using a clinical audit process was an effective intervention for improving knowledge and compliance of healthcare workers with protocols for the prevention of sharps injuries in low-resource settings.

Cross-sectional study assessing the risk of needlestick injury from an insulin pen among nursing care providers

Objective

Needlestick injuries caused by insulin pen injection are a serious occupational hazard for health care workers in China. We evaluated the prevalence of stick injuries with insulin pen injection and identified associated risk factors.

Methods

This cross-sectional survey was conducted from 1 October to 30 November 2018 in two tier three hospitals in Chongqing, China. Self-administered questionnaires were developed by the Chinese Nursing Association Diabetes Care Special Committee. We analyzed associations between potential risk factors and injuries at different operational steps.

Results

A total 233 of 302 (77%) participants (mean age 28.5±5.3 years) reported a needlestick incident. Most respondents (49%) had 3 to 10 years’ working experience and had received injection safety training. Most needlestick injuries occurred while recapping needles after injection. The risk of injury was significantly associated with department and job position. The injury rate increased with increased number of years worked. Respondents with ≥10 years working experience reported the highest needle-capping injury rate (88%): odds ratio 1.93, 95% confidence interval, 1.01 to 3.69.

Conclusion

Recapping needles after injection showed the highest risk for stick injury with an insulin pen. Nurses in the surgery department and those with longer work histories were more likely to be injured.

The Prevalence of Needlesticks and Sharp Injuries, and the Associated Factors Among Midwives and Nurses in North Wollo Zone Public Hospitals, North East Ethiopia: An Institution-based Cross-sectional Study

Background

Health professionals are at high risk of exposure for needlestick or sharp injury due to repeated exposure in clinical areas. This exposure leads to the acquiring of different infectious diseases like human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and other infectious diseases. Nurses and midwives having repeated exposure due to long working time, not wearing personal protective equipment, less work experience, and who are unable to apply infection prevention utilization guidelines are at high risk of needlestick and sharp injuries.

Methods

An institutional-based, cross-sectional study design was conducted in North Wollo Zone public hospitals. A simple random sampling technique was applied to select study subjects. The method of data collection was self-administered questionnaires that are structured and pretested from February to March 2019. The data were analyzed using both descriptive and analytical statistics. Binary logistic regressions were used to test the association between variables. Then, P-value <0.05 was considered as statistically significant in this study.

Results

Of the 147 respondents who participated in the study, 50.3% were female and 49.7% were male. The prevalence of needlestick and the sharp injuries was 75.5%. Recap practice of needle (AOR: 3.880; 95%CI: 1.666–9.036), working room (maternal care room) (AOR: 2.968; 95%CI: 1.012–8.703), and contagious room like emergency room (AOR: 3.587; 95%CI: 1.383–9.301) are significantly associated with needlestick and sharp injuries.

Conclusion

This study showed that three-quarters of the study subjects were exposed to needlestick injury at least once in the past year. Needle recapping practice and working room were associated with needlestick and sharp injuries. Then, health personnel should avoid the practice of recapping a needle and tale care themself to avoid needle and sharp injuries in the workplace.

Magnitude of Needlestick and Sharp Injury and Its Associated Factors Among Nurses Working at Health Institutions in Western Ethiopia, 2020

Background

Needlestick and sharp injury represent a major occupational hazard in the healthcare environment with nurses experiencing a large proportion of the burden. It is a potential for transmission of bloodborne pathogens including the human immunodeficiency virus, hepatitis B and C virus. Needlestick and sharp injuries are neglected and are often not reported. Few studies have been conducted in Ethiopia, and no study was conducted particularly in the Western part of a country. Therefore, this study aimed to assess needlestick and sharp injuries and associated factors among nurses working at health institutions in western Ethiopia, 2020.

Methods

An institutional based cross-sectional study was conducted on 297 nurses, from January 15 to 30, 2020. The study participants were selected by a simple random sampling method and data were collected using a self-administered questionnaire. Multivariable logistic regression was used to identify associated factors of needlestick and sharp injury. The association between needle stick and sharp injury and associated factors were measured using the odds ratio at a 95% confidence interval. The statistical significance was made at a p-value of less than 0.05.

Results

Out of 297 nurses who participated in the study, 100 (33.7%) had encountered needlestick and sharp injury in the past 12 months. Recapping the needle (AOR=3.99 95% CI: 2.20, 7.21), non-utilization of infection prevention guideline (AOR= 2.69, 95% CI: 1.29, 5.60), not taking injection safety training (AOR = 2.25, 95% CI: 1.22, 4.13) and having job-related stress (AOR= 1.93, 95% CI: 1.10, 3.41) were significantly associated with the needlestick and sharp injury.

Conclusion

In this study, the magnitude of needlestick and the sharp injury was high. The nurse should not recap the needles, should utilize infection prevention guidelines, should minimize stress, and routine injection safety training should be given to minimize needlestick and sharp injuries.

Infection prevention knowledge, practice, and its associated factors among healthcare providers in primary healthcare unit of Wogdie District, Northeast Ethiopia, 2019: a cross-sectional study

BACKGROUND

Adequate knowledge and safe practice of infection prevention among healthcare providers are vital to prevent nosocomial infections. Thus, this study aimed to assess the level of knowledge and practices of healthcare providers towards infection prevention and its associated factors in the health facilities of Wogdie District, Northern Ethiopia.

METHODS

Institution based cross-sectional study was conducted among 171 healthcare providers who were selected by a simple random sampling technique. Data were collected using interviewer-administered questionnaire. Multivariable logistic regression was performed to identify factors associated with knowledge and practice of infection prevention.

RESULT

About 70.8 and 55.0% of healthcare providers had adequate knowledge and safe practice of infection prevention respectively. Having infection prevention guideline (AOR = 3.65, 95% CI; 1.26, 10.54), taking infection prevention training (AOR = 2.2, 95% CI; 1.01, 4.75), having five years or more work experience (AOR = 1.52:95%CI; 1.13, 4.51), and working in maternity unit (AOR = 1.67:95%CI; 1.38-5.23) were positively associated with adequate knowledge of infection prevention. The odds of safe practice were higher in participants who received infection prevention training (AOR: 2.4; 95% CI; 1.01, 4.75) but lower among healthcare providers who are working in the facility which has no continuous water supply (AOR = 0.48:95% CI; 0.21, 0.83).

CONCLUSION

A significant proportion of healthcare providers had inadequate knowledge and unsafe practice of infection prevention. To improve healthcare worker's knowledge of infection prevention, adequate pre-service as well as on job training should be given.

The prevalence of occupational injury and its associated factors in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Occupation related fatality and mortality rate is becoming the devastating issue globally as reported by the International Labor Organization (ILO). Though there are reports about exposure and burden of occupational injury from the regional states, the studies were fragmented and inconclusive ones at the national level. Hence, the authors' intention being to come up with the national pooled estimates of occupation related injury and the associated factors in Ethiopia.

METHODS

The international reputable databases (PubMed, Google Scholar, ScienceDirect and Cochrane Library), cross-referencing and manual search strategies were explored rigorously following Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P) guideline. Studies that reported the prevalence of occupational injury were included for this systematic review and meta-analysis. The Newcastle-Ottawa quality assessment tool scale for cross-sectional studies was used for the critical appraisal of the studies. The heterogeneity between the studies was checked using Cochran Q statistic with the inverse variance (I2) value. Random effects meta-analysis was considered assess the summative effect size of occupational injury and the factors associated with it. Subgroup analysis and meta-regression were also employed to identify the possible source of heterogeneity and factors associated with occupational injury respectively. Both Egger's and Begg's test with the p-value less than 5% were used to declare the presence of publication bias.

RESULTS

A total of 23 original studies were considered to estimate the pooled effect size of occupational injury in Ethiopia. The pooled prevalence of occupational injury in Ethiopia was 44.66% (95% CI: 43.83, 45.49). Based on the subgroup analysis, the highest prevalence of occupational injury was reported from the construction sites (50.8%) in particular of the Addis Ababa city administration (49.5.Being male workers [OR = 1.46 (95% CI: 1.01, 2.11)], working more than eight hours per day [OR = 2.84 (95% CI: 1.81, 4.46)], absence of supervision for labor workers [OR = 1.60 (95% CI: 1.08, 2.37)], lack of personal protective equipment [OR = 3.01 (95% CI: 1.61, 5.63)] and lack of occupational health and safety training [OR = 1.49 (95% CI: 1.15, 1.92)] had increased odds of occupational injury.

CONCLUSION

Based on this systematic review and meta-analysis, it is concluded that nearly half of the labor workers in Ethiopia were experienced occupational injury. This issue was more encountered among the labor workers of construction sites and whose working place were at the Addis Ababa city administration respectively. Being male sex, working more than eight hours per day, lack of personal protective equipment, lack of supervision, and lack of training about occupational health and safety had increased odds of occupational injury in Ethiopia. Hence, the concerned body should give special emphasis for all the explored factors in order to minimize occupation related injury, mortality and morbidity in the country.

Job stress and needlestick injuries in nurses: a retrospective observational study

Background:

The prevention of needlestick injuries (NSIs) in nurses employed in Emergency Departments (EDs) represents a special issue for healthcare organizations globally. Stressful working conditions, lack of organizational arrangements and lack of supporting one another at work, may contribute to increase the risk of NSIs.

Methods:

We conducted an observational study to analyze: 1) the effectiveness of organizational interventions to minimize the occurrence of NSIs in ED nurses; 2) to measure the impact of such interventions on the safety budget.

Results:

The occurrence of NSIs detected after organizational level interventions was significantly lower than the occurrence observed previously such interventions (p<0,05). By results, cost saving from managing fewer NSIs than the previous period was found.

Conclusion:

The study shows that the proactive, integrated and comprehensive management of organizational features at workplace brings benefits to employees and reduces the burden of the occurrence of NSIs. As result of the reduced NSIs frequency, the overall costs for follow-up of injured workers were reduced. (www.actabiomedica.it)

Needle Stick and Sharp Injuries Among Healthcare Workers: A retrospective six-year study

Objectives

This study aimed to examine the proportion of needle stick and sharp injuries (NSSIs) among healthcare workers at King Hussein Medical Center (KHMC), Amman, Jordan.

Methods

All NSSI reports referred from departments at KHMC to the Preventive Medicine Department between 2013-2018 were retrospectively reviewed. Proportion of NSSIs were calculated and stratified according to age, gender, job title, place and site of injury and the procedure/task during which the injury occurred.

Results

There were a total of 393 NSSIs. A significant association was found between the proportion of NSSIs and all tested variables (P <0.001). The reported proportion of NSSIs was highest among nurses (39.7%) followed by cleaners (36.3%), physicians (10.4%), other workers (7.4%) and lab technicians (5.9%) during the study's six-year period. Hospital wards were the most common locations (46.1%) where injuries took place. Injuries also occurred most frequently during medical waste collection (38.2%).

Conclusion

The proportion of NSSIs was highest among nurses and cleaners. Safety policies and training among high-risk groups should be reviewed to reduce the risk of NSSIs. Multicentre studies at a national level should be conducted to examine whether this study's findings reflect national trends.

Incidence of work accidents involving exposure to biological materials among healthcare workers in Brazil, 2010-2016

BACKGROUND

Work accidents involving exposure to biological materials (WAEMB) are frequent among healthcare workers (HCW) and might have consequences for their health.

OBJECTIVE

To describe the characteristics of WAEMB involving HCW and post-exposure measures in Brazil as a whole.

METHODS

Ecological study based on secondary data recorded by System of Information on Notifiable Diseases (SINAN) for the period from 2010 to 2016. We performed descriptive analysis and calculated incidence coefficients (IC) per 1,000 HCW/year using software Stata 14.0.

RESULTS

The highest IC corresponded to 2014 (16.84). On analysis per state, the highest IC corresponded to Goiás, Minas Gerais, São Paulo and Paraná. Most victims were women, nursing assistants or technicians (64.71%), workers aged 15-31 years old, and with ≥12 years of formal education. Most accidents involved blood (74.93%) and percutaneous exposure (75.33%); needles were the most frequent causative agent (57.59%). About 29.71% of victims did not wear gloves at the time of the accident, and 1.12% refused chemoprophylaxis. Data missed for several variables of interest.

CONCLUSION

Our description points to the need for effective preventive measures mainly based on use of personal protective equipment, lifelong learning and continuing education for HCW and adequate WAEMB reporting.

Assessment of needle stick and sharp injuries among health care workers in central zone of Tigray, northern Ethiopia

Objective

Accidental occupational injuries to health care workers (HCWs) continue to have a significant problem in the healthcare system. Thus, the aim of this study was to assess prevalence of needle sticks and sharp injury and associated factors among health care workers working in Central Zone Tigray northern Ethiopia.

Result

The prevalence of needle stick and sharp injury in the past 12 months preceding the study and entire job were 25.9% and 38.5% respectively. Nearly one-third (31%) of the injuries occurred in emergency unit and 122 (71.3%) of the materials caused injury were used on patients. Practice of needle recap, ever used cigarette in last 12 months, training, work hours > 40 per week, job dissatisfaction and work experience less than 5 years were found factors significantly associated with needle stick and sharp injury for health care workers. The magnitude of Needle stick and sharp injury is high in the study area. Policy makers should formulate strategies to improve the working condition for healthcare workers and increase their adherence to universal precautions.

Prevalence of needlestick injury among healthcare workers in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Health facilities can provide diagnostic, curative, and prognostic services for the community. While providing services, healthcare workers can be exposed to needlestick injuries that can transmit pathogenic organisms through body fluids.

OBJECTIVE

The aim was to establish the pooled prevalence of needlestick injuries among healthcare workers in Ethiopia.

METHODS

This systematic review and meta-analysis was conducted according to PRISMA guidelines. Articles were searched from Google Scholar, PubMed, Science Direct, and Scopus databases using a combination of keywords and Boolean functions. All the searched articles were imported into the EndNote X9 software, and then, duplicate data files were removed. Article screening and data extraction were done independently by two authors. Data manipulation and analyses were done using STATA version 15.1 software.

RESULTS

The analysis of 23 full-text articles showed that the prevalence of the 12-month and lifetime needlestick injuries among the primary studies ranged from 13.2 to 55.1% and 18.6 to 63.6%, respectively. The pooled prevalence of needlestick injuries among the Ethiopian healthcare workers was 28.8% (95% CI 23.0-34.5) and 43.6% (95% CI 35.3-52.0) for the 12 months and lifetime, respectively.

CONCLUSIONS

The pooled prevalence of needlestick injuries among Ethiopian healthcare workers was high. Therefore, efforts should be implemented to reduce the occurrence of injuries. Adequate protective equipment and safety-engineered devices should be supplied for the healthcare workers. It could be more effective to reduce the factors contributing to increased exposures through the allocation of adequate numbers of the healthcare workforce and implementing in-service training.

Occupational Hazards among Healthcare Workers in Africa: A Systematic Review

Background:

While all healthcare workers are exposed to occupational hazards, workers in sub-Saharan Africa have higher rates of occupational exposure to infectious diseases than workers in developed countries. Identifying prevalence and context of exposure to blood and bloodborne pathogens may help guide policies for prevention.

Objective:

This systematic review examined occupational exposure rates to blood and bloodborne pathogen among healthcare workers in sub-Saharan Africa.

Methods:

In November 2017, a comprehensive literature search was conducted to identify studies reporting exposure of health workers in African coutnries to blood and bodily fluids. Title, abstract and full text screening were used to narrow our search. Studies more than 10 years old, or published in non-English languages were excluded.

Findings:

Fifteen studies reported a variety of exposures. The lifetime prevalence of needlestick injury ranged from 22–95%, and one-year prevalence ranged from 39–91%. Studies included a range of descriptive statistics of knowledge, attitudes, practice and access factors related to exposures. Two studies reported 21–32% of respondents linked poor knowledge or training with prevention of needlestick injuries. Rates of recapping needles ranged from 12–57% in four studies. Attitudes were generally positive toward occupational safety procedures while access was poor.

Conclusions:

The high burden of blood and bloodborne pathogen exposures demonstrated here indicates a high risk for contracting bloodborne illnesses. Although the data are sparse, implementation of preventative policies based on current knowledge remains critical to minimize risk and reduce exposure. There remains a pressing need for high quality data on occupational hazards to identify the burden of exposures and inform preventive policies in Sub-Saharan Africa. Additional studies are needed to determine whether differential exposures exist between professions and the associations with knowledge, attitudes, practices, and access factors to create targeted strategies to diminish occupational hazards.

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.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6628-1) contains supplementary material, which is available to authorized users.

Occupational exposure to blood and body fluids and associated factors among health care workers at the University of Gondar Hospital, Northwest Ethiopia

Background

Occupational exposure to blood and body fluids (BBFs) is a serious concern for health care workers (HCWs) and presents a major risk factor for transmission of infectious diseases such as hepatitis B virus (HBV), hepatitis C virus, and human immune deficiency virus. The main objective of this study was to assess the magnitudes of occupational exposure of blood and body fluids and associated factors among health workers at the University of Gondar Hospital.

Methods

An institution-based cross-sectional study was conducted from 1 February to 31 May 2017 at the University of Gondar Hospital. A total of 282 health care workers were selected by simple random sampling technique. Descriptive data was presented as absolute number with percentage, and multivariate analysis was used to assess the statistical association between associated factors and occupational exposure to BBFs. A P value of < 0.05 was considered as statistical significant.

Result

A total of 282 HCWs participated with the mean (±SD) age of 30.51 ± 5.86 year. Of the total, 58.5% (165) and 42.2% (119) of the study participants had been exposed to BBFs splash and needlestick injury (NSI) in their lifetime, respectively. However, 39.0% (110) and 20.6% (58) of the HCWs were exposed to splash and NSI in the past 1 year, respectively. Not wearing eye goggle, lack of training on infection prevention, taking of HBV vaccination, and recapping of used needle were risk factors associated with BBFs splash exposure, whereas taking HBV vaccination and recapping of used needle were associated risk factors with NSI exposure.

Conclusion

This study showed a high percentage of occupational exposure to blood and body fluids among health care workers. Not wearing eye goggle, HBV vaccine status, and recapping needles were found to be independent predictors of occupational exposure to BBFs among HCWs. Therefore, relevant stakeholders need to formulate strategies to create a favorable working environment and increase their adherence to universal precautions.

Prevention and Care of Hepatitis B in Senegal; Awareness and Attitudes of Medical Practitioners

In highly endemic settings for hepatitis B virus (HBV) infection such as Senegal, access to HBV prevention and care is rapidly evolving. In this context, all medical practitioners should have baseline knowledge on HBV infection and promote access to vaccination, screening, and care. A knowledge and attitudes survey on HBV infection was conducted among a randomly selected sample of medical practitioners in Senegal. Participants were asked to fill-out a questionnaire on the HBV epidemiology, prevention, and treatment. A 60-item knowledge score was computed; the lower quartile of the observed score was used to define poor knowledge. Factors associated with poor knowledge were assessed using a logistic regression model. A total of 127 medical practitioners completed the questionnaire. Only 14 (11.0%) participants knew that HBV vaccine could be safely administered to pregnant women and 65 (51.2%) to newborns. Older practitioners (> 40 years) as well as general practitioners (compared with specialists) were more likely to have a poor knowledge score with odds ratios (ORs) of 3.1 (95% confidence interval [CI] 1.0-9.2) and 2.6 (95% CI 1.0-7.3), respectively. Practitioners who declared not to recommend HBV screening frequently during their consultation were more likely to present a poor knowledge score [OR: 3.0; (95% CI 1.1-8.2)]. As universal HBV screening is being promoted in countries with endemic HBV infection, our finding that poor screening attitudes were associated with a poor knowledge is of concern. There is a need to raise awareness of medical practitioners in Senegal toward universal HBV screening and early vaccination of newborns.

Sharp instrument injuries among hospital healthcare workers in mainland China: a cross-sectional study

OBJECTIVES

To determine the prevalence of sharp instrument injuries in hospital-based healthcare workers (HCWs) in mainland China and the contributing factors.

DESIGN

Cross-sectional study.

SETTING

The data were derived from public hospitals.

PARTICIPANTS

A total of 360 hospitals were recruited in the study, including 289 general hospitals and 71 specialised hospitals. Among them, 194 are tertiary-level hospitals and 166 are secondary level. The study population finally consisted of 223 149 hospital HCWs.

PRIMARY OUTCOME MEASURES

A questionnaire was designed based on the aim of the study. Profession of HCWs, workplace, circumstance and medical apparatus and instrument were covered in the survey. HCWs completed a self-administered questionnaire regarding details of sharp instrument injuries within the previous month. Prevalence estimates for the injuries were calculated for the overall HCWs and for subgroups according to profession, workplace, circumstance or instrument.

RESULTS

Within the included HCWs, the prevalence of sharp instrument injuries was 0.08 per person-month. Only 4.6% of the HCWs reported to their hospitals after injury. The highest number of injuries occurred in nursing staff (10.3%). Injuries took place most frequently on general wards (44.5%). The circumstances that involved most frequent injuries include surgical needle insertion, removing an arteriovenous needle from a patient and recapping the needle. Single-use syringe caused more injuries incidents than other instruments.

CONCLUSIONS

These results indicate that sharp instrument injuries have become a major occupational problem of HCWs in mainland China. Attentions need to be paid to the issue and strategies for preventing such injuries are needed.

Occupational Exposure to Needle Stick and Sharp Injuries and Associated Factors among Health Care Workers in Awi Zone, Amhara Regional State, Northwest Ethiopia, 2016

BACKGROUND

Needle stick and sharp injuries were one of the major risk factors for blood and body fluid borne infections at health care facilities.

OBJECTIVE

To assess occupational exposure to needle stick and sharp injuries and associated factors among health care workers in Awi zone, 2016.

METHODS

institutional based cross-sectional study was conducted among 193 health care workers. Study participants were selected using systematic random sampling technique.

RESULT

When queried, 18.7% of the respondents' encountered needle stick and sharp injury in the last 1 year. Participants who practiced needle recapping and had job related stress were 21.3 and 7.3 times more likely to face needle stick and sharp injury, respectively. However, those who apply universal precautions and acquire the required skill were 99% and 96% times less likely to face needle stick and sharp injury, respectively, than their counterparts.

CONCLUSION AND RECOMMENDATION

The prevalence of needle stick and sharp injury was relatively low as compared to previous studies. Recapping of needle after use, job related stress, not applying universal precautions, and lack of the required skill were associated with needle stick and sharp injuries. Therefore, health care providers should apply universal precaution.

Period Prevalence and Reporting Rate of Needlestick Injuries to Nurses in Iran: A Systematic Review and Meta-Analysis

The purpose of this systematic review and meta-analysis was to provide a precise estimate of the period prevalence of needlestick injuries (NSI) among nurses working in hospitals in Iran and the reporting rate of NSI to nurse managers. We searched both international (PubMed, Scopus and the Institute for Scientific Information) and Iranian (Scientific Information Database, Iranmedex and Magiran) scientific databases to find studies published from 2000 to 2016 of NSI among Iranian nurses. The following keywords in Persian and English were used: "needle-stick" or "needle stick" or "needlestick," with and without "injury" or "injuries," "prevalence" or "frequency," "nurses" or "nursing staff," and "Iran." In a sample of 21 articles with 6,480 participants, we estimated that the overall 1-year period prevalence of NSI was 44% (95% confidence interval [CI], 35-53%) among Iranian nurses. The overall 1-year period prevalence of reporting NSI to nurse managers was 42% (95% CI, 33-52%). In meta-regression analysis, sample size, mean age, years of experience, and gender ratio were not associated with prevalence of NSI or reporting rate. The year of data collection was positively associated with period prevalence of NSI (p < .05), but not with the period prevalence of reporting NSI to nurse managers. Results indicated a high NSI period prevalence and low NSI reporting rate among nurses in Iran. Thus, effective interventions are required in hospitals in Iran to reduce the prevalence and increase the reporting rate of NSI. © 2017 Wiley Periodicals, Inc.

Occupational exposure to sharps injury among healthcare providers in Ethiopia regional hospitals

BACKGROUND

Sharps injury is a penetrating stab wound from a needle, scalpel, or another sharp object that may result in exposure to blood or other body fluids. According to World Health Organization pooled estimate, the annual incidence of sharps injury in Africa was ranged from 2.10 to 4.68 per person per year, but research data in Ethiopia is limited. The aim of the study was to investigate sharps injury prevalence and associated risk factors.

METHODS

Institution based cross-sectional study was conducted with 200 healthcare providers (HCP) in Northeast Ethiopia. Proportionate stratified sampling was used to select HCP. Sharps injury during the last 12 months was an outcome variable whereas demographic characteristics, behavioral attributes, and job environment characteristics were independent variables. Data was collected from April to May 2016 using self-administered questionnaire; which was adapted from World Health Organization best practices for injections and related procedures toolkit. Bivariate and multivariate logistic regression analysis was carried out to identify sharps injury associated risk factors. Epi Info version 3.5.1 software package was used for data coding and entry whereas Statistical Package for Social Sciences (SPSS) version 20 software package was used for analysis.

RESULTS

In total, 195 HCP participated with a response rate of 97.5%. The prevalence of sharps injury was 32.8%. Following adjustment for covariates, lack of in-service job training and previous exposure to sharps injury were statistically significant risk factors for sharps injury. HCP who had no in-service job training were 4.7 times more likely sustained sharps injury compared with those who had in-service job training (p < 0.001, OR = 4.7, 95% CI = 2.05-10.56). HCP who had previous exposure to sharps injury were 3.7 times more likely sustained sharps injury compared with those who were not exposed (p-value = 0.002, OR = 3.7, 95% CI = 1.62-8.27).

CONCLUSIONS

This study revealed 32.8% or at least three out of ten HCP exposed to sharps injury. This was found statistically significant among HCP who had no in-service job training and who had previous exposure to sharps injury. Thus, training HCP perhaps increase their skill and curiosity to reduce exposure to sharps injury.

Long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan: A national survey

BACKGROUND

Needlestick and sharps injuries are prevalent work-related injuries among nurses. Safety devices prevent only one-quarter of related injuries. More studies of modifiable risk factors are needed.

OBJECTIVES

To examine whether long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan.

DESIGN

Cross-sectional survey.

SETTINGS/PARTICIPANTS

This analysis included 19,386 full-time bedside nurses working in 104 hospitals across Taiwan.

METHODS

Participants filled out an anonymous questionnaire from July to September 2014. Chronic insomnia, needlestick injuries, and sharps injuries during the past year were each measured by a yes/no question. Multivariate logistic regression models were applied to examine the effects of long work hours and chronic insomnia on needlestick and sharps injuries, given with control for sex, marital status, educational level, age, years of practice, work unit, and hospital level in the model.

RESULTS

More than 70% of study nurses worked long hours during the previous week (>50h: 27.5%; 41-50h: 43.2%), and 15.5% of nurses reported chronic insomnia. The percentage of sharps injuries (38.8%) was higher than that for needlestick injuries (22.4%) during the previous year among nurses. After adjusting for potential confounders, logistic regression yielded significant results showing that those who worked 41 to 50h per week, >50h per week, and had chronic insomnia were 1.17 times (95% C.I.=1.04-1.32), 1.51 times (95% C.I.=1.32-1.72), and 1.45 times (95% C.I.=1.25-1.68) more likely to experience needlestick injuries, and 1.29 times (95% C.I.=1.17-1.42), 1.37 times (95% C.I.=1.23-1.53), and 1.56 times (95% C.I.=1.37-1.77) more likely to experience sharps injuries, respectively, than those who worked fewer hours and did not have insomnia.

CONCLUSIONS

This nationwide nurse survey showed that high rates of needlestick and sharps injuries persist in hospital nurses in Taiwan. The common problems of long work hours and chronic insomnia increase the risk of these injuries. We suggest that hospital managers follow regulations on work hours and optimize shift schedules for nurses to decrease related injuries.