Sharps incidents on the work floor in 4 questions

Sharps incidents cover 3 types of injuries:

• A needlestick or sharps accident: the blood of one person is transmitted to another person’s body. This occurs via a sharp object, such as an injection needle or scalpel.
• A splash incident, whereby blood comes into contact with mucous membranes or broken skin.
• A bite accident: blood comes into contact with mucous membrane or saliva comes into contact with an open wound.

Sharps incidents may result in team members contracting the hepatitis B virus (HBV), hepatitis C virus (HCV) or HIV. Crucial elements here are the depth of the wound, the extent of body fluid penetration into the employee’s body and the source of the body fluid. If the source is a HIV or hepatitis B and C carrier, it does not automatically mean a team member is contaminated: not every remnant of blood contains the virus.

Sharps incidents mainly occur in the healthcare sector. This could include employees in hospitals, nursing homes and laboratories. But there is also an increased risk of sharps incidents in prisons, police stations, public toilets and public transport.

There are many ways in which blood or other body fluids can be transmitted. Examples are:

• A hospital employee is pricked by a used injection needle.
• Blood spatters into the eyes, mouth or on broken skin in the operating theatre.
• Blood is transferred from the injured person to the helper’s mouth during mouth-to-mouth resuscitation.
• A staff member is bitten during resistance against an arrest or at a psychiatric centre.
• A cleaner pricks himself/herself when finding used drug needles in stations, prisons or trains.

If risk analysis shows that employees are at higher risk of sharps incidents, you - the employer - are obliged to implement 5 measures to protect them.

1. Offer employees preventive vaccinations against hepatitis B.
2. Draft procedures for safe processing of contaminated waste materials, such as needles.
3. Provide the necessary aids and protective devices in the workplace so that employees are able to prevent any contact with blood or body fluids, such as gloves and adapted work clothing. A mask and safety glasses are also useful, for example in operating theatres.
4. Carefully monitor that employees comply with the agreed measures.
5. Implement clear reporting and registration procedures of sharps incidents. This should include a no-blame culture: employees must be able to report incidents with impunity.

If staff members do happen to come into contact with blood, take the following actions immediately:

• First aid procedure: in the event of needlestick, sharps or bite incidents, hold the wound under warm running water and leave to bleed as much as possible. Then disinfect using Hibitane (alcohol solution) or HAC (Hospital Antiseptic Concentrate, a cleansing solution) and cover the wound with a sterile dressing. In the event of a splash incident, thoroughly wash the skin with soap. If the blood came into contact with the mouth or eyes, flush with water or a sterile saline solution respectively.
• Blood sampling: inform the direct supervisor immediately and ensure a blood sample is taken within 24 hours at a hospital’s emergency services. This way, the blood can be tested for HIV, hepatitis B and C. The occupational health physician must also be notified within the same timeframe. He or she will decide whether follow-up treatment is required.
• Occupational accident report: complete the occupational accident statement within 24 hours and determine whether the accident was preventable. If yes, take additional prevention measures.
• Determine the serostatus of the source: if possible, test the source for HIV and hepatitis B and C. Are one or more of the viruses detected? If yes, report this to the occupational health physician immediately.

Read more about occupational safety.