Sharps injuries

A sharps injury is an incident which causes a needle or sharp instrument, such as a scalpel (collectively referred to as ‘sharps’), to penetrate the skin. This is sometimes called a percutaneous injury. If the sharp is contaminated with blood or other body fluid, there is a potential for transmission of infection.

Although rare, injuries from sharps contaminated with an infected patient’s blood can transmit more than 20 diseases, including Hepatitis B, C and human immunodeficiency virus (HIV)

Because of this transmission risk, sharps injuries can worry the many thousands who receive them.

What to do if you receive a sharps injury

If you suffer an injury from a sharp which may be contaminated:

Encourage the wound to gently bleed, ideally holding it under running water
Wash the wound using running water and plenty of soap.
Don’t scrub the wound whilst you are washing it
Don’t suck the wound
Dry the wound and cover it with a waterproof plaster or dressing
Seek urgent medical advice (for example from your Occupational Health Service), as effective prophylaxis (medicines to help fight infection) are available
Report the injury to your employer.

What you need to know

What is the risk?

The main risk is exposure to infections, especially blood-borne viruses (BBV).

Transmission of infection depends on a number of factors, including the person’s natural immune system. We know the number of injuries each year is high, and only a small number are known to have caused infections that become serious illnesses. The blood-borne viruses of most concern are:

Hepatitis B;
Hepatitis C; and
HIV.

Who is at risk?

Workers in health and social care are at risk.

There is a higher risk of infection from a sharps injury involving hollow-bore needles. Higher risk procedures include intra-vascular cannulation, venepuncture and injections and use of IV cannulae, winged steel-butterfly-needles, needles and syringes and phlebotomy needles.

A significant proportion of sharps injuries occur when healthcare workers fail to follow standard precautions. The person who is injured may be another healthcare worker, a support worker or a patient or visitor. These incidents are avoidable, and reducing them is primarily dependant on high quality education, training and monitoring of how staff carry out procedures.

What employers need to do

As an employer, you will need to take action to manage the risks if your workers:

use sharps to provide care or other services to people,
provide care or other services to people who are likely to use sharps,
are involved in handling such equipment after use (eg in waste disposal),
are likely to inadvertently come across used sharps (eg during laundering)

You must undertake a risk assessment. The risk management process will help you, identify the hazards; consider the nature of the work; evaluate the risks; and implement, monitor and review control measures to reduce the risk.

You must:

ensure standard precautions for infection control are in place
ensure all employees, and workers under your control, have information and instruction on safe use of sharps
ensure that suitable clinical waste disposal procedures, including use of sharps containers, are followed
provide access to occupational health advice, and immunisation, where appropriate
have clear procedures for response to sharps injury, including speedy access to appropriate prophylaxis treatments
record work-related sharps injuries in your accident book and report to HSE an infection to an employee if it is reliably attributable to their work
report to HSE if the sharp causing injury is known to present an infection risk.

Sharps with safety engineered mechanisms

A range of sharp medical instruments/devices are now available that are designed to be safer to use. There is evidence that their use can reduce the incidence of injuries to healthcare workers, when combined with appropriate training and safe working practices. Where it is reasonably practicable to reduce injuries to your employees and other workers you should;

replace conventional medical instruments with safer devices; and
if you currently require employees to recap needles, use alternative systems of work and/or use safer devices.

HSE enforcement

In October 2010 the Health and Safety Executive prosecuted an NHS trust after a
healthcare worker contracted the Hepatitis C virus after injuring herself on a
needle used to take blood from an infected patient. The trust was fined £12, 500
plus £9, 000 costs. View press release ‘Hospital fined after health worker infected with Hepatitis C’.