Needlestick Injuries in the Era of COVID-19 : Institutional Controls Can Dictate the Safety Culture
By Kelly M . Pyrek
Occupational exposures and sharps-related injuries in the healthcare environment have been perennial challenges for decades , long before the COVID-19 pandemic reframed how clinical care is delivered .
The COVID-19 pandemic – and the requisite increase in the number of vaccinations administered and lines placed in patients — has directed attention toward occupational exposure to contaminated needles , syringes and other sharps that can transmit infection . Two experts say there is a significant opportunity to advance the protection of workers through improved application of industrial hygiene hierarchy of controls . They explain that a greater focus on the institutional controls “ can dictate the safety culture and climate of institutions that roll out COVID-19 vaccination programs , while maintaining careful focus on preventing sharps injuries and blood exposure .”
Despite regulatory efforts and engineering controls , healthcare workers are still at unnecessary risk of needlestick injuries ( NIs ), say Eric Persaud , a doctoral candidate in public health at the Department of Environmental and Occupational Health Sciences at State University of New York-Downstate Health Sciences University , and Amber Mitchell , president and executive director of the International Safety Center .
Occupational exposures and sharps-related injuries in the healthcare environment have been perennial challenges for decades , long before the COVID-19 pandemic reframed how clinical care is delivered . With the enormity of the vaccination efforts currently underway everywhere in the world , the suboptimal occupational exposure rates present a significant concern compounding
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Regulating Sharps Injuries
The Occupational Safety and Health Administration
( OSHA ) Bloodborne Pathogens Standard has been in effect since 1991 , but because of high incidence of ongoing needlesticks reported by employers , in 2000 , the U . S . Congress passed into law the Needlestick Safety and Prevention Act , requiring OSHA to update its standard to include more emphasis on the use of engineering controls — specifically , devices with sharps injury prevention features — for a higher degree of protection . It also included the requirement for more robust injury incident surveillance via the Sharps Injury Log . All workplaces that have employees with occupational exposure to blood or other potentially infectious materials have the minimum requirements to comply with all applicable elements of the Bloodborne Pathogens , Respiratory Protection , and Personal Protective Equipment Standards . The OSHA Bloodborne Pathogens Standard includes precautions such as an employer site-specific exposure control plan which includes worker training . Part of the worker training requires an explanation of appropriate engineering controls , work practices , and personal protective equipment as it relates to preventing or reducing bloodborne pathogen exposure .
Source : Persaud and Mitchell ( 2021 )
the stressors on an already-overburdened healthcare workforce .
“ There have never been robust national surveillance and exposure incident reporting systems for occupational exposure to blood and body fluids ,” says Persaud , who focuses on evaluating and researching training programs related to preparing workers for emergencies and disasters and hazardous workplaces . “ During the current COVID-19 pandemic , focus on preventing exposures