Workplace safety and health training may be used to raise the awareness and skill level of workers , such as healthcare workers facing potential NIs .” to bloodborne pathogens have continued to take a back seat . In addition , fewer publications have continued to publish on the importance of staying focused on preventing occupational HIV and HCV . Given mass vaccination program roll-out across the country — often in non-healthcare settings like pharmacies and convention centers — it is even more important to ensure that workers have the protections in place that they need . These include access to devices with sharps injury prevention features ( engineering controls ), sharps containers , training , and medical care should an exposure occur . One example of how the COVID-19 pandemic , and future infectious disease responses may impact sharps safety includes the possible shortage in supply of Food and Drug Administration ( FDA ) -cleared and Occupational Health and Safety Administration ( OSHA ) -compliant sharps disposal containers . Recently , the Centers for Disease Control and Prevention ( CDC ) published a factsheet on strategies for managers and purchasing agents on how to navigate this issue . The need for production of engineering controls and other control technologies , rather than sacrificing worker health and safety is paramount , not just during COVID-19 but in the preparedness and response of future infectious disease events that require sharps .”
The ongoing occupational risk has been exacerbated by the COVID-19 pandemic , where “ Healthcare workers are facing working conditions such as long hours , staff shortages , and organizational inexperience that may increase the risk of NIs as they continue to care for others and participate in the delivery of the COVID-19 vaccine ,” according to Persaud and Mitchell ( 2021 ) who emphasize that frontline healthcare workers are at nearly 12 times greater risk of COVID-19 infection than the general population in the United States .” ( Nguyen , et al ., 2020 ) They add , “ Burdened with heightened risk of infection during the COVID-19 pandemic , HCWs are additionally facing staff shortages , workplace violence , emotional and psychological toll , stigma and fear of infecting others , inadequate personal protection and lack of hierarchy of controls , and unclear protocols and practices .”
With injuries from hypodermic syringes used for skin injection already the most prevalent type of needlestick according to surveillance data from both the Exposure Prevention Information Network ( EPINet ®) and the Massachusetts Department of Public Health , the mass SARS-CoV-2 vaccination programs currently underway present the potential for a tidal wave of occupational exposures and injuries .
Persaud and Mitchell ( 2021 ) advise that , “ Annual training and education for exposed workers needs to be provided as a forum for engagement and discussion related to new and existing needlesticks can help prepare workers . Needlestick and sharps injury prevention training to develop strategies related to innovative devices can further help HCWs safely use and dispose of needlesticks .”
Mitchell says that with institutional elements in place , workers then need the right tools . “ This includes confidence and competence through training , education , and safer device selection . The Bloodborne Pathogen Standard requires that frontline employees evaluate and select medical devices – in this case – syringes and needles used for vaccination programs . Devices cannot simply be selected by a distribution plan orchestrated by federal government purchasing organizations based on price . Workers need to know how to use a device , safely activate its sharps injury prevention (‘ safety ’) feature and safely dispose of it into a sharps container . Devices must be selected that first and foremost protect workers from needlesticks and not devices made for developing countries that primarily prevent reuse from person to person .”
While variability exists when it comes to how well healthcare institutions educate and train their personnel relating to occupational exposure prevention , Persaud says , “ Ultimately , it is difficult to say how training is applied across industries and occupations as it related to OSHA ’ s Bloodborne Pathogen Standard . However , given that the majority of new mass vaccination sites are in non-healthcare settings , it is crucial that workers who may have less prior experience and training , or who are coming out of retirement to serve , are given access to effective sharps safety training . These community-based settings and those administering programs within them , may not be as familiar with OSHA BPS compliance and need to elicit guidance from local healthcare providers and available national guidance – like NIEHS Worker Training Program . Including these elements lead to confidence in administering COVID-19 vaccinations in a manner that protects both themselves and the public .”
As Persaud and Mitchell ( 2021 ) observe in their paper , “ Workplace safety and health training may be used to raise the awareness and skill level of workers , such as healthcare workers facing potential NIs . The use of other administrative controls , such as policies to address staff shortages which may lead to feelings of urgency and variable work hours , may further address the difficult challenges Healthcare workers are facing , not just during COVID-19 vaccinations , but in their daily working activities . Considering the barriers to implementing policy changes , enhanced worker training is an immediate response within the hierarchy of controls that can increase awareness and skill level needed for safer workplaces .”
Persaud and Mitchell agree that advancing the hierarchy of controls as part of an institution ’ s safety culture – as mandated by the Bloodborne Pathogen Standard — is one of the very best ways to conquer sharps injuries and occupational exposures . Acknowledging the demands placed on healthcare facilities and their workforces , the experts note , “ With the hierarchy of controls , when hazard elimination and substitution are not possible , using engineering and administrative controls is recommended next before the last line of defense — personal protective equipment . Beyond the traditional hierarchy of controls , ‘ institutional controls ’ may help address sharps injury prevention at the highest level . Institutional controls are focused on a culture of safety and full-facility collaboration to support workers with exposure potential to infectious diseases and work-related injuries , such as COVID-19 and NIs . In fact , experts in sharps safety and needlestick prevention posit that institutional controls should sit at the very top of the hierarchy of controls , as they have ‘ the biggest influences on the rest of the program as a whole .’”
Buy-in by all institutional stakeholders is a critical indicator of the success that any occupational health program will experience , and it holds true for upholding the hierarchy of controls .
“ Part of our call to action in advancing the hierarchy of controls is highlight the critical importance of the use of institutional controls . Institutional controls sit at the top of the hierarchy and