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needlestick injury
Established within the Centers for Disease Control and Prevention (CDC), the National Surveillance System for Healthcare Workers (NaSH) defines a percutaneous injury, or needle-stick injury (NSI), as penetration of skin resulting from a needle or other sharp object, which prior to the exposure was in contact with blood, tissue, or other body fluid.〔The National Surveillance System for Healthcare Workers (NaSH) Summary Report for Blood and Body Fluid Exposure (1995 - 2007). Retrieved October, 2015 from http://www.cdc.gov/nhsn/PDFs/NaSH/NaSH-Report-6-2011.pdf〕 Occupational needle-stick injuries are most prevalent within the healthcare sector.〔Leigh JP, Markis CA, Iosif A, Romano PS. California's nurse-to-patient ratio law and occupational injury. International archives of occupational and environmental health. 2015;88:477.〕 Approximately 80% of all workplace NSI in the US occur among healthcare workers (HCW).〔 Various other occupations are also at increased risk of NSI, including but not limited to law enforcement, laborers, tattoo artists, food preparers, and agricultural workers.〔〔Alamgir H, Yu S. Epidemiology of occupational injury among cleaners in the healthcare sector. Occupational Medicine. 2008;58:393-399.〕 Though the acute physiological effects of a needle-stick injury are generally negligible, the efficiency with which these devices transmit blood-borne diseases place those exposed to occupational NSI at increased risk of contracting infectious diseases, such as hepatitis B (HBV), hepatitis C (HCV), and the human immunodeficiency virus (HIV).〔Tarigan LH, Cifuentes M, Quinn M, Kriebel D. Prevention of needle-stick injuries in healthcare facilities: a meta-analysis. Infection control and hospital epidemiology. 2015;36:823.〕 Among healthcare workers (HCW) & laboratory personnel worldwide, more than 25 blood-borne viruses have been reported associated with NSI.〔
Notwithstanding the potentially significant consequences of inaction, it is estimated that half of all occupational needlestick injuries are not reported.〔Massachusetts Department of Public Health Occupational Health Surveillance Program. (2010) Sharps Injuries among Hospital Workers in Massachusetts, 2010: Findings from the Massachusetts Sharps Injury Surveillance System.〕〔Boden LI, Petrofsky YV, Hopcia K, Wagner GR, Hashimoto D. Understanding the hospital sharps injury reporting pathway. American Journal of Industrial Medicine. 2015;58:282-289.〕 Additionally, an unknown number of occupational NSI are reported by the affected employee, yet due to organizational failure, institutional record of the injury does not exist.〔 Increasing recognition of the unique occupational hazard posed by NSI, as well as the development of efficacious interventions to minimize the largely preventable occupational risk, engendered legislative regulation in the US, precipitating a decline in NSI among HCW.〔Wicker S, Ludwig A, Gottschalk R, Rabenau HF. Needlestick injuries among health care workers: Occupational hazard or avoidable hazard? Wiener klinische Wochenschrift. 2008;120:486-492.〕〔
==Cause==
Needlestick injuries are a common event in the healthcare environment. When drawing blood, administering an intramuscular or intravenous drug, or performing innumerable other procedures involving sharps, accidents transpire, facilitating the transmission of blood-borne pathogens. Injuries also commonly occur during needle recapping or via improper disposal of devices into an overfilled or poorly located sharps container. Lack of access to appropriate personal protective equipment, or alternatively, employee failure to utilize provided equipment, increases the risk of occupational needlestick injuries.() NSI are also at increased risk of ensuing as needles are exchanged between personnel, loaded into a needle driver, or when sutures are tied off while still connected to the needle. Night shifts have demonstrated increased risk of occupational needlestick injuries in the healthcare environment.() A lack of professional experience also demonstrates increased risk. During surgery, a surgical needle or other sharp instrument may inadvertently penetrate the glove and skin of operating room personnel; scalpel injuries tend to be larger than a needlestick. Generally though needlestick injuries cause only minor visible trauma or bleeding; however, even in the absence of bleeding the risk of viral infection remains.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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