If you pierce or puncture your skin with a used needle, follow this first aid advice immediately: You should also seek urgent medical advice as you may need treatment to reduce the risk of getting an infection: Injuries from needles used in medical procedures are sometimes called needle-stick or sharps injuries. Sharps can include other medical supplies, such as syringes, scalpels and lancets, and glass from broken equipment. Once someone has used a needle, viruses in their blood, such as hepatitis B, hepatitis C or HIV, may contaminate it. This includes needles used to inject illegal drugs. Blood can also contaminate sharps. The healthcare professional treating you will assess the risks to your health and ask about your injury – for example, how and when it happened, or who had used the needle. Samples of your blood may need to be tested for hepatitis B and C or HIV. Although rare, there's also a small risk of other infections being transmitted through contaminated blood, such as cytomegalovirus (CMV) and Epstein-Barr virus, which causes glandular fever. Your healthcare professional may also arrange to test samples of the other person's blood if they give their consent. If your healthcare professional thinks you're at low risk of infection, you may not need any treatment. If there's a higher risk of infection, you may need: If there's a high risk of infection with HIV, your healthcare professional may consider treatment called post-exposure prophylaxis (PEP). Your healthcare professional may recommend that you get:
If you injure yourself with a used needle at work, report the incident immediately to your supervisor or manager. Read the answers to more questions about accidents, first aid and treatments.
Page last reviewed: 8 July 2021
Needlestick injuries are wounds caused by needles that accidentally puncture the skin. Needlestick injuries are a hazard for people who work with hypodermic syringes and other needle equipment. These injuries can occur at any time when people use, disassemble, or dispose of needles. When not disposed of properly, needles can hide in linen or garbage and injure other workers who encounter them unexpectedly.
"Sharps" include needles, as well as items such as scalpels, lancets, razor blade, scissors, metal wire, retractors, clamps, pins, staples, cutters, and glass items. Essentially, any object that is able to cut the skin can be considered a "sharp".
These injuries transmit infectious diseases, especially blood-borne viruses. Concern includes the Human Immunodeficiency Virus (HIV) which leads to AIDS (Acquired Immune Deficiency Syndrome), hepatitis B, and hepatitis C. Incidental punctures by contaminated needles can inject hazardous fluids into the body through the skin. There is potential for injection of hazardous drugs, but contact with infectious fluids, especially blood, is by far the greatest concern. Even small amounts of infectious fluid can spread certain diseases effectively. Sharps can create a cut in the skin which allows contact between blood, or fluids. The risk of infection after exposure to infected blood varies by bloodborne pathogen. The Ontario Hospital Association/Ontario Medical Association (2016) estimate that after an injury in workplace situations from a needle contaminated with hepatitis B virus, there is a 6 to 30% chance that an exposed person will be infected. In a similar situation with HIV, there is about a 0.3% chance of infection, and there is about a 1.8% chance of infection for hepatitis C. Note also that because the hepatitis B virus may survive on environmental surfaces for more than a week, indirect exposure can occur via contaminated inanimate objects. Injuries have transmitted many other diseases involving viruses, bacteria, fungi, and other microorganisms to health care workers, laboratory researchers, and veterinarian staff. The diseases include:
Many of these diseases were transmitted in rare, isolated events. They still demonstrate, however, that needlestick and sharps injuries can have serious consequences.
Injuries can occur at every stage of their use, disassembly, or disposal. A report from the Centers for Disease Control and Prevention (CDC) in the United States lists the following percentages for injury rates from a study with data collected from 1995 to 2007: Injuries involving hollow-bore needles:
Injuries involving solid sharps:
Equipment design, nature of the procedure, condition of work, staff experience, recapping, and disposal have all been mentioned as factors that influence these occurrences.
Preventing injuries is the most effective way to protect workers. A comprehensive sharps injury prevention program would include:
The Centre for Communicable Diseases and Infection Control at the Public Health Agency of Canada (PHAC) reviews, publishes, and updates guidelines to protect staff from exposure to all infection causing agents in healthcare settings. The current guideline is titled "Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings". Preventing injuries from sharps and needlesticks is considered a part of the "routine practices" used by healthcare workers. Workers who use sharps require education and training as part of a sharps injury prevention program. Workers should be educated in how to protect themselves during use, and to protect others who may encounter the device during or after procedures. The use of safety-engineered devices such as protected needle devices, or needle-free systems with self-sealing ports and syringes is encouraged. PHAC states that use of such safety devices is required by some jurisdictions. Using these devices must take into consideration both the safety of the health care worker and the patient. PHAC recommends that:
PHAC also refers to the CDC "Workbook for designing, implementing and evaluating a sharps injury prevention program" as an example of a program. This workbook uses a hierarchy of control approach, including: Elimination - find ways to eliminate or reduce needle use during procedures, medication delivery, and specimen collection. Engineering controls - remove or isolate the hazard by using sharps disposal containers or other devices that have an integrated injury prevention feature. Safety devices must be chosen with care as no one device or strategy will work in every situation. Work-practice controls - Steps that can be taken to reduce injuries include using instruments to grasps needles or load/unload scalpels, avoiding hand-to-hand passage of sharps, separating sharps from other waste, not carry garbage or linen bags close to the body, etc. Personal Protective Equipment (PPE) - PPE should be used as the last control approach, where appropriate. In situations where recapping is considered necessary, develop safe approaches which workers can follow. Workers should never move an exposed needle tip towards an unprotected hand. Recap by laying the cap on a flat surface and scoop it onto the tip of a syringe held in one hand. Keep the free hand away from the sheath and well behind the exposed needle. In addition, all workers at risk should be aware that there is a vaccine available for Hepatitis B.
An effective system for disposing of used needles and sharps is crucial to preventing injuries. Have disposal containers readily available. Workers should place needles in wide-mouth, puncture-proof containers. Locate disposal containers specifically where needles and sharps are used to make safe disposal possible. Replace the containers before they are completely filled - sharps containers should be removed and replaced when they are three quarters full. Make sure they are sealed, collected, and disposed of in accordance with local regulations for biomedical waste. All staff should report every incident in which they find needles or sharps left at the bedside or thrown into the regular garbage.
Surveillance programs that provide in-depth analysis of accidents are an important tool for obtaining information. The goals of these programs should include:
Document last updated on July 26, 2018
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When discarding used needles and syringes, which of the following is appropriate nursing action
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