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  • Title: The epidemiology of needlestick and sharp instrument accidents in a Nigerian hospital.
    Author: Adegboye AA, Moss GB, Soyinka F, Kreiss JK.
    Journal: Infect Control Hosp Epidemiol; 1994 Jan; 15(1):27-31. PubMed ID: 8133006.
    Abstract:
    OBJECTIVES: To characterize the epidemiology of percutaneous injuries of healthcare workers (HCWs) in Ile-Ife, Nigeria. DESIGN: A cross-sectional survey of a random sample of HCWs regarding details of needlestick and sharp instrument injuries within the previous year. SETTING: University hospital and clinics in Ile-Ife, Nigeria. PARTICIPANTS: Hospital personnel with potential occupational exposure to patients' blood. RESULTS: Needlestick accidents during the previous year were reported by 27% of 474 HCWs, including 100% of dentists, 81% of surgeons, 32% of nonsurgical physicians, and 31% of nursing staff. The rate of needlestick injuries was 0.6 per person-year overall: 2.3 for dentists, 2.3 for surgeons, 0.4 for nonsurgical physicians, and 0.6 for nursing staff. Circumstances associated with needlestick injuries included unexpected patient movement in 29%, handling or disposal of used needles in 23%, needle recapping in 18%, accidental stick by a colleague in 18%, and needle disassembly in 10%. Sharp instrument injuries were reported by 15% of HCWs and most commonly involved broken glass patient specimen containers (39%). Almost all HCWs were aware of the potential risk of HIV transmission through percutaneous injuries, and 91% considered themselves very concerned about their occupational risk of HIV acquisition. CONCLUSIONS: The high frequency of percutaneous exposure to blood among HCWs in this Nigerian hospital potentially could be reduced by simple interventions at modest cost. During the spring of 1991 in Nigeria, 474 health care workers (HCWs) of the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) in Ile-Ife responded to a questionnaire on needlestick and sharp instrument injuries they had experienced in the last year and on their knowledge of HIV transmission. Current HIV seroprevalence at OAUTHC was less than 2%. 97% knew that an HIV-contaminated needlestick or skin penetration with HIV-infected blood could transmit HIV. 91% were very worried about occupational exposure to HIV. Gloves were always available to only 43%. 34% had experienced at least one accidental percutaneous injury due to a needle stick or sharp instrument during the last 12 months. The rate of percutaneous injuries was 0.8 per person-year. 27% (126) reported at least one needlestick injury. The rate of needlestick injury was 0.6 per person-year. 39 HCWs experienced at least 3 needlestick injuries. Dentists, surgeons, and mortuary attendants experienced the most needlestick injuries (100%, 81%, and 60%, respectively). The most common needlestick injuries occurred during suturing (24%), intramuscular injection (23%), and handling or disposal of used needles (23%). Unexpected patient movement (29%), needle recapping (18%), and accidental stick by colleague accounted for needlestick injuries. 15% (69) of HCWs reported at least one sharp instrument injury. 12 HCWs had at least 3 sharp instrument injuries. HCWs most affected by sharp instrument injuries were dental therapists/assistants (42%), dentists (40%), mortuary attendants (40%), surgeons (35%), and laboratory staff (25%). Broken glass containers containing patient specimens (39%), scalpels (32%), and dental instruments (20%) contributed to most injuries by sharp objects. Some possible cost-effective interventions to prevent occupational exposure to HIV among HCWs include educational seminars, preparation of patients before procedures to reduce unexpected patient movement, and infection control committees.
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