needlesticks

Needlesticks, or needlestick injuries (NSIs), are puncture wounds caused by needles or other sharp medical devices that are contaminated with blood or other potentially infectious fluids. They commonly occur in healthcare settings but can happen in laboratories, waste handling, tattooing, and other occupations that handle needles or sharps.

Pathogens of concern include HIV, hepatitis B (HBV), and hepatitis C (HCV). Transmission risk per exposure varies by pathogen and instrument. HIV transmission is estimated around 0.3% for percutaneous exposure. HBV risk is higher and depends on the vaccination status and whether the source is HBV-positive. HCV transmission risk is about 1–2% on average. Risks are influenced by factors such as needle type, depth of penetration, and whether blood is visible on the device.

Immediate management involves: cleansing the wound with soap and water, not squeezing or bleeding the wound, and reporting the incident to a supervisor or occupational health service. A medical evaluation should determine the need for post-exposure prophylaxis (PEP) for HIV, hepatitis B vaccination or immunoglobulin, and baseline and follow-up testing for HIV, HBV, and HCV. PEP is most effective when started promptly, ideally within hours of exposure.

Prevention focuses on engineering and administrative controls, safe handling practices, and vaccination. Use safety-engineered needles, avoid recapping needles, and dispose of sharps promptly in puncture-resistant containers. Adhere to standard precautions and exposure-control plans, receive HBV vaccination, and ensure access to PEP protocols and post-exposure testing. Education and reporting are essential to reduce NSIs and improve workplace safety. NSIs are largely preventable with proper precautions and prompt management.