Needlestick injuries in the operation room of a university hospital in Belgium

Introduction
In Europe, it is estimated that 1.2 million occupational blood exposure accidents (BEA) occur in health care workers (HCW) annually putting them at risk for HBV, HCV, and HIV infection. Few studies have been done in operation rooms (OR), though it could be assumed that the risk is increased due to the intensive use of needles and sharps instruments. The study aimed to estimate the size and evolution of occupational BEA in HCW working in the OR in a University Hospital in Belgium.

Methods
Descriptive analysis of surveillance data during 2002-2008 using the EPINet system.

Results
A total of 1427 BEA (1241 needlestick injuries) were reported in the University Hospital. 347 (28%) of the needlestick injuries occurred in the OR. Nurses reported almost half of the needlestick injuries, surgeons and dentists 25% and support personnel 20%. The source patient was known in 72,3% of the cases. 9,6% of the source patients are infected. One third were primary users of device. Only 18,2% had a sharps container within reach. Most needlestick injuries in the OR occurred during use (42.5%) and removal (35.7%). Two thirds occurred with a surgical instrument. The reported use of safety devices was low.

Discussion
This study shows that needlestick injuries frequently occur in the OR. Prevention should include changing procedures, introduction of safety equipment and the use of alternatives (eg. blunt-tip needles, diathermy, stapling and adhesives). Double gloving can reduce the severity of a needlestick injury. Prevention of needlestick injuries requires a comprehensive strategy. To avoid sharps injuries in the OR, a proper structured approach to prevention is needed. The (Belgian) Superior Health Council has issued guidelines including the universal standard measures and good working practices. Recently, a European Directive was adopted to create a working environment as safe as possible for HCW and to prevent needlestick injuries.