Diseases caused by needlestick injuries have increased in recent years because of the proliferation of diseases such as hepatitis B and C and HIV in the population.
For every 100 needlestick injuries involving Hepatitis C-positive blood, four result in transmission (four per cent risk). For Hepatitis B needlestick injuries, the risk is 30 per cent (30 in 100) and for HIV the risk is just 0.4 per cent (four in 1000).
- Exposure classifications and risk factors
- Should a person suffer a needle stick injury, the following procedures should be followed:
- Remove contaminated clothing.
- Wash the area gently with soap and running tap water as soon as possible.
- Apply an antiseptic and a clean dressing.
- Place the needle in a rigid plastic container and take it with you to the doctor.
- All staff and students who sustain a sharps injury in which there is any risk of contamination must either attend the University Medical Centre or a general practitioner for assessment, advice and if necessary counselling.
- If a source individual is identified, they should be strongly encouraged to undergo blood testing
- Complete the University’s Confidential Needlestick/Sharps Injury or Exposure to Body Fluid Report and forward to Safety and Health.
Exposure classifications and risk factors
A general practitioner will assess the level of risk to determine further medical management. Please refer to the exposure classifications and the pre-test counselling information sheet for more information. Advice is also available from The Needlestick Hotline on 1800 804 823.
In the case of massive, definite or possible parenteral exposure, the health status of the source individual should be investigated. If the status of the source individual is unknown, the following blood tests should be undertaken from the source following appropriate counselling: HIV antibody, Hepatitis B surface Antigen and Hepatitis C antibody. Testing should not be performed if consent is refused.
The recipient should be assessed and examined to confirm the nature and seriousness of the exposure and counselled about the possibility of transmission of a blood-borne virus.
Treatment for an exposure to possible or definite HIV should begin as soon as possible after exposure. Immediate advice should be sought from the Immunology staff at Royal Perth Hospital, Sir Charles Gairdner Hospital or Infectious Diseases staff at Fremantle Hospital.
Management of exposure to definite or possible Hepatitis B is dependent upon whether the recipient has been previously vaccinated for Hepatitis B or been previously infected with it. When the recipient has not been previously infected and is not immune, Hepatitis B immunoglobulin should be given within 72 hours of injury. A Hepatitis B vaccination should also be administered.
If the source is unable to be identified, any follow-up will depend on the type of exposure, the likelihood of the source being positive for a blood pathogen and the prevalence of blood-borne infections in the community from which the needles or instruments come.
The risk of tetanus should also be determined as the person may require either tetanus immunoglobulin, a course of adult diphtheria and tetanus (ADT) or an ADT booster.