Needle stick injury - a widespread issue

In fact, one milliliter of blood can contain anywhere from 10⁵ up to, in rare cases, 10¹⁴ HIV particles,³ a viral load that could even be higher than the total number of trees on earth (3 trillion).⁴ Globally, job-related sharps injuries are thought to account for about 40% of HBV and HCV infections and 2.5% of HIV infections among healthcare professionals (HCPs).⁵

To reduce the risk of NSIs, the European Union (EU) and the US Occupational Safety and Health Administration (OSHA) have issued guidelines to help protect HCPs from bloodborne diseases.

According to OSHA’s Bloodborne Pathogens standard, safety measures such as “engineering and work practice controls shall be used to eliminate or minimize employee exposure,” which includes using sharps designed with safety features to prevent injury.⁶

In Europe, EU Directive 2010/32 introduced a framework aimed at preventing injuries from sharps for those working in hospitals and healthcare settings.⁷ This requires an assessment to eliminate risks of NSIs. Management of these risks involves supplying medical devices with safety features, safe disposal solutions, and proper training.⁸

The EU-OSHA highlights a study performed at the University Hospital of Heidelberg in Germany for the State Health Office Baden-Wurttemberg.⁹ This controlled study demonstrated a notable reduction in NSIs among those using safety devices over a year-long period.

Passive safety pen needles are the first kind of safety device intended to prevent NSIs when HCPs use injection pens to give medications. An international survey by an independent research firm, to be released in a white paper in September, examines the use of these passive safety pen needles.

The survey, conducted with over 200 HCPs who use passive safety pen needles, confirmed concerns about NSIs and showed that HCPs prefer these safety devices. Four out of five said using a safety pen needle offers more protection against NSIs than a traditional pen needle. Still, most also mentioned practical difficulties in using passive safety needles, which will be discussed further in this paper.

A widespread issue

Sharps injuries happen often among HCPs. For example, in England, cases of exposure to bloodborne viruses increased by 33% from 373 in 2004 to 496 in 2013, despite regulations and the use of passive safety devices. The number of reported needlestick injuries through the skin rose 22% in the same period, from 283 to 344.¹⁰ A systematic literature review noted that, depending on country, environment, and research methods, as many as 69% of HCPs have experienced an NSI.¹ However, a third of European nurses, 38% of trainee doctors, and 52% of surgeons never reported their NSI.^{11, 12} This means the actual number of NSIs is likely higher than reported time.²

NSIs can take place at different stages during injections:^{11, 12} 14% of NSIs in trainee doctors and 30% of those in nurses treating diabetes happened while recapping a needle.^{11, 12} In one French study, injection pens were responsible for 39% of NSIs connected to subcutaneous injections—six times the rate seen with disposable syringes. About 60% of NSIs happened when taking apart the pen, which is also about six times higher than when recapping a syringe.¹³

The physical and psychological burden

A sharps injury can take a toll, both physically² and mentally.^{12, 14} The chance of contracting HBV after a sharps injury is about 1 in 3. The risks for HCV and HIV (1:30 and 1:300, respectively) are lower than for HBV. Regardless, the risk following an NSI is much greater than that from mucosal contact with infected fluids, which is less than 1 in 1,000 for HIV. Many factors impact risk, such as the type of injury, the patient’s viral load, the HCP’s immune status, and local healthcare policies like immediate post-exposure treatment.²

The effects of an NSI go beyond just the physical. A UK study found that 12% of trainee doctors with an NSI showed evidence of post-traumatic stress disorder (PTSD), about four times the rate in the general public.¹² Another study followed 13 individuals with adjustment disorder and four with PTSD referred to a trauma clinic after an NSI. Each month someone waited for clear test results, their psychiatric illness lasted 1.8 months longer. Although none of the HCPs became infected, mental health issues related to the NSI affected their work life, family life, and sexual health.¹⁴

Survey shows unmet needs

As mentioned above, the international survey found that 81% of 204 HCPs agreed that using a safety pen needle improves protection against NSIs when compared to a standard pen needle. Additionally, 83% would rather use safety pen needles than traditional ones.

Still, there are some practical problems when using passive safety needles. Among HCPs who responded, 71% agreed that safety pen needles can activate before the injection is fully administered. Of those, 69% said this early activation made them unsure whether the full medication dose had been delivered.

These findings show that there needs to be a balance between safety and control: 86% of respondents said that both safety and control are equally important in a pen needle during injections.

Work is ongoing to achieve this balance. Owen Mumford, a company recognized for medical device innovation over the past 60 years, is combining world-class research, design, and engineering expertise to develop new ways to further decrease the risk of NSIs, while also giving HCPs better confidence in the accuracy of medication delivery.

About Owen Mumford

Owen Mumford is a leading healthcare company and device producer that markets innovative medical products under its own brands as well as custom device solutions for top pharmaceutical and diagnostic companies around the world. Owen Mumford aims to expand access to diagnostics, support better treatment adherence, and help lower healthcare costs, making a meaningful impact for people everywhere.

By using advanced research with end-users and healthcare professionals, along with extensive design and manufacturing skills, Owen Mumford creates top-tier medical devices used globally, with more than 85% of its products exported to over 60 countries.

Owen Mumford has been chosen as one of The World Economic Forum’s Global Growth Companies and is a trusted partner to many of the world’s biggest diagnostic and pharmaceutical firms.