History

Over 20 million dedicated health care providers (HCP) expose themselves to biological, chemical, and mechanical hazards daily. The World Health Organization estimates that approximately three million health care providers are exposed to blood and body fluid due to needle stick or sharps injuries annually. Blood and body fluid exposures have resulted in 57 documented cases of HIV seroconversion among healthcare personnel through 2001. Two thousand workers a year become infected with hepatitis C, and 400 contract hepatitis B. There are more than 20 additional types of infectious agents documented to be transmitted through needle sticks. More than 80% of needle stick injuries are preventable with the use of safe needles.

devices. Legislation has been developed in many countries to protect HCPs by encouraging employers to use best practices to prevent these exposures. Many different protocols for post-exposure management of needle stick injuries or blood and body fluid exposure have been proposed. The effectiveness of a protocol depends on the early initiation of post-exposure management. HIV prophylaxis has the smallest window of time for treatment and has to be initiated as soon as possible, preferably in the first few hours. Hepatitis B immunoglobulin (HBIg) could be given within the first seven days. Healthcare institutions should develop policies and procedures to reduce needle stick injuries by proactively instituting these recommendations, vaccinating all HCP for Hepatitis B (HBV), and incorporating improved engineering controls into a comprehensive needle stick injury prevention program. In this review, we present the historical background, nature, and size of the problem, followed by a review of the state of the art of prevention, clinical management, and corporate responsibilities.