Eye of the needle report 2012 from the Health Protection Agency (HPA)


Intravenous news: The HPA have published the ‘Eye of the needle’ report “This report is an important source of information for health professionals and provides insight into the current burden of occupational exposures to bloodborne viruses and the challenges still to be met in reducing and managing them. The European Union Council Directive on the prevention of sharps injuries in the hospital and healthcare sector requires member countries to provide the safest possible working environment to comply with the Directive by May 2013. The developments presented in this report are therefore timely.


The data collected indicate that:

  • Between 2002 and 2011, 4381 significant occupational exposures were reported (increasing from 276 in 2002 to 541 in 2011).
  • Between 2008 and 2011, there were five hepatitis C virus nosocomial transmissions from patients to healthcare workers following percutaneous exposure injuries; three reported from England and two in Scotland.
  • Even though percutaneous injuries remain the most commonly reported occupational exposures in the healthcare setting, they have decreased over time as a percentage of all exposures (from 79%; 218/276 in 2002 to 67%; 363/541 in 2011), whilst mucocutaneous exposures have shown an increase (from 21%; 58/276 in 2002 to 29%; 159/541 in 2011).
  • The percentage of healthcare workers reporting percutaneous exposures that involved a hepatitis C virus infected source patient has declined from 38% (105/276) in 2002 to 32% (173/541) in 2011.
  • Between 2002 and 2011 most occupational exposures involved nursing professions. Medical and dental professions reported a similar number of occupational exposures as nursing professions in 2011 (231 compared to 237), with exposures in medical and dental professions increasing by 131% (100 to 231) between 2002 and 2011.
  • Seventy two significant occupational exposures reported between 2002 and 2011 involved ancillary staff, a staff group with no direct involvement in patient care; of these, 81% (58/72) were due to percutaneous exposures, with 62% (36/58) of them caused by hollowbore needles. The majority of these exposures were due to non-compliance with standard infection control precautions for the handling and safe disposal of clinical waste.
  • The total number of hepatitis C virus seroconversions in healthcare workers reported between 1997 and 2011 now stands at 20; 17 cases reported in England and three in Scotland. Eight of the cases in England occurred after the immediate procedure and most could have been prevented with adherence to standard infection control precautions for the safe handling and disposal of clinical waste. To date, no cases have been reported from Wales or Northern Ireland.
  • Of healthcare workers exposed to an HIV positive source patient between 2002 and 2011, 78% (1048/1336) began HIV post-exposure prophylaxis (PEP) after sustaining a significant exposure. Of these exposures, a third (34%; 221/645) had commenced HIV PEP within an hour of their exposure and 89% (577) within 24 hours. However, a minority of healthcare workers are remaining on HIV PEP drugs for longer than necessary in cases where the source has been shown to be negative.
  • The last case of an HIV seroconversion in an occupationally exposed healthcare worker was reported in 1999.”

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