Sharps Injuries among Healthcare Workers in Massachusetts Emergency Departments

Sharps injuries (SI) represent a significant occupational hazard for healthcare workers (HCW). The risk of SI may be higher in emergency departments (ED) due to a combination of patient (e.g., high patient traffic) and environmental (e.g., compact treatment spaces) factors. Studies examining ED SI rates are few. Therefore, we sought to examine SI rates among HCW in EDs in Massachusetts, 2002 – 2004.

State public health regulations require all hospitals licensed by the Massachusetts Department of Public Health to report sharps injuries among HCW to the MDPH Sharps Injury Surveillance System. Statewide data on 818 SI among HCW in the ED during 2002-2004 as reported by 71 acute care hospitals were examined. There were 13 SI per 100,000 patient visits during this time period. Distribution of injuries by occupation closely matches that of sharps injuries hospital-wide, with most injuries occurring among nurses (44%). Injuries in the ED occurred mostly with devices lacking engineered sharps injury prevention features (48%, 393). Hypodermic needles accounted for 29% (240) of all injuries; 51% of which occurred with devices without injury prevention features. Many injuries occurred during disposal (9%, 71), in addition to during activation of the safety feature (7%, 59) and improper disposal (6%, 53).

Identifying potential risk factors for this setting is useful in developing comprehensive prevention strategies for the ED. These prevention strategies range from modifying hospital purchasing practices to increase the selection and use of devices with injury prevention features to encouraging practitioners to dispose of used sharps promptly and properly.