Needlestick injury risk factors in the Philadelphia Fire Department

Background: Few data are available regarding risks of and risk factors for needlestick injuries among firefighter-EMTs and paramedics. Studies are lacking that evaluate detailed databases of fire department populations, or that include clinical data, risk factors or mechanisms of injury. Needlesticks are preventable; prevention is critical to safety and health. We investigated needlestick injuries in the Philadelphia Fire Department (PFD). Methods: Data from 62 needlestick and sharps injuries recorded by the PFD's Infection Control Office [ICO] between September 2001 (when the ICO was established) and November 2010 were analyzed. Information regarding demographics, clinical factors and outcomes, and mechanisms, time and setting of injury were studied. Results: Analysis indicated trends in the data. There were no seroconversions to HIV, hepatitis B, or hepatitis C. Of 62 needlesticks, 46 (74.2%) were clinically significant, 19 (30.4%) were determined preventable. Paramedics had 50 (80.7%) of the injuries. Needlesticks occurred most often on Saturdays, in October and March, at night, and among members with fewer years' experience. The average cost per needlestick injury to the City of Philadelphia was $1317.54. Conclusions: This is the first such detailed study of firefighter-paramedic needlestick exposures, to our knowledge. While no seroconversions to HBV, HCV, or HIV occurred, needlestick injuries remain a serious threat to the health of Philadelphia Firefighter-EMTs and Paramedics. They are also costly. For prevention, a Standard Operating Procedure is being written and implemented as part of the PFD's Exposure Control Manual to reduce the effects of needlesticks and other sharps injuries.