Objectives: To characterize the epidemiology of percutaneous injuries of healthcare workers (HCWs) in Ile-Ife, Nigeria.
Design: A cross-sectional survey of a random sample of HCWs regarding details of needlestick and sharp instrument injuries within the previous year.
Setting: University hospital and clinics in Ile-Ife, Nigeria.
Participants: Hospital personnel with potential occupational exposure to patients' blood.
Results: Needlestick accidents during the previous year were reported by 27% of 474 HCWs, including 100% of dentists, 81% of surgeons, 32% of nonsurgical physicians, and 31% of nursing staff. The rate of needlestick injuries was 0.6 per person-year overall: 2.3 for dentists, 2.3 for surgeons, 0.4 for nonsurgical physicians, and 0.6 for nursing staff. Circumstances associated with needlestick injuries included unexpected patient movement in 29%, handling or disposal of used needles in 23%, needle recapping in 18%, accidental stick by a colleague in 18%, and needle disassembly in 10%. Sharp instrument injuries were reported by 15% of HCWs and most commonly involved broken glass patient specimen containers (39%). Almost all HCWs were aware of the potential risk of HIV transmission through percutaneous injuries, and 91% considered themselves very concerned about their occupational risk of HIV acquisition.
Conclusions: The high frequency of percutaneous exposure to blood among HCWs in this Nigerian hospital potentially could be reduced by simple interventions at modest cost.
PIP: During the spring of 1991 in Nigeria, 474 health care workers (HCWs) of the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) in Ile-Ife responded to a questionnaire on needlestick and sharp instrument injuries they had experienced in the last year and on their knowledge of HIV transmission. Current HIV seroprevalence at OAUTHC was less than 2%. 97% knew that an HIV-contaminated needlestick or skin penetration with HIV-infected blood could transmit HIV. 91% were very worried about occupational exposure to HIV. Gloves were always available to only 43%. 34% had experienced at least one accidental percutaneous injury due to a needle stick or sharp instrument during the last 12 months. The rate of percutaneous injuries was 0.8 per person-year. 27% (126) reported at least one needlestick injury. The rate of needlestick injury was 0.6 per person-year. 39 HCWs experienced at least 3 needlestick injuries. Dentists, surgeons, and mortuary attendants experienced the most needlestick injuries (100%, 81%, and 60%, respectively). The most common needlestick injuries occurred during suturing (24%), intramuscular injection (23%), and handling or disposal of used needles (23%). Unexpected patient movement (29%), needle recapping (18%), and accidental stick by colleague accounted for needlestick injuries. 15% (69) of HCWs reported at least one sharp instrument injury. 12 HCWs had at least 3 sharp instrument injuries. HCWs most affected by sharp instrument injuries were dental therapists/assistants (42%), dentists (40%), mortuary attendants (40%), surgeons (35%), and laboratory staff (25%). Broken glass containers containing patient specimens (39%), scalpels (32%), and dental instruments (20%) contributed to most injuries by sharp objects. Some possible cost-effective interventions to prevent occupational exposure to HIV among HCWs include educational seminars, preparation of patients before procedures to reduce unexpected patient movement, and infection control committees.