Skip to main content Accessibility help
×
×
Home

How Much do Needlestick Injuries Cost? A Systematic Review of the Economic Evaluations of Needlestick and Sharps Injuries Among Healthcare Personnel

  • Alice Mannocci (a1), Gabriella De Carli (a2), Virginia Di Bari (a2), Rosella Saulle (a1), Brigid Unim (a1), Nicola Nicolotti (a2), Lorenzo Carbonari (a3), Vincenzo Puro (a2) and Giuseppe La Torre (a1)...
Abstract
OBJECTIVE

To provide an overview of the economic aspects of needlestick and sharps injury (NSI) management among healthcare personnel (HCP) within a Health Technology Assessment project to evaluate the impact of safety-engineered devices on health care

METHODS

A systematic review of economic analyses related to NSIs was performed in accordance with the PRISMA statement and by searching PubMed and Scopus databases (January 1997–February 2015). Mean costs were stratified by study approach (modeling or data driven) and type of cost (direct or indirect). Costs were evaluated using the CDC operative definition and converted to 2015 International US dollars (Int$).

RESULTS

A total of 14 studies were retrieved: 8 data-driven studies and 6 modeling studies. Among them, 11 studies provided direct and indirect costs and 3 studies provided only direct costs. The median of the means for aggregate (direct + indirect) costs was Int$747 (range, Int$199–Int$1,691). The medians of the means for disaggregated costs were Int$425 (range, Int$48–Int$1,516) for direct costs (9 studies) and Int$322 (range, Int$152–Int$413) for indirect costs (6 studies). When compared with data-driven studies, modeling studies had higher disaggregated and aggregated costs, but data-driven studies showed greater variability. Indirect costs were consistent between studies, mostly referring to lost productivity, while direct costs varied widely within and between studies according to source infectivity, HCP susceptibility, and post-exposure diagnostic and prophylactic protocols. Costs of treating infections were not included, and intangible costs could equal those associated with NSI medical evaluations.

CONCLUSIONS

NSIs generate significant direct, indirect, potential, and intangible costs, possibly increasing over time. Economic efforts directed at preventing occupational exposures and infections, including provision of safety-engineered devices, may be offset by the savings from a lower incidence of NSIs.

Infect Control Hosp Epidemiol 2016;37:635–646

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      How Much do Needlestick Injuries Cost? A Systematic Review of the Economic Evaluations of Needlestick and Sharps Injuries Among Healthcare Personnel
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      How Much do Needlestick Injuries Cost? A Systematic Review of the Economic Evaluations of Needlestick and Sharps Injuries Among Healthcare Personnel
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      How Much do Needlestick Injuries Cost? A Systematic Review of the Economic Evaluations of Needlestick and Sharps Injuries Among Healthcare Personnel
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Address correspondence to Gabriella De Carli, MD, Infezioni Emergenti e Riemergenti e Centro di Riferimento AIDS, Department of Epidemiology, Pre-Clinical Research and Advanced Diagnostics, L. Spallanzani National Institute for Infectious Diseases - IRCCS, Via Portuense 292, 00149, Rome, Italy (gabriella.decarli@inmi.it).
References
Hide All
1. Puro, V, De Carli, G, Petrosillo, N, Ippolito, G, Studio Italiano Rischio Occupazionale da HIV Group. Risk of exposure to bloodborne infection for Italian healthcare workers, by job category and work area. Infect Control Hosp Epidemiol 2001;22:206210.
2. PHASE Study Group. Prevention of occupational exposure to biohazard resulting from accidental percutaneous injury (puncture, wound, cut) in the hospital and healthcare sector. Technical overview and recommendations for the transposition and implementation of European Council Directive 2010/32/EU in Italy, 2012.
3. Panlilio, AL, Orelien, JG, Srivastava, PU, et al. EPINet Data Sharing Network. Estimate of the annual number of percutaneous injuries among hospital-based healthcare workers in the United States, 1997–1998. Infect Control Hosp Epidemiol 2004;25:556562.
4. Venier, AG, Vincent, A, L’Heriteau, F, et al. Surveillance of occupational blood and body fluid exposures among French healthcare workers in 2004. Infect Control Hosp Epidemiol 2007;28:11961201.
5. Salzer, HJ, Hoenigl, M, Kessler, HH, et al. Lack of risk-awareness and reporting behavior towards HIV infection through needlestick injury among European medical students. Int J Hyg Environ Health 2011;214:407410.
6. Elder, A, Paterson, C. Sharps injuries in UK health care: a review of injury rates, viral transmission and potential efficacy of safety devices. Occup Med (Lond) 2006;56:566574.
7. Zhang, M, Wang, H, Miao, J, Du, X, Li, T, Wu, Z. Occupational exposure to blood and body fluids among health care workers in a general hospital, China. Am J Ind Med 2009;52:8998.
8. Fica, CA, Jemenao, P MI, Ruiz, R G, et al. Biological risk accidents among undergraduate healthcare students: five years experience. Rev Chilena Infectol 2010;27:3439.
9. De Carli, G, Abiteboul, D, Puro, V. The importance of implementing safe sharps practices in the laboratory setting in Europe. Biochem Med (Zagreb) 2014;24:4556.
10. Tarantola, A, Abiteboul, D, Rachline, A. Infection risks following accidental exposure to blood or body fluids in health care workers: a review of pathogens transmitted in published cases. Am J Infect Control 2006;34:367375.
11. Prüss-Ustün, A, Rapiti, E, Hutin, Y. Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers. Am J Ind Med 2005;48:482490.
12. Centers for Disease Control and Prevention. Recommendations for prevention of HIV transmission in health-care settings. Morb Mortal Wkly Rep 1987;36(Suppl2):1S18S.
13. National Institute for Occupational Safety and Health. A curriculum guide for public-safety and emergency-response workers: prevention of transmission of human immunodeficiency virus and hepatitis B virus. Cincinnati, OH: DHHS Publication No. (NIOSH), 1989; pp. 89–108.
14. Linnemann, CC Jr, Cannon, C, DeRonde, M, Lanphear, B. Effect of educational programs, rigid sharps containers, and universal precautions on reported needlestick injuries in healthcare workers. Infect Control Hosp Epidemiol 1991;12:214219.
15. Lamontagne, F, Abiteboul, D, Lolom, I, et al. Role of safety-engineered devices in preventing needlestick injuries in 32 French hospitals. Infect Control Hosp Epidemiol 2007;28:1823.
16. Tosini, W, Ciotti, C, Goyer, F, et al. Needlestick injury rates according to different types of safety-engineered devices: results of a French multicenter study. Infect Control Hosp Epidemiol 2010;31:402407.
17. Roudot-Thoraval, F, Montagne, O, Schaeffer, A, Dubreuil-Lemaire, ML, Hachard, D, Durand-Zaleski, I. Costs and benefits of measures to prevent needlestick injuries in a university hospital. Infect Control Hosp Epidemiol 1999;20:614617.
18. Needlestick Safety and Prevention Act of 2000. Publication No. 106-430, 114 Stat. 1901; November 6, 2000.
19. Occupational Safety and Health Administration (OSHA). Occupational exposure to bloodborne pathogens; needlesticks and other sharps injuries; Final rule. 29 CFR part 1910. Washington (DC): US Department of Labor; 2001.
20. Occupational Safety and Health Administration (OSHA). OSHA instruction CPL 202.69: enforcement procedures for the occupational exposure to bloodborne pathogens. Washington (DC): OSHA Directorate of Compliance Programs, 2001.
21. Council of the European Union. Council Directive 2010/32/EU of 10 May 2010 implementing the Framework Agreement on prevention from sharp injuries in the hospital and healthcare sector concluded by HOSPEEM and EPSU. Official Journal of the European Union. 2010 (June 1):L 134(53):66–72. Eur-Lex website. http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2010:134:0066:0072:en:pdf. Published 2010. Accessed January 13, 2015.
22. Solano, VM, Hernández, MJ, Montes, FJ, Arribas, JL. Update of the cost of needlestick injuries in hospital healthcare personnel. Gac Sanit 2005;19:2935.
23. Whitby, M, McLaws, ML, Slater, K. Needlestick injuries in a major teaching hospital: the worthwhile effect of hospital-wide replacement of conventional hollow-bore needles. Am J Infect Control 2008;36:180186.
24. O’Malley, EM, Scott, RD, Gayle, J, et al. Costs of management of occupational exposures to blood and body fluids. Infect Control Hosp Epidemiol 2007;28:774782.
25. Oh, HS, Yoon Chang, SW, Choi, JS, Park, ES, Jin, HY. Costs of post-exposure management of occupational sharps injuries in health care workers in the Republic of Korea. Am J Infect Control 2013;41:6165.
26. Liberati, A, Altman, DG, Tetzlaff, J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ital J Public Health 2009;6:354391.
27. Workbook for Designing, Implementing and Evaluating a Sharps Injury Prevention Program, 2008. Centers for Disease Control and Prevention website. http://www.cdc.gov/sharpssafety/pdf/sharpsworkbook_2008.pdf; Published 2008. Accessed January 13, 2015.
28. La Torre, G, Nicolotti, N, de Waure, C, Ricciardi, W. Development of a weighted scale to assess the quality of cost-effectiveness studies and an application to the economic evaluations of tetravalent HPV vaccine. J Public Health 2001;19:103111.
29. Armadans Gil, L, Fernández Cano, MI, Albero Andrés, I, et al. Safety-engineered devices to prevent percutaneous injuries: cost-effectiveness analysis on prevention of high-risk exposure. Gac Sanit 2006;20:374381.
30. Cazzaniga, S, De Carli, G, Sossai, D, Mazzei, L, Puro, V. Il costo delle ferite accidentali e l’impatto dei dispositivi di sicurezza per la prevenzione del rischio di puntura accidentale. Mecosan 2006;58:99116.
31. Glenngård, AH, Persson, U. Costs associated with sharps injuries in the Swedish health care setting and potential cost savings from needle-stick prevention devices with needle and syringe. Scand J Infect Dis 2009;41:296302.
32. Hanmore, E, Maclaine, G, Garin, F, Alonso, A, Leroy, N, Ruff, L. Economic benefits of safety-engineered sharp devices in Belgium—a budget impact model. BMC Health Serv Res 2013;13:489.
33. Jagger, J, Bentley, M, Juillet, E. Direct cost of follow-up for percutaneous and mucocutaneous exposures to at-risk body fluids: data from two hospitals. Adverse Exposure Prevention 1998;3:2534.
34. Lee, WC, Nicklasson, L, Cobden, D, Chen, E, Conway, D, Pashos, CL. Short-term economic impact associated with occupational needlestick injuries among acute care nurses. Curr Med Res Opin 2005;21:19151922.
35. Leigh, JP, Gillen, M, Franks, P, et al. Costs of needlestick injuries and subsequent hepatitis and HIV infection. Curr Med Res Opin 2007;23:20932105.
36. Nidegger, D, Castel, O, Peltier, MP. Assessing the cost of occupational exposures to blood, in a French university hospital. Med Mal Infect 2004;34:2836.
37. Solano Bernad, VM, Rubio Cebrián, S, Hernández Navarrete, MJ, et al. Costs of accidental punctures in hospital health personnel. Gac Sanit 1998;12:2938.
38. U.S. Public Health Service. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR Recomm Rep 2001;50:152.
39. Deuffic-Burban, S, Abiteboul, D, Lot, F, Branger, M, Bouvet, E, Yazdanpanah, Y. Costs and cost-effectiveness of different follow-up schedules for detection of occupational hepatitis C virus infection. Gut 2009;58:105110.
40. Fisman, DN, Mittleman, MA, Sorock, GS, Harris, AD. Willingness to pay to avoid sharps-related injuries: a study in injured health care workers. Am J Infect Control 2002;30:283287.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed