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Sharps Disposal and Needlestick Injuries

31/10/2014

WHAT ARE SHARPS?

Although the term ‘sharps’ is frequently used to refer to hypodermic needles, it can also be applied to scalpels, other types of knife, broken glass, broken ceramics and even bone fragments.

Appropriate handling and disposal of sharps is essential to avoid needlestick injuries that can result in serious infection.

This guide outlines some of the risks posed by sharps, how to dispose of them properly and what to do in the event of a needlestick injury.

WHAT ARE THE DANGERS?

Unfortunately needlestick injuries are no longer limited solely to medical environments. As the presence of sharps in our everyday environments increases, so does the risk of infection.
The most serious infections stemming from needlestick injuries are all transmitted through blood or bodily fluid and include:

HEPATITIS B
 
Hepatitis B is a virus that infects the liver and is one of the more common infections to stem from needlestick injuries.

Many people infected with hepatitis B have no symptoms and frequently do not know that they are infected. Occasionally flu like symptoms may develop as well as a slight yellowing of the skin around the eyes (jaundice).

It is possible to protect oneself against possible Hepatitis B infection through a course of vaccines. Speak to your doctor or Occupational Health nurse about these vaccines if you regularly come into contact with sharps at your place of work.

HEPATITIS C

Hepatitis C also infects the liver but unlike hepatitis B, there is no vaccine to protect against infection.

Although signs and symptoms of infection can vary and are often uncommon, they may include:
1. Aching muscles and high temperature
2. Fatigue
3. Nausea & loss of appetite
4. Weight loss
5. Depression
6. Liver pain
7. Mild jaundice
8. Joint pains
9. Poor memory
 
Your doctor can perform a blood test to find out whether you are infected with Hepatitis C. Courses of drug therapy are available that can clear the virus in around 50% of cases.

If you do become infected with hepatitis C, it is essential to limit alcohol intake or cut out alcohol altogether.

HIV

Human Immunodeficiency Virus (HIV) is the virus that causes AIDS, a fatal disease.
There is no vaccine to protect against HIV infection although there are drugs that can reduce the onset of AIDS in some cases.

Although there are some symptoms associated with HIV infection, many people who become infected with the virus do not display any symptoms for many years.The only way to determine whether you are infected is to be tested by a doctor.

SAFE HANDLING & DISPOSAL OF SHARPS

The majority of needlestick injuries occur as a result of inappropriate use of sharps and the methods used to dispose of them.

When handling sharps the following rules should always apply:
1.  Always wear gloves when handling sharps. Wear two pairs of gloves if necessary.
2.  Never pass sharps directly from hand to hand.
3.  Handling should be kept to a minimum. Forceps and grabbing devices should be used wherever possible.
4.  Never re-sheath needles by hand.
5.  Always dispose of sharps at the point of use.
6.  Always dispose of sharps in a suitable container that complies with BS 7320.
7.  Where approved sharps disposal containers are not available, sharps should be placed in an appropriate puncture resistant container with a secure lid or cap.
8.  Never fill containers above the manufacturer’s marked line.
9.  Always lock the container in accordance with the manufacturer’s instructions when ready for disposal.
10.  Never dispose of sharps with other clinical waste.
11.  Never dispose of sharps in yellow clinical waste bags.
12.  Always dispose of syringes and needles as one whole unit.
13.  Always dispose of sharps either by incineration or maceration.

DEALING WITH CONTAMINATED SHARPS IN PUBLIC AREAS

Cases of sharps being disposed of ‘maliciously’ have increased greatly over recent years. This is particularly so with hypodermic needles that are often left in public places and, on occasion, placed deliberately where they will cause injury.

This has vastly increased the dangers of needlestick injury to those involved in tasks such as cleaning and building maintenance in public areas.

The previously outlined guidelines for disposing of sharps can also be applied to contaminated sharps found in public areas.

Precautions should centre on minimising contact with the contaminated object and safe disposal.
1. Specialist kits complete with gloves, disinfectant materials and sharps disposal containers should be made available to individuals who may come into contact with contaminated sharps in their every day work.
2. Reinforced ‘sharps disposal’ gauntlets should always be used when there is a risk that sharps have been deliberately placed where they will cause injury. Common locations where this might occur include underneath banister rails and on top of poster/picture frames.

WHAT TO DO IN THE EVENT OF A NEEDLESTICK INJURY?

In the vast majority of needlestick injuries, it is not known whether the person who used the needle had an infection. The chances of infection from a contaminated needle depend upon a number of factors.

These include:
1. The number of needle users in the area who have an infection.
2. How long the needle was left on the ground.
3. Whether the needle caused a deep injury or a scratch.
4. Whether there was a syringe attached to the needle.
5. Whether the injured party has been vaccinated against possible infection.

If you should receive a needlestick injury
1. Gently squeeze the area around the puncture to encourage it to bleed. DO NOT SUCK THE WOUND
2. Hold the wound under running water for at least 5 minutes. Wash the area with soap and cover with a washproof plaster.
3. Always visit your Doctor or Accident & Emergency Department immediately.
They will be able to advise you on the relevant immunisations.

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