In the name of GOD

* Shahid Beheshti University of Medical Sciences Exposure Risk of Needle Stick and Sharp Devices Injuries: Two Years longitudinal Study in the Main Referral Hospital of TB and HIV TB in Tehran, Iran. (2007) ---------------------------------------------------------------------- Simin Taavoni ** M. Sc in Medical Education, M. Sc in Midwifery, Faculty Member & Researcher staavoni@iums.ac.ir 2- M R. Masjedie. * Professor of Medicine, 3- K. Barzegar * B. Sc in Nursing, 4- H. Haghanie. ** PhD Student of Statistic, 5- Z. Etaatie. * M. Sc. in Community Health, 6- Sh. Nassirie. * B. Sc in Nursing. * Shahid Beheshti University of Medical Sciences ** Iran University of Medical Sciences

Safety practice is an important element of work place safety and quality of health care. Blood and infectious body fluid exposure are common safety problem for health care workers.

Physician, nurses, midwives and other health care workers are at risk of exposures to patients’ blood and body fluids (BBF). Some of these patients may be infected with Hepatitis B (HBV), Hepatitis C (HCV) and the Human immunodeficiency Virus (HIV).

In most of studies Needle stick injuries were the most commonly reported BBF exposure.

* Rivers et al (2003) said: There are approximately 800000 needle sticks per year with the risk of contracting a life-threatening blood borne disease such as HIV and hepatitis C.

Nsubuga and Jaakkola (2005) said: The strongest predictor for needle stick injuries was lack of training. Other important risk factors were related to long working hours, working habits, and experience.

Wilburn (2004) reported: In the United States, needle stick injuries have begun to decrease from an estimated one million exposure per year in 1996 to 385000 per year in 2000. This decline has resulted from the protections afforded by the Occupational safety and Health Administration’s Blood borne Pathogens Standard.

Objective: To analyze the blood and body fluids (BBF) exposure risk and risk factors among employees of main referral hospital of TB and HIV TB in Tehran, Iran during a 2- year period (2005- 2006).

Methods: This is a longitudinal descriptive study, which was done in Massih Daneshvari research and teaching hospital of TB and HIV TB in Tehran. In this main referral hospital 190 nurses, 17 high school practical nurses, 10 operating room technicians, approximately 240 residents…have been employed. 22 BBF cases happened during our two years follow up. Data were analyzed in year 2007.

Results

Table 1: Gender of Samples % No. Gender 36.36 8 Male 63.46 14 Female 100 22 Total

Table 2: Samples` Age Age No. % 25-30 12 54.55 30-35 6 27.27 35-40 2 9.09 40-45 45+ Total 22 100

Level Table 3: Samples` Level of Education Technician Physician % No. 13.64 3 Non Academic 18.18 4 Technician 54.55 12 NURSE Physician 100 22 Total

Table 4: Samples` years of employment % No. year 36.36 8 ≥ 5 50 11 5-10 10-15 4.55 1 15-20 20-25 9.09 2 25-30 100 22 Total

Table 5: Time of injury % No. Time 72.73 16 Morning Sh. 18.18 4 Evening Sh. 9.9 2 Night Sh. 100 22 Total

All samples had been vaccinated against Hepatitis B, 3 times.

The total incidence density of BBF exposures was 2 The total incidence density of BBF exposures was 2.63 per 100 Nurses in year 2005 and 3.68 in year 2006. This rate was 10 and 30 in operating room technicians, 11.76 and Zero in high school practical nurses, 0.82 and 0.42 during these two years. This rate was 1.9 in Hsieh, Chiu, Lee and Haung’s study (Taiwan, 2006)

Needle stick injuries were the most commonly reported BBF exposure, accounting for 72.72% of reported cases, (18.75% of it was because of recapping of needles and happened in year 2005). This rate was 80% in the Hsieh, Chiu, Lee and Haung’s study (2006) and 51% (791) in the Jovic-Vranes, Jankovic, and Vranes (2006) (they had 38% “599” cuts from sharp instruments).

Conclusion & Discussion

In our study 72. 73% was because of Needle stick and 27 In our study 72.73% was because of Needle stick and 27.27% of BBF was because of sharp injuries. Data analysis showed that the greatest among occurred in three groups: group who had 5-10 years job experience, 25-30 years of age, and nurses. In addition 5 hospital workers were injured incidentally due to presence of sharp devices in the Landry and bed linen. These samples were not included in the study, because they were not involved directly with patients.

Some of risk factors are related to long working hours, working habits, and experience. (Nsubuga and Jaakkola, 2005) Most injuries in our study happened in the morning shift (72.73%) compared to night shift (9.9%). This may be due to more working pressure in the morning shift.

In our study the reduction in the needle stick and sharp device injuries could be due to the educational short courses based on universal offered to the personnel.

We need to add that we didn’t see any cases due to recapping of needles in the 2nd year. Finally it is necessary to have a correlation research to find the related factors to sharp device injuries.

سپاسگزارم Thank you Merci Beaucoup Danke schön Graci

Terima Kasih