Skip to content

Advertisement

Open Access

Occupational infection and needle stick injury among clinical laboratory workers in Al-Madinah city, Saudi Arabia

Journal of Occupational Medicine and Toxicology201813:15

https://doi.org/10.1186/s12995-018-0198-5

Received: 12 February 2018

Accepted: 13 May 2018

Published: 21 May 2018

Abstract

Background

Clinical laboratory workers face biohazard such as needlestick injury and occupational infection on a daily basis. In this study, we examined self-reported frequency of occupational infection and needlestick injury among the clinical laboratory workers in Al- Madinah, Saudi Arabia.

Methods

A total of 234 clinical laboratory workers were recruited from private and government health sectors to answer a self-administered questionnaire that was prepared to achieve the aims of the study.

Results

The results showed that approximately 33% of the sample had an experienced occupational infection while 24% had experienced a needlestick injury. Approximately, 49% reported that they always recap needle after use, whereas 15% reported doing that most of the times. Occupational infection, needlestick injury and recapping needles after use were associated with lack of training on biosafety (P < 0.05).

Conclusion

The frequency of occupational infection and needlestick injury among clinical laboratory workers in Al-Madinah is high. Interventions related to biosafety and infection control and the use of needlestick prevention devices might be useful in lowering such frequency.

Keywords

BiosafetyClinical laboratoryAl-MadinahOccupational infectionNeedlestick

Background

Clinical laboratory workers are subjected daily to occupational hazards that include infections from biological samples and contaminated equipment [1]. For example, literature showed that workers at clinical laboratory are at increased risk of acquiring viral infections such as hepatitis viruses (HBV and HCV), human immunodeficiency viruses (HIV), Middle East Respiratory Syndrome (MERS-CoV), and others [2, 3]. In addition, bacterial occupational infection has been shown to be high among clinical laboratory workers and other health care providers [46]. For example, in a study that was conducted in the United Kingdom, clinical laboratory workers were at about seven times higher risk of acquiring tuberculosis infection in reference to the general population [7].

One of the major sources of infection among health care professionals is needlestick injuries [8, 9]. According to the literature, needlestick injury is responsible for the majority of hepatitis and HIV infections among health care professionals. In addition, the majority of these infections occur in developing countries [10]. Analysis of needlestick injuries showed that injuries could happen during all steps of needle use procedures [8]. However recapping of the needle, work load and lack of training, and not following safety precautions are among major risk factors [1113]. Requiring workers to follow procedures and practices related to infection control, injury prevention and the use of protective equipment can significantly reduce infections and needlestick injury [14, 15].

The aim of the current study is to investigate self-reported frequency of occupational infection and needlestick injury among the clinical laboratory workers in Al- Madinah. In addition, factors that are associated with these incidences were also examined.

AL-Madinah city, the second holiest site in Islam after Mecca, receives more than 10 million pilgrims each year, who come from all the world. The city provides health services to pilgrims and residents through 10 major hospitals and several medical centers. The considerable diversity of patients and heavy load highlight the importance of adopting good practices and safety protection measures to limit the spread of diseases in the city. Therefore, this study was designed to examine the self-reported occurrence of needlestick injuries, safety practices (i.e. recapping), and occupational infection among laboratory workers in Al-Madinah. The results of the current study can be used for interventions that target the enhancement of biosafety measures among Al-Madinah clinical laboratory workers.

Methods

Study participants

A survey-based study design was adapted to investigate the incidence and factors associated with needlestick injury and occupational infection among clinical laboratory workers in Al-Madinah city. Al-Madinah is the second holy city after Mecca in Saudi Arabia that host the Prophet’s Mosque. According to the Statistics Directorate, the population of Al-Madinah is estimated to be close to 1.5 million. The city receives more than 10 million pilgrims each year who came from most world countries.

Clinical laboratory staff from the majority of Al-Madinah clinics (eight private and ten governmental) was invited to be part of the study. Details about the purpose of the study and assurance of confidentiality were presented to participants as part of the recruitment procedure. About 405 participants were invited to fill out the questionnaire among which 234 agreed to participate (58%). The questionnaire was anonymous and self-administered and required about 5–8 min to fill out. This anonymity was a requirement that ensured no possible risks for the participants. To ensure confidentiality, the research team has removed the IP addresses from the data spreadsheet after completion of the recruitment process. The study was approved by the Institutional Review Board of the Faculty of Applied Medical Sciences (ID number: MLT 2016–23).

Study instrument

The questionnaire was prepared from previous studies that examined needlestick injury, occupation safety and factors associated with their incidence [1618]. The questionnaire comprised of 20 items that were presented with a choice of answers. The instrument was subjected to several revisions after comments were received from colleagues at the Department of Medical Laboratory Sciences and a pilot study that involved 20 staff from diagnostic clinical labs. The questionnaire was divided into three parts. The first part gathered information about participants’ age, gender, experience, prior training on biosafety, specialty, academic degree and place of work. The second part focused on needlestick injury and related behaviors such as covering needle after use (re-sheathing or re-capping). In this part, the participants were asked if they have experienced a needlestick injury during their career period. In addition, the participant was asked about frequency of re-capping needles after use. The third part focused on occupational infection and knowledge about disinfection procedures and infection routes. Participants were asked if they have experienced an occupational infection, which was defined as acquiring bacterial or viral infection from work place during their career period. Participants filled the questionnaire electronically using google forms.

Statistical analysis

The SPSS software was used to analyze the data, which was presented as frequencies and number of participants in each category. Chi square test, Fisher Exact test and odd ratios with 95% confidence intervals were used to correlate demographic variables with needlestick and occupational infection. The P value of significance was set at 0.05 threshold.

Results

A total of 234 medical laboratory workers was recruited to participate in the study. The majority (Table 1) of participants were young (57.7%, age range: 18–30), males (62.8%), married (55.6%), belong to governmental clinics (56.4%), bachelor degree holder (71.4%), have a specialty in clinical laboratory sciences (74.4%), works as technicians (60.3%) and received training on laboratory safety (65%). About 40% have less than 3 years of experience, whereas 27.4% have between 4 and 6 years of experience (Table 1). The sample is well distributed according different branches of laboratory sciences that include clinical chemistry (30.3%), hematology (42.3%), histology (11.5%) and microbiology/immunology (15.8%). All participants were vaccinated against HBV as this a requirement by health law in Saudi Arabia before employment in medical laboratories.
Table 1

General characteristics of participants

Variable

Category

Number of subjects

Percentage

Age

18–30

135

57.7%

31–40

70

29.9%

> 40

29

12.4%

Gender

Male

147

62.8%

Female

87

37.2%

Social position

Married

130

55.6%

Single

96

41.0%

Divorced/widowed

8

3.4%

Place of work

Governmental clinics

132

56.4%

Private clinics

102

43.6%

Academic degree

College degrez

30

12.8%

Bachelor degree

167

71.4%

Graduate degree

37

15.8%

Academic Field

Laboratory Sciences

174

74.4%

Applied Biology

25

10.7%

Health Science

19

8.1%

Others

16

6.8%

Assigned work

Clinical chemistry

71

30.3%

Hematology

99

42.3%

Histology/pathology

27

11.5%

Microbiology/ Immunology

37

15.8%

Years of experience

≤ 3

91

38.9%

4–6

64

27.4%

7–10

50

21.4%

> 10

28

12.0%

Position

Residency

50

21.4%

Technician

141

60.3%

Lab director

18

7.7%

Consultant

25

10.7%

Training on Biosafety

Yes

152

65.0%

No

82

35.0%

The results showed that about 24% of the sample had experienced a needlestick injury. The results showed that the needlestick injury was associated with private clinics (P < 0.05) and lack of training on biosafety (Table 2). The participants were asked about capping needle directly after use. Approximately, 49% reported that they always do that, whereas 15% reported doing that most of the times (Table 3). Recapping needle after use, was associated with governmental clinics (P < 0.01), technician/residency staff (P < 0.01) and lack of training (P < 0.05, Table 3). Table 4 shows the incidence of occupational infection among participants. The incidence was about 33% and it was associated with college degrees (P < 0.05) and training on biosafety (P < 0.05, Table 4).
Table 2

Incidence of needle stick injuries among participants

Variable

Category

(Yes) Had needle stick injuries

(NO) Had needle stick injuries

Odd ratio

95% confidence interval

P. value

Age

18–30

32 (57.2%)

103 (57.9%)

 

31–40

18 (32.1%)

52 (29.2%)

1.123

0.60–2.09

0.714

> 40

6 (10.7%)

23 (12.9%)

0.864

0.35–2.08

0.739

Gender

Male

39 (69.6%)

108 (60.7%)

 

Female

17 (30.4%)

70 (39.3%)

0.672

0.37–1.20

0.181

Social status

Married

34 (60.7%)

96 (53.9%)

 

Single

18 (32.1%)

78 (43.8%)

0.643

0.36–1.15

0.139

Divorced/widowed

4 (7.1%)

4 (2.2%)

3.098

0.62–15.5

0.167

Place of work

Governmental clinics

25 (44.6%)

107 (60.1%)

 

Private clinics

31 (55.4%)

71 (39.9%)

1.833

1.04–3.21

0.034

Academic degree

College degree

8 (14.3%)

22 (12.4%)

 

Bachelor degree

38 (67.9%)

129 (72.5%)

0.798

0.34–1.84

0.598

Graduate degree

10 (17.9%)

27 (15.2%)

1.020

0.36–2.88

0.957

Academic Field

Laboratory Sciences

40 (71.4%)

134 (75.3%)

 

Applied Biology

9 (16.1%)

16 (9.0%)

1.877

0.77–4.52

0.159

Health Science

6 (10.7%)

13 (7.3%)

1.452

0.55–3.81

0.449

Others

1 (1.8%)

15 (8.4%)

0.261

0.05–1.28

0.099

Assigned work

Clinical chemistry

15 (26.8%)

55 (30.9%)

 

Hematology

22 (39.3%)

77 (43.3%)

1.041

0.53–2.04

0.906

Histology/pathology

8 (14.3%)

19 (10.7%)

1.460

0.56–3.75

0.431

Microbiology/Immunology

10 (17.9%)

27 (15.2%)

1.377

0.58–3.24

0.464

Years of experience

≤ 3

16 (28.6%)

75 (42.1%)

 

4–6

18 (32.1%)

46 (25.8%)

1.782

0.88–3.59

0.106

7–10

17 (30.4%)

33 (18.5%)

2.286

0.92–4.81

0.062

> 10

4 (7.1%)

24 (13.5%)

0.724

0.26–2.01

0.536

Position

Residency

14 (25.0%)

36 (20.2%)

 

Technician

32 (57.1%)

109 (61.2%)

0.747

0.37–1.49

0.408

Lab director

7 (12.5%)

(6.2%)11

1.733

0.56–5.37

0.341

Consultant

3 (5.4%)

22 (12.4%)

0.333

0.10–1.10

0.072

Training on Biosafety

Yes

29 (51.8%)

123 (69.1%)

 

No

(48.2%) 27

(30.9%) 55

2.054

1.15–3.66

0.014

Table 3

Covering needle directly after use as reported by participants expressed as number of participants (%)

Variable

Category

Always

Most Times

Neutral

Sometimes

Never

P. value

Age

18–30

76 (61.3)

21 (61.8)

26 (48.1)

6 (50.0)

6 (60.0)

0.770

31–40

35 (28.2)

8 (23.5)

18 (33.3)

6 (50.0)

3 (30.0)

> 40

13 (10.6)

5 (14.7)

9 (16.7)

0 (0.0)

1 (10.0)

Gender

Male

80 (64.55)

18 (52.9)

36 (66.7)

8 (66.7)

5 (50.0)

0.610

Female

44 (35.5)

16 (47.1)

18 (33.3)

4 (33.3)

5 (50.0)

Social status

Married

73 (58.9)

18 (52.9)

27 (50.0)

7 (58.3)

5 (50.0)

0.804

Single

46 (37.1)

16 (47.1)

24 (44.4)

5 (41.7)

5 (50.0)

Divorced/widowed

5 (4.0)

0 (0.0)

3 (5.6)

0 (0.0)

0 (0.0)

Place of work

Governmental clinics

79 (63.7)

18 (52.9)

21 (38.9)

5 (41.7)

9 (90.0)

0.004

Private clinics

45 (36.3)

16 (47.1)

33 (61.1)

7 (58.3)

1 (10.0)

Academic degree

College degree

16 (12.9)

7 (20.6)

4 (7.4)

3 (25.0)

0 (0.0)

0.066

Bachelor degree

88 (71.0)

26 (76.5)

41 (75.9)

6 (50.0)

6 (60.0)

Graduate degree

20 (16.1)

1 (2.9)

9 (16.7)

3 (25.8)

4 (40.0)

Academic Field

Laboratory Sciences

87 (70.2)

24 (70.6)

46 (85.2)

10 (83.3)

7 (70.0)

0.631

Applied Biology

14 (11.3)

4 (11.8)

4 (7.4)

1 (8.3)

2 (20.0)

Health Science

10 (8.1)

4 (11.8)

3 (5.6)

1 (8.3)

1 (10.0)

Others

13 (10.5)

2 (5.9)

1 (1.9)

0 (0.0)

0 (0.0)

Assigned work

Clinical chemistry

37 (29.8)

9 (26.5)

15 (27.8)

7 (58.3)

3 (30.0)

0.658

Hematology

50 (40.3)

17 (50.0)

25 (46.3)

3 (25.0)

4 (40.0)

Histology/pathology

14 (11.3)

6 (17.6)

4 (7.4)

2 (16.7)

1 (10.0)

Microbiology/ Immunology

23 (18.5)

2 (5.9)

10 (18.5)

0 (0.0)

2 (20.0)

Years of experience

≤ 3

54 (43.5)

17 (50.0)

12 (22.2)

4 (33.3)

4 (40.0)

0.365

4–6

31 (25.0)

6 (17.6)

18 (33.3)

5 (41.7)

4 (40.0)

7–10

23 (18.5)

8 (23.5)

16 (29.6)

3 (25.0)

0 (0.0)

> 10

15 (12.1)

3 (8.8)

8 (14.8)

0 (0.0)

2 (20.0)

Position

Residency

32 (25.8)

8 (23.5)

10 (18.5)

0 (0.0)

0 (0.0)

0.001

Technician

74 (59.7)

19 (55.9)

37 (68.5)

6 (50.0)

5 (50.0)

Lab director

9 (7.3)

4 (11.8)

3 (5.6)

0 (0.0)

2 (20.0)

Consultant

9 (7.3)

3 (8.8)

4 (7.4)

6 (50.0)

3 (30.0)

Training on biosafety

Yes

69 (55.6)

24 (70.6)

46 (85.2)

7 (58.3)

6 (60.0)

0.024

No

55 (44.4)

10 (29.4)

8 (14.8)

5 (41.7)

4 (40.0)

Table 4

Incidence of occupational infection among participants

Variable

Category

Yes

No

Odd ratio

95% confidence interval

P. value

Age

18–30

47 (60.2%)

88 (56.4%)

 

31–40

23 (29.5%)

47 (30.1%)

0.933

0.50–1.74

0.828

> 40

8 (10.3%)

21 (13.5%)

0.666

0.27–1.62

 

Gender

Male

47 (60.2%)

100 (64.1%)

 

Female

31 (39.7%)

56 (35.9%)

1.185

0.66–2.09

0.560

Social status

Married

43 (55.1%)

87 (55.8%)

 

Single

29 (37.2%)

67 (42.9%)

0.876

0.49–1.55

0.652

Divorced/widowed

6 (7.7%)

2 (1.3%)

7.12

0.84–59.86

0.070

Place of work

Governmental clinics

43 (55.1%)

89 (57.1%)

 

Private clinics

35 (44.9%)

67 (42.9%)

1.084

0.620–1.895

0.775

Academic degree

College degree

17 (21.8%)

13 (8.3%)

 

Bachelor degree

50 (64.1%)

117 (75.0%)

0.310

0.12–0.74

0.009

Graduate degree

11 (14.1%)

26 (16.7%)

0.318

0.10–0.93

0.037

Academic Field

Laboratory Sciences

56 (71.8%)

118 (75.6%)

 

Applied Biology

12 (15.4%)

13 (8.3%)

1.97

0.79–4.94

0.144

Health Science

4 (5.1%)

15 (9.6%)

0.527

0.17–1.61

0.264

Others

6 (7.7%)

10 (6.4%)

1.206

0.41–3.49

0.729

Assigned work

Clinical chemistry

29 (37.2%)

42 (26.9%)

 

Hematology

28 (35.9%)

71 (45.5%)

0.571

0.29–1.10

0.096

Histology/pathology

8 (10.3%)

19 (12.2%)

0.608

0.22–1.61

0.317

Microbiology/ Immunology

13 (16.7%)

24 (15.4%)

0.827

0.35–1.94

0.662

Years of experience

≤ 3

33 (42.3%)

58 (37.2%)

 

4–6

18 (23.1%)

46 (29.5%)

0.675

0.33–1.36

0.272

7–10

15 (19.2%)

35 (22.4%)

0.760

0.35–1.62

0.478

> 10

11 (14.1%)

17 (10.9%)

1.23

0.48–3.10

0.656

Position

Residency

19 (24.4%)

31 (19.9%)

 

Technician

47 (60.3%)

94 (60.3%)

1.400

0.57–3.39

0.457

Lab director

5 (6.4%)

13 (8.3%)

0.750

0.24–2.29

0.613

Consultant

7 (9.0%)

18 (11.5%)

0.751

0.29–1.91

0.546

Training on Biosafety

Yes

42 (53.8%)

110 (70.5%)

 

No

36 (46.2%)

46 (29.5%)

2.085

1.16–3.74

0.013

Figure 1 shows the awareness of participants about disinfection procedures and infection routes. The results showed that the majority of participants reported excellent to very good awareness levels (> 80%).
Figure 1
Fig. 1

Awareness of participants about disinfection procedures and infection routes. A total of 234 participants were included in the study. More than 80% of study sample reported having excellent to very good awareness about disinfection procedures and infection routes

Discussions

In this study, the incidence of occupational infection and needlestick injury among clinical laboratory workers in Al-Madinah city was investigated.

With respect to the self-reported frequency of needlestick injury, approximately 24% of the sample had such experience during their career period. This rate is comparable to what was reported in some previous studies [1618]. For example, an incidence rate of 22.4% sharp injuries over a period of 12 months was reported in a cross-sectional study that was conducted in Dominican Republic [16]. In an Egyptian cross-sectional interview-based study, about 36% of participants reported exposure to at least 1 needlestick injury during the past 3 months [18]. However, higher frequencies (63–73%) were reported in cross-sectional survey-based studies that were conducted in Bosnia [19] and Afghanistan [20] and include the whole career period. Needlestick injuries reported in this study could be due to what was reported by the participants that they always (49%) recap needle after use, whereas 15% reported doing that most of the times. Recapping needle after use was associated technician/residency staff and lack of training. In a Poland study, 64% of respondents occasionally recap needles after injections [21]. In Morocco, 51% reported recapping needles after use [22]. In a review that was conducted by De Carli and colleagues [8], issues related to management of sharp disposals, needle recapping, and the transfer of sampled blood from syringes into tubes account for the majority of needlestick injuries. Thus, behavior of medical staff plays an important in sharp injuries [23]. Needlestick and sharp injuries can be prevented by applying educational and biosafety training programs and needle protective devices [24, 25]. The finding of the present study that needlestick injuries were strongly associated with the lack of training on biosafety and private clinics confirmed the importance of education in reducing sharp injuries in medical laboratories. Finally, the results showed that needledstick injuries were less frequent in governmental clinics and recapping was performed more frequently. Thus, additional factors seem to contribute to needlestick injury, such as workloads and adherence to safety guidelines that are expected to differ in governmental and private clinics. More studies are required to determine the exact factors that contribute to the observed high frequency of needlestick injury among Al-Madinah clinical laboratory workers.

The results showed that approximately 33% of participants experienced occupational infection during their career period. Previous studies have shown increased risk of clinical laboratory workers to diverse types of infection from their work places [26] that include blood borne pathogens (HBV, HCV, HIV), respiratory illnesses (MERS-CoV, influenza viruses, Tuberculosis) [27] and skin infections [28]. In a cross-sectional survey study that was conducted in clinics from 10 Moroccan cities, 58.9% of the subjects underwent at least one occupational blood exposure [22]. The results showed an association between occupational infection and college degree holders and training on biosafety.

The results showed that > 80% of the sample reported very-good to excellent knowledge regarding infection routes and disinfection procedures. Thus, other factors apart from education are likely to play a role in determining incorrect behaviors such as the adherence to infection control guidelines. However, the association between needlestick injury and occupational infection with lack of training on biosafety highlights the importance of training in reducing such biohazards. Previous studies have pointed to the effectiveness of the adherence to infection control guidelines, use of injury prevention devices and biosafety educational programs in the prevention of occupational infection and injury [29, 30].

In this cross-sectional study, we asked the participants if they have ever experienced needlestick injury or occupational infection. To have a better assessment of the current situation, conduction of a longitudinal study is strongly recommended where the incidence of such biohazards can be accurately measured. Inclusion of more questions in the assessment such as how often the participants perform phlebotomy and whether they use needlestick prevention devices are strongly recommended. Other limitations include the validity of key measures such as recall bias and social desirability related to recapping practices, selection bias and the data were not adjusted for confounder factors.

In conclusion, the frequency occupational infection and needlestick injury among clinical laboratory workers in Al-Madinah was relatively high as self-reported by participants. Strict implementation of biohazard guidelines in the health care settings and the use of needlestick prevention devices are recommended to reduce the risk of occupational health infections.

Declarations

Acknowledgments

Authors would like to thank the Clinical Laboratory Sciences Department at Taibah University for their support.

Funding

Taibah University.

Availability of data and materials

The datasets and all materials used during the current study available from the corresponding author on reasonable request.

Authors’ contributions

All authors (OK, KA and WM) contributed to study design, data collection and data analysis/interpretations. OK prepared the first draft of the manuscript and Dr. KA and WM revised the first draft of the manuscript and finalized it. All authors read and approved the final manuscript.

Ethics approval and consent to participate

All participants gave informed consent according to the Research Ethics Committee of the Faculty of Applied Medical Sciences at Taibah University (approval number MLT201623).

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors’ Affiliations

(1)
Department of Clinical Laboratory Sciences, Taibah University, Al-Madinah, Saudi Arabia
(2)
Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan

References

  1. Nathavitharana RR, Bond P, Dramowski A, et al. Agents of change: the role of healthcare workers in the prevention of nosocomial and occupational tuberculosis. Presse Med. 2017;46:e53–62.View ArticlePubMedPubMed CentralGoogle Scholar
  2. Pedrosa PB, Cardoso TA. Viral infections in workers in hospital and research laboratory settings: a comparative review of infection modes and respective biosafety aspects. Int J Infect Dis. 2011;15:e366–76.View ArticlePubMedGoogle Scholar
  3. 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;34:367–75.View ArticlePubMedGoogle Scholar
  4. Auta A, Adewuyi EO, Tor-Anyiin A, et al. Health-care workers' occupational exposures to body fluids in 21 countries in Africa: systematic review and meta-analysis. Bull World Health Organ. 2017;95:831–41F.View ArticlePubMedPubMed CentralGoogle Scholar
  5. Baron EJ, Miller JM. Bacterial and fungal infections among diagnostic laboratory workers: evaluating the risks. Diagn Microbiol Infect Dis. 2008;60:241–6.View ArticlePubMedGoogle Scholar
  6. Joshi R, Reingold AL, Menzies D, Pai M. Tuberculosis among health-care workers in low- and middle-income countries: a systematic review. PLoS Med. 2006;3:e494.View ArticlePubMedPubMed CentralGoogle Scholar
  7. Tormey WP, O'Hagan C. Cerebrospinal fluid protein and glucose examinations and tuberculosis:will laboratory safety regulations force a change of practice? Biochem Med (Zagreb). 2015;25:359–62.View ArticleGoogle Scholar
  8. De Carli G, Abiteboul D, Puro V. The importance of implementing safe sharps practices in the laboratory setting in Europe. Biochem Med (Zagreb). 2014;24:45–56.View ArticleGoogle Scholar
  9. Marini MA, Giangregorio M, Kraskinski JC. Complying with the occupational safety and health Administration's Bloodborne pathogens standard: implementing needleless systems and intravenous safety devices. Pediatr Emerg Care. 2004;20:209–14.View ArticlePubMedGoogle Scholar
  10. Sabermoghaddam M, Sarbaz M, Lashkardoost H, et al. Incidence of occupational exposure to blood and body fluids and measures taken by health care workers before and after exposure in regional hospitals of a developing country: a multicenter study. Am J Infect Control. 2015;43:1137–8.View ArticlePubMedGoogle Scholar
  11. Gabriel J. Reducing needlestick and sharps injuries among healthcare workers. Nurs Stand. 2009;23:41–4.View ArticlePubMedGoogle Scholar
  12. Matsubara C, Sakisaka K, Sychareun V, Phensavanh A, Ali M. Prevalence and risk factors of needle stick and sharp injury among tertiary hospital workers, Vientiane, Lao PDR. J Occup Health. 2017;59:581–5.View ArticlePubMedPubMed CentralGoogle Scholar
  13. Motaarefi H, Mahmoudi H, Mohammadi E, Hasanpour-Dehkordi A. Factors associated with Needlestick injuries in health care occupations: a systematic review. J Clin Diagn Res. 2016;10:IE01–4.PubMedPubMed CentralGoogle Scholar
  14. Glenngard 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;41:296–302.View ArticlePubMedGoogle Scholar
  15. Tarigan LH, Cifuentes M, Quinn M, Kriebel D. Prevention of needle-stick injuries in healthcare facilities: a meta-analysis. Infect Control Hosp Epidemiol. 2015;36:823–9.View ArticlePubMedGoogle Scholar
  16. Moro PL, Moore A, Balcacer P, et al. Epidemiology of needlesticks and other sharps injuries and injection safety practices in the Dominican Republic. Am J Infect Control. 2007;35:552–9.View ArticlePubMedGoogle Scholar
  17. Qazi AR, Siddiqui FA, Faridi S, et al. Comparison of awareness about precautions for needle stick injuries: a survey among health care workers at a tertiary care center in Pakistan. Patient Saf Surg. 2016;10:19.View ArticlePubMedPubMed CentralGoogle Scholar
  18. Talaat M, Kandeel A, El-Shoubary W, et al. Occupational exposure to needlestick injuries and hepatitis B vaccination coverage among health care workers in Egypt. Am J Infect Control. 2003;31:469–74.View ArticlePubMedGoogle Scholar
  19. Musa S, Peek-Asa C, Young T, Jovanovic N. Needle stick injuries, sharp injuries and other occupational exposures to blood and body fluids among health care workers in a general hospital in Sarajevo, Bosnia and Herzegovina. Int J Occup Saf Health. 2014;4:31–7.View ArticlePubMedPubMed CentralGoogle Scholar
  20. Salehi AS, Garner P. Occupational injury history and universal precautions awareness: a survey in Kabul hospital staff. BMC Infect Dis. 2010;10:19.View ArticlePubMedPubMed CentralGoogle Scholar
  21. Rogowska-Szadkowska D, Stanislawowicz M, Chlabicz S. Risk of needle stick injuries in health care workers: bad habits (recapping needles) last long. Przegl Epidemiol. 2010;64:293–5.PubMedGoogle Scholar
  22. Laraqui O, Laraqui S, Tripodi D, et al. Assessing knowledge, attitude, and practice on occupational blood exposure in caregiving facilities, in Morocco. Med Mal Infect. 2008;38:658–66.View ArticlePubMedGoogle Scholar
  23. Castella A, Vallino A, Argentero PA, Zotti CM. Preventability of percutaneous injuries in healthcare workers: a year-long survey in Italy. J Hosp Infect. 2003;55:290–4.View ArticlePubMedGoogle Scholar
  24. Adams D. Needlestick and sharps injuries: practice update. Nurs Stand. 2012;26:49–57. quiz 58View ArticleGoogle Scholar
  25. Wilburn SQ. Needlestick and sharps injury prevention. Online J Issues Nurs. 2004;9:5.PubMedGoogle Scholar
  26. Wei Q, Li XY, Wang L, et al. Preliminary studies on pathogenic microorganisms laboratory-acquired infections cases in recent years and its control strategies. Zhnghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2011;25:390–2.Google Scholar
  27. Chughtai AA, Seale H, Dung TC, et al. Compliance with the use of medical and cloth masks among healthcare Workers in Vietnam. Ann Occup Hyg. 2016;60:619–30.View ArticlePubMedGoogle Scholar
  28. Duman Y, Yakupogullari Y, Otlu B, Tekerekoglu MS. Laboratory-acquired skin infections in a clinical microbiologist: is wearing only gloves really safe? Am J Infect Control. 2016;44:935–7.View ArticlePubMedGoogle Scholar
  29. Rice BD, Tomkins SE, Ncube FM. Sharp truth: health care workers remain at risk of bloodborne infection. Occup Med (Lond). 2015;65:210–4.View ArticleGoogle Scholar
  30. Trim JC, Elliott TS. A review of sharps injuries and preventative strategies. J Hosp Infect. 2003;53:237–42.View ArticlePubMedGoogle Scholar

Copyright

© The Author(s). 2018

Advertisement