Supplementary memorandum submitted by
the Safer Needles Network
Further to our submission dated 2 May 2003[10]
enclosing a memorandum with respect to the NAO Report, A Safer
Place to Work, we have now had an opportunity to review the
transcript of the evidence hearing which was posted on the Committee's
website.
At the conclusion of the hearing the Chairman
mentioned part of the memorandum submitted by the Safer Needles
Network as an example which would indicate the potential for serious
consequences which might follow as a result of sero-conversion
to a blood-borne virus such as HIV as a result of a needlestick
injury.
We have sought the expert opinion of the Health
Protection Agency which provided the evidence on which the quoted
element in our memorandum is based on. They have supplied us with
the attached[11]
article from the Public Health Laboratory Service publication,
CDR Weekly dated 1 August 2002. This clearly indicates that there
have been five cases in which transmission occurred in the UK.
There are also 12 probable cases that have been reported in the
UK. These 12 fall into the "probable" category, because
no baseline negative specimen was obtained at the time of the
needlestick injury. The five definite UK transmissions have been
published in national journals.
On another matter in connection with needlestick
injuries Sir Nigel Crisp and Mr Gerry Steinberg had an exchange
about the incidence of needlestick injuries.[12]
Firstly, I would remind you that in relation
to the scale of the problem of needlestick injuries we have estimated
a rate of under-reporting in the range of 60-70% which is in the
same range of 60% as that identified in the NAO Report for all
incidents. I am also very keen to ensure that there is some clarity
about the current state of research in connection with the way
that needlestick injuries occur and therefore what remedial actions
need to be taken to prevent their occurrence. Training is one
of several important components of the solution to the problem.
Data from a study conducted by the Health Protection Agency from
July 1997 to December 2002 shows that the occurrence of exposure
to blood-borne viruses breaks down as follows:
During/After Disposal 16%
After Procedure (before disposal) 21%
Thus, 37% of incidents do not relate to the
actual medical procedure involved and 21% of those are not related
to disposal so there is clearly a proportion of injuries which
do arise where needles have been left lying around. There is therefore
an ongoing need for further procedural or disposal training.
In a parallel surveillance programme, called
EPINet, of needlestick injuries conducted by the RCN, data from
January to June 2002 shows that 57% of injuries occurred to the
original user of the sharp item but 40% did not. In the same period,
26% of needlestick injuries occurred during the procedure, 21%
after use before disposal, 8% placing in disposal, 8% in multi-step
procedure, 7% device left in inappropriate place, 6% dissembling
device and 3% recapping.
Finally in, as yet, unpublished research conducted
by the Scottish Centre for Infection and Environmental Health
for the Scottish Executive, recently presented to the Safer Needles
Network Conference on 22 May in London, out of a total of 1,022
reported sharps incidents:
385 occurred during procedure
101 due to unsafe disposal
In addition, a series of expert panels estimated
that between 40.7% and 52.7% of incidents could have been prevented
if a safety device had been available or used.
The research outlined above informs the Safer
Needles Network in its firm belief that a dramatic reduction in
the incidence of needlesticks can be achieved by the following
combination of actions: implementing proper surveillance
and reporting procedures; a range of preventative measures and
safer working practices; and the adoption of "needle protection"
technologies through the purchase of safety engineered devices
that are made available to all healthcare workers in the place
of work.
We have been working very closely with the Department
of Health over the last couple of years to achieve our objective
of making a significant contribution to reducing the number of
needlestick injuries and we are hopeful that shortly they will
be able to say something more about how they will address all
the issues and actions we have outlined above.
Dr Paul Grime
Chairman
9 June 2003
10 Ev 23-25 Back
11
Not printed. Back
12
Qq 199-202 Back
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