Many workers face the daily risk of injury from skin punctures caused by hypodermic needles and other sharp instruments. If needlestick injuries are a hazard in your workplace, then follow the Action plan for OHS reps to eliminate or reduce the risk.
Action Plan for Health and Safety Representatives
Because the risk of contracting an infectious disease may be high at small exposures, representatives will need to make sure they are effectively consulted throughout the risk assessment, development of procedures to ensure exposure to needlestick injuries is prevented or controlled.
Identify the hazard and assess the risks
- Assess the risk of needlestick injuries for individual tasks. All work areas and tasks should be assessed.
- Determine how many and which workers could be exposed.
- Carry out inspections, observe, evaluate current existing precautions.
- Talk to members of your work group - ask co-workers whether they have found needles, ensure these are reported.
- Gather information about previous needle finds in specific areas.
- Ensure that workers always report needlestick injuries.
- Investigate any past incidents, including first aid, injury and illness and workers compensation records kept by your employer.
Risk Prevention and Control
The vast majority of needlestick injuries are preventable. Some workplaces maintain high safety standards and have put many precautions in place to try to avoid injury. But these procedures alone cannot stop needlestick injuries. The introduction of specially designed safer needles would greatly reduce the current number of injuries.
If needles are used in the workplace, negotiate the use of safer needles. The term 'safer needles' is broad and includes those where the needle retracts into the syringe after use, those that have a protective shield over the needle and some that do not use needles at all.
Other measures to prevent needlestick injuries include:
- Introduction of plastic wheelie bins to replace plastic bags - this measure has significantly reduced sharps injuries to workers where it has been introduced in domestic rubbish collecting;
- Your employer supporting and working with needle exchange programs in the area to ensure that injecting drug users are encouraged to return used needles;
- Developing safer work procedures for specific jobs - for example, drivers putting boards over the seat of returned vehicles in case needles have been placed in the upholstery.
The risk should be controlled in all other circumstances.
What reps should do:
- Negotiate a needlestick policy with your employer which details safe systems of working. The policy should cover such things as: how contact with syringes and sharps can be prevented, the provision of protective clothing and sharps' containers, procedures for disposal and so on.
- Be involved in the development and implementation of safe work practices and procedures, for example, for:
- proper use and disposal of needles, syringes and sharps
- handling of specimens and samples
- cleaning up and disposal of infectious waste
- cleaning of other contaminated materials
- Ensure that the employer provides workers at risk with appropriate equipment such as:
- disposable tongs;
- appropriately strong rubber gloves;
- a sharps disposal container.
- Negotiate an immunisation program for workers at significant risk of infection. (No vaccination is available for hepatitis C or HIV, but vaccination is available for hepatitis B and tetanus).
- Ensure that workers can easily report finding needles. Where the source can be clearly identified, it may be possible to give advice on safe disposal. If it is the case that another employer puts workers at risk by careless disposal of needles, then report them to your employer and WorkSafe.
- Ensure the employer provides workers with information, instruction and training. Those who come across needles "incidentally" should be trained in what to do if they find used needles, the risks involved and the reasons for any precautions. Training should explain the levels of risk and how the procedures and control measures will reduce that risk.
- Ensure that all incidents regarding discarded needles and needlestick injuries are reported, recorded and investigated.
- Ensure that the employer, in consultation with the reps and workers, regularly monitors and evaluates all control measures.
Post- Exposure Procedure
Counselling and periodic monitoring should be offered to any of your members who sustains a needlestick injury. In counselling they should be informed as to the risk of transmission and the risk of disease development. Such counselling should also inform them about the disease's likely means of action, and steps they can take to either identify or control problems that arise out of disease activity. An occupational physician should provide advice on post exposure testing and treatment. In most cases it should be possible for a person to continue to work normally if they are able to do so, even if an infectious disease is contracted. Minor modifications may be appropriate depending on the actual local conditions and the disease in question.
The employer has a duty under the Victorian Occupational Health and Safety Act (2004) to provide and maintain for employees, as far as is reasonably practicable, a working environment that is safe and without risks to health. This includes providing safe plant, a safe system of work, information, training, supervision, and where appropriate personal protective equipment. The employer also has the duty to monitor conditions at the workplace and to monitor the health and safety of employees.
Further, under the
Public Health and Wellbeing Act (2008) and Regulations (2009) there
is a requirement for medical practitioners and others to notify the
government health authorities of a large number of infectious diseases,
including diseases such as hepatitis, Q fever, Tuberculosis, Legionella
and others occurring in an occupational environment. This is due to the
high risks to public health in general. The purpose is to ensure that
the department takes immediate steps to identify the sources of
infection and implement necessary action.
(Note: these regulations replaced a number of older regulations including the Health (Infectious Diseases) regulations).
20 different pathogens (viruses, bacteria etc) can be transmitted from infected people to workers via needles. Three are particularly hazardous: Hepatitis B and C (which can lead to liver disease and cancer) and HIV (which can lead to the development of AIDS). Campaigning on the part of unions has raised awareness of this problem.
What are the health effects of needlestick injuries?
A worker sustaining a needlestick injury may become infected by a virus or develop another blood-borne condition. The health effects of these vary according to the disease (see the specific Hazard sheets for more information). Further, given that there is often a time lag between the injury, the test and the results of the test, the worker is also subjected to high levels of stress, not knowing whether or not he has in fact contracted a disease.
Four UK health workers have died after being injured with needles used on patients infected with HIV, according to official figures released in October 2003. Another nine are living with HIV after suffering similar needlestick injuries while working in the National Health Scheme. Hundreds of incidents are reported every year.
Who is at risk?
Examples of situations where risk of needlestick injuries exists:
|Site||People most at risk|
|Hospitals, medical centres, nursing homes||Nursing and other medical staff, cleaners|
|Accident scenes||Ambulance officers|
|Toilets (including bins)||Cleaners, waste handlers|
|Rubbish bins and bags||Cleaners|
|Temporary accommodation - hotels/motels/homes (eg in mattresses, lounges, rubbish)||Cleaners, housekeeping staff, care workers|
|Disused/vacant buildings||Building, caretaking workers and contractors, cleaners|
|Parks||Gardeners, municipal workers and contractors, children|
|Lift wells||Maintenance workers|
|Stolen cars, hire cars||Recovery drivers, police, employees of car hire companies|
|Sewers, gullies||Sewerage and cleaning workers|
|School playing areas||Teachers, site supervisors, cleaners, gardeners, students|
|Post boxes||Postal workers|
|Bedding, clothing, hospital laundry||Laundry/dry cleaning workers|
|Concealed on person||Police, prison, customs officers|
|Beaches||Life guards, members of the public|
|Public transport||Drivers, conductors, cleaners and passengers|
|Public playgrounds||Municipal workers, contractors, children|
- Other information pages in the Infectious diseases section of this site, including Hepatitis A, B & C, HIV/AIDS, etc.
- Clinical guidelines on Needlestick Injuries from the Royal Children's Hospital, Melbourne
- Further information on infectious diseases can be obtained from community and public health offices (for example the Victorian Government Department of Health and Human Services or this information on Needlestick Injuries on the Better Health Channel)
- The UK union Unison poster/leaflet: Needle Safety at Work [pdf] - intended to provide clear straightforward advice to reduce sharps injuries.
- Now archived, but useful for reference purposes: National Code of Practice for the Control of Work Related Exposure to Hepatitis and HIV (blood-borne) Viruses [NOHSC: 2010 (2003)]
- From the UK's HSE: Sharps Injuries a webpage exploring the main risks, who is at risk and more.
- Your union
This Hazard Sheet is based on a section of 'Hazards at Work - TUC Guide to health and safety'.
Last amended June 2018