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HIV & AIDS Education

Training for Managers, Supervisors and Labor Leaders

Needlestick Injuries

The greatest risk of contact with blood on the job comes from needlestick injuries. Every needlestick injury should be treated as a serious event because of the chance of getting hepatitis B, hepatitis C, or HIV from the used needle contaminated with blood. The risk of infection with HIV following one needlestick exposure is approximately 0.3 percent (i.e, three-tenths of one percent, or about 1 in 300) and ranges from 6 percent to 30 pecent (6%-30%) for HBV and from 1.8% percent (1.8%) for HCV. The majority of needlestick injuries could be prevented if safer-designed syringes and needles were made available to the health care workers who use them. For example, there are needles available today that recap themselves after use, and IV line connections that don't use needles.

In many health care institutions, unions have actively promoted the use of safer needles and other medical devices. Many unions have worked on product and purchasing committees to advocate for the purchase and use of safer equipment.

How can I (or my employees) avoid needlestick injuries?

To avoid needlestick injuries, observe the following safety precautions:

Eliminate the use of needles where safe and effective alternatives are available (you may want to research what these are with your infection control coordinator).
Always put used needles, lancets, scalpels, and razors in a needle disposal box.
Make sure the box is thick enough so sharp objects can't poke through.
Use the box close to the place where needles are used, such as the patient's room.
Replace the box when it has been filled to the indicated safe level.
Never recap, cut, or break needles.

What should I do if I am exposed to the blood of a patient?

Immediately following an exposure to blood:
- Wash needlesticks and cuts with soap and water
- Flush splashes to the nose, mouth, or skin with water
- Irrigate eyes with clean water, saline, or sterile irrigants
No scientific evidence shows that using antiseptics or squeezing the wound will reduce the risk of transmission of a bloodborne pathogen. Using a caustic agent such as bleach is not recommended.
Report the exposure to the department (e.g., occupational health, infection control) responsible for managing exposures. Prompt reporting is essential because, in some cases, postexposure treatment may be recommended and it should be started as soon as possible. Discuss the possible risks of acquiring HBV, HCV, and HIV and the need for postexposure treatment with the provider managing your exposure.

Any labor leader or worker who has concerns or questions is encouraged to call his or her union's health and safety representative. For additional information regarding HIV/AIDS prevention, contact the CDC Business and Labor Resource Service at
1-877-242-9760.

Preventing or Reducing Needlestick Injuries

There are several steps that local unions can take to help prevent or reduce the number of needlestick injuries in a facility. They may include the following:

Find out about the product evaluation or purchasing committee at the facility. These are the committees that usually make decisions about buying new medical equipment for health care workers. If the union is not currently represented on one of these committees, make sure that workers are placed on it.
Develop contract language that gives the union a role in making decisions about buying safer equipment and needles.
Evaluate the safety features of needles, equipment, and other medical devices.
Make sure all needlestick injuries and other exposures to blood are recorded, not just those requiring medical treatment. Record the type of device used, where it was used, and how the injury happened. Information about all incidents is necessary to study injury patterns.
See that all needlestick injuries and other blood exposures are investigated by the health and safety committee or, if there is no committee, by union stewards.
See that all workers receive training and education on universal precautions when they are first hired. All workers should be trained at least annually on universal precautions and infection control.
When new needles and other products are put into use, make sure that workers get training on how to use them properly.

For up-to-date information on occupational exposure to HIV and occupational risk reduction call CDC's Business and Labor Resource Service (BLRS) at
1-877-242-9760 or 1-240-514-2780 (TTY).