Jason J
Jason and Jarvis Associates, LLC, Hilton Head Island, SC 29928, USA.
J Public Health (Oxf). 2013 Sep;35(3):422-30. doi: 10.1093/pubmed/fdt033. Epub 2013 Apr 3.
The escalating number of persons self-injecting medications, predominantly insulin, has generated concerns that the public is at risk of acquiring blood-borne infections from discarded needles/syringes. Communities have developed disposal guidelines but a debate continues over the need for further legislation and/or at-home safety devices. This study examines the number, characteristics, treatment and costs of community-acquired needlestick injuries (CANSIs).
US-representative CANSI rates and characteristics were derived from 2001-08 National Electronic Injury Surveillance System All Injury Program data on product-related injuries treated at US emergency departments (EDs). CANSI-related medical care was examined using 2003-09 National Hospital Ambulatory Medical Care Surveys, representing all US ED visits. Cost analyses used 2010 Current Procedural Terminology Coding and Medicare rates.
In 2001-08, an estimated 16 677 CANSIs were treated in US EDs, with an associated annual rate of 0.7 per 100 000 US citizens (95% CI 0.6-0.8) and no observable temporal trend. The estimated maximum annual medical cost of ED-treated CANSIs was $9.8 million, or $0.03 per citizen, $1.66 per insulin-injecting person and $0.0018 per insulin injection.
US ED-treated CANSI rates are extremely low. Stricter disposal programs and the at-home use of safety devices do not appear to be needed at this time.
自行注射药物(主要是胰岛素)的人数不断增加,引发了人们对公众因丢弃的针头/注射器而面临血源性感染风险的担忧。各社区已制定了处置指南,但对于进一步立法和/或家用安全装置的必要性仍存在争议。本研究调查了社区获得性针刺伤(CANSIs)的数量、特征、治疗情况及费用。
美国代表性的CANSIs发生率和特征数据来自2001 - 2008年国家电子伤害监测系统全伤害项目,该项目涵盖了在美国急诊科(EDs)接受治疗的与产品相关的伤害数据。使用2003 - 2009年国家医院门诊医疗调查来研究与CANSIs相关的医疗护理情况,该调查代表了美国所有的急诊就诊情况。成本分析采用2010年现行程序术语编码和医疗保险费率。
在2001 - 2008年期间,估计有16677例CANSIs在美国急诊科接受治疗,相关年发生率为每10万美国公民0.7例(95%可信区间0.6 - 0.8),且未观察到明显的时间趋势。急诊科治疗CANSIs的估计最高年度医疗费用为980万美元,即每位公民0.03美元、每位胰岛素注射者1.66美元以及每次胰岛素注射0.0018美元。
美国急诊科治疗的CANSIs发生率极低。目前似乎不需要更严格的处置计划和在家中使用安全装置。