Grimmond and Associates, Microbiology Consultants, Hamilton, New Zealand.
Occup Med (Lond). 2019 Aug 22;69(5):352-358. doi: 10.1093/occmed/kqz087.
The 2013 UK sharps safety regulations require healthcare facilities to use safety-engineered devices (SEDs) to protect staff. The recent increase in UK-reported occupational exposures could indicate increased reporting or increased exposures from suboptimal SED use.
To ascertain SED use through examination of sharps container contents in a sample of UK hospitals.
Reusable sharps containers (RSCs) were selected from seven UK hospitals in 2013 and seven different hospitals in 2016. At licensed processing facilities, the operator, wearing protective apparel, decanted RSCs, separated hollow-bore needles (HBNs) from other sharps and enumerated HBNs into capped/uncapped non-SEDs, activated/non-activated/tampered SEDs, and blunt draw-up SEDs. Probability, risk ratios (RRs) and 95% confidence limits (95% CLs) were calculated using WinPepi v2.78.
In 2013 and 2016, respectively, 2545 HBNs were categorized from 22 RSCs versus 2959 HBNs from 33 RSCs; 70% of HBNs were SEDs versus 93% (P < 0.001; RR 1.33; CL 1.30-1.37); 32% of activatable HBNs were not activated versus 22% (<0.001; 0.67; 0.60-0.76); 41% of HBNs were discarded 'sharp' versus 20% (<0.001; 0.48; 0.44-0.52); 25% of HBNs were uncapped needles versus 6% (<0.001; 0.22; 0.19-0.26); 5% of HBNs were capped needles versus 1% (P > 0.05); and 1% of SEDs were tampered with in both years (P > 0.05). Hospital practices varied widely.
SED use and activation have increased significantly since 2013. Of concern is that in 2016, 22% of SEDs were non-activated and 20% of sharps were discarded 'sharp'. Increased training in SED handling, assiduous adherence to safe sharps work practices and a higher level of individual safety-ownership are indicated.
2013 年英国锐器安全法规要求医疗保健机构使用安全工程设备（SED）来保护员工。最近英国报告的职业暴露增加可能表明报告增加或由于 SED 使用不当导致暴露增加。
通过检查英国医院的锐器容器内容物来确定 SED 的使用情况。
2013 年和 2016 年分别从英国的七家医院和七家不同的医院选择可重复使用的锐器容器（RSC）。在许可处理设施中，操作人员穿着防护装备，将 RSC 倾析，将空心针（HBN）从其他锐器中分离出来，并将 HBN 计数为带帽/无帽非 SED、激活/未激活/篡改的 SED 和钝头抽吸 SED。使用 WinPepi v2.78 计算概率、风险比（RR）和 95%置信区间（95%CL）。
2013 年和 2016 年，分别从 22 个 RSC 中分类了 2545 个 HBN，从 33 个 RSC 中分类了 2959 个 HBN；70%的 HBN 是 SED，而 93%（P<0.001；RR 1.33；CL 1.30-1.37）；32%的可激活 HBN 未激活，而 22%（<0.001；0.67；0.60-0.76）；41%的 HBN 丢弃为“锋利”，而 20%（<0.001；0.48；0.44-0.52）；25%的 HBN 是无帽针，而 6%（<0.001；0.22；0.19-0.26）；5%的 HBN 是帽针，而 1%（P>0.05）；并且 2013 年和 2016 年都有 1%的 SED 被篡改（P>0.05）。医院的做法差异很大。
自 2013 年以来，SED 的使用和激活显著增加。令人担忧的是，2016 年有 22%的 SED 未激活，20%的锐器被丢弃为“锋利”。这表明需要加强 SED 处理方面的培训，严格遵守安全锐器工作实践，并提高个人安全意识。
