NEEDLE STICK RISK
Hundreds of medical workers become infected with the AIDS or hepatitis
viruses from accidental punctures each year.
By Kathleen F. Phalen - The Washington Post Company
Tuesday, August 11, 1998; Page Z10
Sept. 9, 1992.
Lynda Arnold was working the evening shift at a hospital in
Lancaster, Pa. Just a few months out of nursing school, Arnold
was living her dream of being a critical care nurse.
care unit was lightly staffed that night. And the evening
shift supervisor got called to another floor. Arnold was left
behind to handle the unexpected.
"We got a
critically ill patient who came directly from the outpatient
clinic," she recalls. "There were no doctor’s
orders, and we weren’t sure what was wrong with the patient.
But I knew I had to start an IV catheter. It was standard ICU
She gathered her
supplies, found a good vein in his left arm, near his wrist,
and inserted the catheter. "The patient suddenly moved. .
. . It was violent and he hit my hand, the one that held the
needle," she says, recounting the details that never seem
to fade. "It punctured my latex glove and was thrust into
my left palm."
She walked to
the sink and took off her glove. There was a jagged tear in
her palm and she was bleeding. "I was 23 years old, four
months out of nursing school, working in a 206-bed hospital in
the middle of Amish land," Arnold says, recounting her
early thoughts. "I decided nothing would happen to
discovered that the patient had AIDS. He died two weeks after
the injury. Six months later, she tested positive for the
human immunodeficiency virus (HIV) that causes AIDS.
"As soon as
I walked in the door of the employee health office, I
knew," she says. "I looked at the nurse and she had
tears in her eyes, and I started crying. It was all
injuries are not uncommon. Thousands of health care workers
each year are injected with patients’ blood when needles
that have been used to perform often life-saving procedures
suddenly become virulent projectiles penetrating a palm, a
wrist, a finger, a thigh. Approximately 800,000 U.S. health
care workers will be injured by patient needles this year,
according to estimates used by the federal Centers for Disease
Control and Prevention (CDC).
estimates from the CDC and EPINet—a computer-based
standardized injury tracking system used by about 1,500 U.S.
hospitals—suggest that more than 2,000 of those workers will
test positive for new infections of hepatitis C, another 400
will get hepatitis B and 35 will contract the AIDS virus.
While AIDS is
the most feared infection, hepatitis B and C are also serious
and life-threatening. Both diseases can lead to liver damage,
cirrhosis and cancer. A vaccine is available for hepatitis B,
which has helped reduce the number of health care workers
infected each year from a high of 17,000 in 1983.
But there is no
vaccine for the C virus, which public health officials believe
has infected more than 4 million Americans. "The risk [of
getting hepatitis C from a needle stick] is ten times greater
than HIV," says Robert Ball, an infectious disease/HIV
consultant and epidemiologist for the South Carolina
Department of Health.
workers, the hazard of contracting a potentially fatal disease
is a constant worry. "It’s not going to go away, needle
sticks happen. This is a huge public health threat," says
Arnold, now 29.
With a swipe of
a hand, a careless act or an unexpected bodily jerk, a medical
worker’s life can be forever altered. Considered an
occupational hazard that’s long been worn like a red badge
of courage, this injury remains under-reported and
under-protected, according to public health officials.
up to a million health-care workers receive a needle stick,
and for many it is a death sentence," says Andrew Stern,
international president of Service Employees International
Union, the largest health care workers’ union in the
country, which is campaigning to have all workers use
specially designed safety needles. "It’s an outrage.
This is a preventable crisis. More die of needle sticks than
died in the ValuJet crash, but ValuJet sparked all kinds of
As the crisis
mounts, public health officials are meeting here yesterday and
today at the Frontline Healthcare Workers Conference to
discuss the issue. Charles E. Jeffress, assistant secretary of
labor for OSHA, acknowledged that more research needs to be
done, but said the first step in the process is gathering
information. In the administration’s first public remarks on
the matter, Jeffress said, "OSHA will be issuing a formal
request for information, calling for public comment and
research results. . . . We believe a comprehensive strategy
represents the best approach to preventing needle sticks. But
we’d like to hear from you on the front lines."