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Needlestick injuries in UK health care workers 2


Clinical bottom line

A prospective study in 1992/3 showed significant variability between centres, with half of ancillary workers and 20% of doctors and nurses unvaccinated.


J Smedley et al. Management of sharps injuries and contamination incidents in health care workers: an audit in the Wessex and Oxford regions. Occupational Medicine 1995 45: 273-275.


Prospective data collection on all incidents reported in a nine-month period during 1992/3 to 15 occupational health departments in the Wessex and Oxford regions of the NHS.


There were 1,102 incidents, 115 in doctors, 697 in nurses and 106 in ancillary workers. Rates per 1,000 members of staff per year ranged from 9 to 44 incidents. The proportion of injured staff members who were naturally immune or who had completed a full course of vaccination ranged from 57% to 83%. Half of ancillary staff had not been vaccinated, and one fifth of doctor and nurses had not been vaccinated. Between 26% and 97% (median 68%) of recipients had satisfactory hepatitis B antibody levels (> 100 IU/L).

The between-department range of testing of source sera for hepatitis B ranged from 13% to 68%.


This prospective audit is now a decade old, and many changes have probably been made to improve vaccination and testing. It demonstrates that, when looked for, significant variability in practice can exist.