October 1998 Bulletin

OSHA seeks plan to curb needle-sticks

Charles Jeffress, assistant secretary of labor for Occupational Health and Safety Administration (OSHA), has called for a comprehensive strategy to end the epidemic of accidental needle injuries that is causing hundreds of health care workers every year to suffer potentially fatal infections.

OSHA plans to publish a formal request in the Federal Register for information to help formulate methods to prevent injuries. He is considering suggestions ranging from emergency regulations requiring the use of safety needles to rewriting compliance rules to allow OSHA inspectors to cite hospitals and other health care employers that fail to provide the safety devices to their employees.

Surgeons generally underestimate the risk of seroconversion after exposure to bloodborne pathogens, according to a study in the August issue of the Annals of Surgery.

A survey of 768 surgeons from two universities and two surgical societies found 88 percent reported only slight or moderate concern that they would contract HIV. Vaccination against hepatitis B was more common among surgeons in practice less than seven years.

Among the 605 surgeons who were vaccinated, a higher proportion always or usually used double gloves. Overall, however, only 12% of respondents reported that they always double-glove.

Only 211 of 418 respondents were aware that the seroconversion rate for HIV is 1/300. Only 76 of 536 knew that the hepatitis B seroconversion rate is 1/10, and only 95 of 489 correctly estimated the seroconversion rate for hepatitis C at 1/20.

"More education regarding the risk of exposure and serocoversion rates may increase compliance with protection against bloodborne pathogens," according to J. Megan M. Patterson and colleagues at Washington University School of Medicine, St. Louis, who analyzed the survey questionnaires. "Senior surgeons should be encouraged to use double gloves and to ensure that those on their surgical teams do so as well."

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