What are your chances of getting HIV, or any other disease, from a needle prick on the finger? (The needle had just been used to collect tubes of blood from a patient, set on the table, and pricked you.)
Needlestick injuries are common in health care settings. It's estimated that approximately 800,000 such percutaneous injuries occur each year in the United States. These injuries expose health care workers not only to HIV, but also to other blood-borne pathogens, such as hepatitis B and C, gonorrhea, typhus, herpes, malaria, Rocky Mountain spotted fever, syphilis, and tuberculosis. Approximately 1,000 U.S. health care workers experience infections from accidental needlesticks every year, and according to the American Nurses Association, nearly two thirds of nurse’s report being stuck at some point in their career.
Most needlestick injuries do not involve HIV-infected blood. The Occupational Safety and Health Administration (OSHA) estimates that of the some 800,000 injuries each year, only about 2 percent (approximately 16,000) involve needles that are likely to be contaminated with HIV. Of those 2 percent of needlestick injuries where HIV-infected blood is known to be present, the chance of HIV transmission is estimated to be between 0.3 and 0.45 percent. The risk of transmission may be increased, however, if the needle is visibly bloody, if the procedure involved placing the needle in one of the patient's veins or arteries, or if there was a deep injury. Regardless of the statistics, getting tested for HIV and other blood-borne pathogens can tell you for sure whether or not you've been infected.
Here’s what you can do if you’re a health care worker who has been stuck by a needle:
- Wash the site immediately with soap and hot water.
- Contact your supervisor for support and proper documentation of the incident.
- Have the source patient tested for HIV and hepatitis B and C if you’re unsure about potential infections or if the patient’s medical records are incomplete. If the patient does not consent to testing, get tested immediately and again after six months have passed.
Consider beginning a regimen of post-exposure prophylaxis (PEP) as soon as possible after the prick.
- PEP for HIV: Health care workers usually take zidovudine (AZT) or lamivudine (3TC) within the first two hours after exposure. PEP has the ability to reduce HIV contraction by up to 80%, but approximately half of health care workers on HIV PEP stop treatment early due to negative side effects. Early termination of PEP treatment may considerably reduce the efficacy of this method of infection prevention.
- PEP for hepatitis B: If you’re vaccinated for hepatitis B, PEP is not necessary. If you’re not vaccinated, however, the hepatitis B Immune Globulin (HBIG) injection provides short-term immunity to hepatitis B. Further, initiation of the hepatitis B vaccination series is highly recommended. Hepatitis B PEP is known to reduce infection by approximately 75 percent. If you’re unvaccinated and do not undergo PEP, your risk of transmission is between 6 – 30 percent.
- PEP for hepatitis C: there is no standard PEP procedure for hepatitis C exposure, but inquire with your supervisor and doctor about experimental hepatitis C PEP. Hepatitis C is a serious concern, but probability of infection via needlestick injury is situated between 0 – 7%, so your chances of infection are relatively slim.
- Receive follow-up counseling and ongoing post-exposure treatment until you and your doctor have completed all steps necessary to prevent or treat needlestick infection.
The best way to prevent these types of infections is to learn how to stop needlesticks from happening in the first place. For example, many health care facilities now use safety syringes, which can prevent accidental needlestick injuries among health care professionals by up to 80 percent. Further, with increased needlestick prevention education, this statistic reaches up to 90 percent. By adhering to health care facilities’ procedures and policies about giving injections and using syringes properly (including how and when to discard them), you can make your workplace environment safer and more productive for you and your patients. Talk to your supervisor about specific procedures for your workplace.
If you’re a Columbia student, you may schedule an appointment with Columbia Medical Services on the Morningside campus via Open Communicator for testing, counseling, and treatment. If you’re on the Medical Center campus, try scheduling an appointment with Student Health at 212-854-7426.Alice!