Letters to the editor / American Journal of Infection Control 42 (2014) 212-4 animal_interface/influenza_h7n9/05_Report-WebH7N9Number.pdf. Accessed May 16, 2013. 7. Yang P, Wang Q, Pang X, Chen L, Tian L, Deng Y. A case of avian influenza A (H7N9) virus occurring in the summer season, China. J Infect 2013;67:624-5. 8. Huang Y, Wille M, Dobbin A, Robertson GJ, Ryan P, Ojkic D, et al. A 4-year study of avian influenza virus prevalence and subtype diversity in ducks of Newfoundland, Canada. Can J Microbiol 2013;59:701-8. Conflicts of interest: None to report.
Chunyu Tu, MB Lijun Fu, MB Shaoxing Center for Disease Control and Prevention, Shaoxing Zhejiang Province, China Rongxiang Tang, MM Shaoxing County Center for Disease Control and Prevention, Shaoxing Zhejiang Province, China Tingting He, MM Jinkun Chen, MM Yirong Fang, MD Jiling Wang, MB Shaoxing Center for Disease Control and Prevention, Shaoxing Zhejiang Province, China *
Zhaohui Huang, MM Shaoxing Center for Disease Control and Prevention Shaoxing Zhejiang Province, China Chinese Field Epidemiology Training Program, Beijing, China * Address correspondence to Zhaohui Huang, MM, Shaoxing Center for Disease Control and Prevention, Shaoxing, Zhejiang 312071, P. R. China. E-mail address: [email protected] (Z. Huang). http://dx.doi.org/10.1016/j.ajic.2013.10.002
Incidence of needlestick and other sharp object injuries in a Chinese hospital To the Editor: Health care workers (HCWs) are among those at highest risk of occupational infection from biologic factors because they are exposed to human body fluids daily. Every year, hundreds of thousands of HCWs are at risk of occupationally acquired bloodborne diseases as the result of needlestick/sharps injuries (NSI).1,2 In 2009, an online network reporting system for NSI among medical personnel was established in Shanghai, China. The study analyzed the data provided by Shanghai International Forum on Infection Control. All NSI events were reported from the Gongli hospital from July 2009 to August 2013. Gongli is a teaching hospital located in Shanghai, China. This is a 600-bed hospital serving a population of 800,000 inhabitants. The average number of HCWs in the past 4 years is 1,208, including doctors, nurses, diagnostic technicians, and health care staff such as cleaners/housekeepers. A total of 122 NSI have been collected. Nursing personnel, including nurses and nurse students, were most likely to experience NSI. Of 122 NSI, 72.73% were nurses, and 18.04% were doctors, This phenomenon is consistent with the findings from other countries concerning NSI.3 This can be explained by the fact that nurses administer most of the injections and are responsible for venipunctures, intravenous fluid administration, and other
213
Table 1 Analysis of needlestick/sharp injuries by circumstances Incidents, n By needles or sharp instruments before use By needles or sharp instruments in used By needles or sharp instruments in used Recapping needles Pulling out the needle from the rubber or other resistance body By needles or sharp instruments after use, before disposed Injured by needles or sharp instruments left untreated or beside a container During the disposal of instruments in container After disposal, injured by needles or sharp instruments outstretching from the garbage bags or other container Injured by needles or sharp instruments that was left on the floor, tables, beds, or others Others Total
Percentage
1 14 1 1 1
0.82 11.48 0.82 0.82 0.82
90
73.77
1
0.82
3 3
2.46 2.46
1
0.82
6 122
4.92 100
procedures that require the use of needles and the greater amount of time nurses spend in direct patient contact.4 In China, most of the patients go to a third-grade hospital for medical treatment because of the lack of family doctors. HCWs in China work under great pressure. By analysis of NSI by circumstances, we found that about 73.77% of the cases happened between needles/sharps after use and before disposal (Table 1). These values were higher than the data found in other studies.3,5 This is due to Chinese HCWs’ heavy workload, especially for nurses. They have no time to concentrate on the proper disposal of the needles or sharp instruments after use. The situation reveals “management shortcoming” in the hospital, and this special period should be considered in the design of biosafety strategies. In addition, the cleaners are also vulnerable, and 9 incidents of NSI were reported. Furthermore, 97.54% of these incidents are preventable by modifying practices such as recapping or preoccupational/occupational training programs. The finding of this study can increase awareness and reduce the occupational risks from NSI. Because the online network reporting system for sharp injuries among medical personnel in China has just been established in some cities in recent years, further investigations are needed to reduce incidence of NSI in Chinese hospitals. References 1. Stein DD, Makarawo TP, Ahmad MF. A survey of doctors’ and nurses’ knowledge, attitudes and compliance with infection control guidelines in Birmingham teaching hospitals. J Hosp Infect 2003;54:68-73. 2. Nagao Y, Baba H, Torii K, Nagao M, Hatakeyama K, Iinuma Y, et al. A long-term study of sharps injuries among health care workers in Japan. Am J Infect Control 2007;35:407-11. 3. Jahan S. Epidemiology of needlestick injuries among health care workers in a secondary care hospital in Saudi Arabia. Ann Saudi Med 2005;25:233-8. 4. Rampal L, Zakaria R, Sook L. Needle stick and sharps injuries and factors associated among health care workers in a Malaysian Hospital. Eur J Soc Sci 2010;13: 354-62. 5. Shiao JS, Mclaws ML, Huang KY, Guo YL. Student nurses in Taiwan at high risk for needlestick injuries. Ann Epidemiol 2002;12:197-201.
Peiwen Zhang, BS Office of Infection, Gongli Hospital Second Military Medicine University, Pudong New Area Shanghai, China Li Wang, PhD Hongqin Bao, BS Zhongyu Gao, MD* Xiaoping Chen, BS Office of Teaching, Gongli Hospital Second Military Medicine University, Pudong New Area Shanghai, China
214
Letters to the editor / American Journal of Infection Control 42 (2014) 212-4
Denghai Zhang, PhD, MD Department of Laboratory Medicine, Gongli Hospital Second Military Medicine University, Pudong New Area Shanghai, China Ning Jiang, BS Department of Urology, Gongli Hospital Second Military Medicine University, Pudong New Area Shanghai, China
* Address correspondence to Zhongyu Gao, MD No. 219, Miaopu Road, Gongli Hospital Second Military Medicine University Pudong New Area Shanghai 200135, China. E-mail address: [email protected] (Z. Gao). http://dx.doi.org/10.1016/j.ajic.2013.09.010
Chunyu Tu, MB Lijun Fu, MB Shaoxing Center for Disease Control and Prevention, Shaoxing Zhejiang Province, China Rongxiang Tang, MM Shaoxing County Center for Disease Control and Prevention, Shaoxing Zhejiang Province, China Tingting He, MM Jinkun Chen, MM Yirong Fang, MD Jiling Wang, MB Shaoxing Center for Disease Control and Prevention, Shaoxing Zhejiang Province, China *
Zhaohui Huang, MM Shaoxing Center for Disease Control and Prevention Shaoxing Zhejiang Province, China Chinese Field Epidemiology Training Program, Beijing, China * Address correspondence to Zhaohui Huang, MM, Shaoxing Center for Disease Control and Prevention, Shaoxing, Zhejiang 312071, P. R. China. E-mail address: [email protected] (Z. Huang). http://dx.doi.org/10.1016/j.ajic.2013.10.002
Incidence of needlestick and other sharp object injuries in a Chinese hospital To the Editor: Health care workers (HCWs) are among those at highest risk of occupational infection from biologic factors because they are exposed to human body fluids daily. Every year, hundreds of thousands of HCWs are at risk of occupationally acquired bloodborne diseases as the result of needlestick/sharps injuries (NSI).1,2 In 2009, an online network reporting system for NSI among medical personnel was established in Shanghai, China. The study analyzed the data provided by Shanghai International Forum on Infection Control. All NSI events were reported from the Gongli hospital from July 2009 to August 2013. Gongli is a teaching hospital located in Shanghai, China. This is a 600-bed hospital serving a population of 800,000 inhabitants. The average number of HCWs in the past 4 years is 1,208, including doctors, nurses, diagnostic technicians, and health care staff such as cleaners/housekeepers. A total of 122 NSI have been collected. Nursing personnel, including nurses and nurse students, were most likely to experience NSI. Of 122 NSI, 72.73% were nurses, and 18.04% were doctors, This phenomenon is consistent with the findings from other countries concerning NSI.3 This can be explained by the fact that nurses administer most of the injections and are responsible for venipunctures, intravenous fluid administration, and other
213
Table 1 Analysis of needlestick/sharp injuries by circumstances Incidents, n By needles or sharp instruments before use By needles or sharp instruments in used By needles or sharp instruments in used Recapping needles Pulling out the needle from the rubber or other resistance body By needles or sharp instruments after use, before disposed Injured by needles or sharp instruments left untreated or beside a container During the disposal of instruments in container After disposal, injured by needles or sharp instruments outstretching from the garbage bags or other container Injured by needles or sharp instruments that was left on the floor, tables, beds, or others Others Total
Percentage
1 14 1 1 1
0.82 11.48 0.82 0.82 0.82
90
73.77
1
0.82
3 3
2.46 2.46
1
0.82
6 122
4.92 100
procedures that require the use of needles and the greater amount of time nurses spend in direct patient contact.4 In China, most of the patients go to a third-grade hospital for medical treatment because of the lack of family doctors. HCWs in China work under great pressure. By analysis of NSI by circumstances, we found that about 73.77% of the cases happened between needles/sharps after use and before disposal (Table 1). These values were higher than the data found in other studies.3,5 This is due to Chinese HCWs’ heavy workload, especially for nurses. They have no time to concentrate on the proper disposal of the needles or sharp instruments after use. The situation reveals “management shortcoming” in the hospital, and this special period should be considered in the design of biosafety strategies. In addition, the cleaners are also vulnerable, and 9 incidents of NSI were reported. Furthermore, 97.54% of these incidents are preventable by modifying practices such as recapping or preoccupational/occupational training programs. The finding of this study can increase awareness and reduce the occupational risks from NSI. Because the online network reporting system for sharp injuries among medical personnel in China has just been established in some cities in recent years, further investigations are needed to reduce incidence of NSI in Chinese hospitals. References 1. Stein DD, Makarawo TP, Ahmad MF. A survey of doctors’ and nurses’ knowledge, attitudes and compliance with infection control guidelines in Birmingham teaching hospitals. J Hosp Infect 2003;54:68-73. 2. Nagao Y, Baba H, Torii K, Nagao M, Hatakeyama K, Iinuma Y, et al. A long-term study of sharps injuries among health care workers in Japan. Am J Infect Control 2007;35:407-11. 3. Jahan S. Epidemiology of needlestick injuries among health care workers in a secondary care hospital in Saudi Arabia. Ann Saudi Med 2005;25:233-8. 4. Rampal L, Zakaria R, Sook L. Needle stick and sharps injuries and factors associated among health care workers in a Malaysian Hospital. Eur J Soc Sci 2010;13: 354-62. 5. Shiao JS, Mclaws ML, Huang KY, Guo YL. Student nurses in Taiwan at high risk for needlestick injuries. Ann Epidemiol 2002;12:197-201.
Peiwen Zhang, BS Office of Infection, Gongli Hospital Second Military Medicine University, Pudong New Area Shanghai, China Li Wang, PhD Hongqin Bao, BS Zhongyu Gao, MD* Xiaoping Chen, BS Office of Teaching, Gongli Hospital Second Military Medicine University, Pudong New Area Shanghai, China
214
Letters to the editor / American Journal of Infection Control 42 (2014) 212-4
Denghai Zhang, PhD, MD Department of Laboratory Medicine, Gongli Hospital Second Military Medicine University, Pudong New Area Shanghai, China Ning Jiang, BS Department of Urology, Gongli Hospital Second Military Medicine University, Pudong New Area Shanghai, China
* Address correspondence to Zhongyu Gao, MD No. 219, Miaopu Road, Gongli Hospital Second Military Medicine University Pudong New Area Shanghai 200135, China. E-mail address: [email protected] (Z. Gao). http://dx.doi.org/10.1016/j.ajic.2013.09.010
