Needles and Sharps PPE

In the ten years between 2012 and 2022, there were 2,600 claims received for needlestick injuries in the NHS. Of these, 1,947 were successful and ended up costing the NHS £10.8 million in damages and legal costs.

Needlestick injuries expose individuals to bloodborne viruses like hepatitis B, hepatitis C and HIV. Beyond the immediate physical harm, these incidents can have long-term consequences for both employees and employers.

To mitigate these risks, proper Personal Protective Equipment (PPE), rigorous safety procedures and comprehensive training are needed.

UK legislation, including the Health and Safety at Work Act 1974 and the Sharps Regulations 2013, sets clear requirements for the safe handling and disposal of sharps, as well as employer responsibilities in preventing injuries.

In this article, we’ll explore the dangers of needlestick and sharps injuries and the protective measures available, including needle-resistant PPE.

The Dangers of Needles and Sharps

Needlestick and sharps injuries are among the most serious occupational hazards for workers in healthcare, waste management and other high-risk industries. These occur when a needle, scalpel or other sharp object accidentally punctures the skin. The exposes the individual to potential infectious diseases and other complications.

Health Risks of Needlestick and Sharps Injuries

The primary concern with needlestick injuries is the transmission of bloodborne viruses. Contaminated sharps could carry infectious diseases like:

• Hepatitis B (HBV) – This is a highly contagious virus that affects the liver. It can lead to chronic disease or liver cancer.
• Hepatitis C (HCV) – A serious viral infection that can cause long-term liver damage. There is no vaccine available to protect against this.
• Human Immunodeficiency Virus (HIV) – A life-altering infection that weakens the immune system, increasing vulnerability to other diseases.

The risk of infection following a needlestick injury varies by the type of virus. For HBV, it is up to 30% risk if the source is infected and unvaccinated. For HCV, there is a 1.8% risk per injury. For HIV, it is approximately 0.3% risk per exposure. Though the likelihood of contracting HIV from a single needlestick injury is relatively low, the psychological impact of potential exposure can be devastating. Many workers months of uncertainty while undergoing post-exposure testing.

Industries Most at Risk

Certain professions face a significantly higher risk of encountering contaminated sharps, including:

• Healthcare workers – Doctors, nurses, paramedics and laboratory staff frequently handle needles and other sharp medical instruments.
• Waste disposal and recycling staff – Workers sorting through general and clinical waste may unknowingly come into contact with improperly discarded sharps.
• Tattoo artists and body piercers – Exposure to needles is a daily occurrence in these industries, making hygiene and protective measures essential.
• Law enforcement and emergency responders – Officers and paramedics often deal with drug-related paraphernalia or sharp objects in high-risk environments.

Additional Risks Beyond Infection

Apart from the threat of disease, needlestick and sharps injuries can result in:

• – Deep puncture wounds can cause long-term nerve damage or scarring.
• Psychological distress – The fear of contracting a serious illness can lead to anxiety, depression or post-traumatic stress.
• Financial and legal consequences – Employers may face legal claims if they don’t provide PPE, adequate training or disposal facilities.

Understanding Needlestick and Sharps Injuries

Injuries occur when a sharp object like a scalpel, need or even broken glass punctures the skin. These injuries are particularly dangerous because they can expose people to bloodborne pathogens and other contaminants. Understanding how incidents happen is essential for implementing preventative measures.

How Needlestick and Sharps Injuries Occur

They can happen in a variety of workplaces. This is often due to improper handling, disposal or unexpected exposure. Common causes include:

• Incorrect disposal – Failing to place used needles in designated sharps bins can lead to accidental contact.
• Recapping needles – This outdated practice increases the risk of self-injury.
• Handling multiple tasks at once – Distractions or rushing can lead to accidental slips of mishandling of sharp instruments.
• Unexpected movement – Patients or individuals receiving injections may move suddenly, leading to accidental injury.
• Improper waste handling – Workers sorting through rubbish or medical waste can be pricked by improperly discarded needles.
• Reusing disposable sharps – In some cases, attempting to reuse single-use needles or scalpels can lead to breakages and injuries.

Immediate and Long-Term Consequences

A needlestick injury may seem minor at first but it can have serious consequences, both short and long term.

The immediate effects are pain, bleeding and potential exposure to infectious materials. The short-term impact is post-exposure treatment, blood tests and psychological distress while awaiting results. The long-term risks are chronic health issues, medical treatments and, in some cases, life-threatening conditions.

As well as the physical risks, there are often emotional and psychological issues to deal with. The uncertainty surrounding potential infection can lead to anxiety. This affects the person’s wellbeing and ability to work.

Protecting yourself from sharps injuries

Preventing injuries from sharps requires a combination of safe handling, proper disposal, adequate training and appropriate PPE.

Safe Handling Practices

Minimising direct contact with sharps and needles is the first step. Best practices include:

1. Avoiding recapping needles. Instead, they should be disposed of in a designated sharps container.
2. Use needle-safe devices. Many modern medical tools have safety mechanisms like retractable needles or sheathed scalpels. These prevent exposure.
3. Be mindful of surroundings. Needlestick injuries often happen when people are distracted or when they’re working in a confined space. Always stay focused. Don’t rush.
4. Pass sharps safely. If you’re handing a sharp object to a colleague, use a designated transfer tray. Don’t pass it directly by hand.
5. Never reach into bins or containers.

Proper Disposal

Incorrect disposal is a leading cause of needlestick injuries. Always use designated sharps bins and don’t overfill them. In the UK, the bins are colour-coded depending on the type of waste they contain. Sharps bins are yellow when they’re for sharps contaminated with medicine, otherwise they’re orange. It’s important to train staff properly on disposing sharps.

Personal Protective Equipment (PPE)

PPE can’t eliminate the risk but it does provide an additional layer of defence. Essential items of PPE include:

• Needle-resistant gloves – These are made from materials like Kevlar or high-performance polyethylene (HPPE). They provide better protection against punctures.
• Protective clothing – Long-sleeved gowns, aprons and reinforced trousers can help against accidental exposure.
• Foot protection – Safety footwear with puncture-resistant soles can prevent injuries from discarded sharps on the ground.
• Eye and face protection – Safety goggles or face shields can protect against splashes from contaminated fluids when handling sharps.

Workplace Training and Risk Awareness

Employers are responsible for ensuring that their employees receive appropriate training on sharps safety. This should include:

• Correct handling and disposal procedures.
• Emergency response in case of injury.
• Use of PPE and safety devices.
• Compliance with UK health and safety laws.

Regular refresher courses can help reinforce practices to help workers remain vigilant.

What to Do if You Suffer a Sharps Injury

Even despite precautions, accidents still happen. If you experience a sharps injury, these steps are important:

1. Encourage the wound to bleed slightly as this may remove contaminants. Don’t squeeze it.
2. Wash the area with soap and water. Avoid scrubbing.
3. Apply a waterproof dressing to protect it from further exposure.
4. Report the incident and complete a report as per workplace policy.
5. Seek medical advice. You may need post-exposure treatment such as a hepatitis B vaccination or HIV prophylaxis.

Safe Handling and Disposal of Sharps

Sharps should always be handled with caution. Use sharps specific tools to help reduce direct hand contact. This might be retractable needles, sheathed scalpels or forceps. When you’re using the implement, you should avoid unnecessary movements. This will help maintain your control and prevent it from slipping. Recapping, bending or breaking needles should be avoided because they increase the risk of accidental punctures. Finally, don’t leave them on surfaces. As soon as you’ve used them, dispose of them straight away.

UK health and safety regulations determine which bins should be used. The sharps containers themselves are puncture resistant and designed for safe disposal. They should be positioned at eye level and within easy reach of anyone handling sharps.

Here are the different bin colours and what they mean:

• Yellow – Sharps contaminated with medicines.
• Orange – Non-medicinal sharps like blood-stained needles.
• Purple – Sharps contaminated with cytotoxic drugs like those used in chemotherapy.
• Blue – Pharmaceutical waste, including partially used medicines.

Needle-Resistant PPE

PPE is important and although no PPE can provide absolute protection, needle-resistant materials can reduce the chances of punctures.

Needle-resistant PPE is specifically designed to prevent punctures and cute from hypodermic needles, scalpels and other sharp instruments. Their effectiveness depends on the materials, construction and design.

High-performance materials like Kevlar, SuperFabric and high-density polyethylene (HDPE) are common materials. These have puncture-resistant properties. Some PPE items use multiple layers of different materials to absorb and disperse the force of a needle impact. Gloves, sleeves and clothing may also have reinforced areas in high risk zones like fingertips, palms or forearms.

Types of Needle-Resistant PPE

Needle-Resistant Gloves

Gloves are one of the most critical PPE components. Hands are the most exposed to sharps injuries. Needle-resistant gloves:

• Provide a balance between dexterity and protection. Users can handle medical instruments and hazardous materials safely.
• Have double or triple-layer protection but are still flexible.
• Use cut-resistant fibres to prevent needle penetration.
• Come in disposable and reuseable options, depending on the industry.

Needle-Resistant Arm and Body Protection

For workers exposed to frequent sharps handling, protective clothing can minimise risks. This comes in the form of arm guards and sleeves that cover the forearms and wrists. These are common areas for accidental injuries. There are also needle-resistant aprons and gowns for full-torso protection. This are useful in medical, veterinary and emergency response settings.

Puncture-resistant trousers are beneficial in waste collection or prison services where sharps could be hidden.

Foot and Leg Protection

Sharp objects aren’t always at hand level. Workers moving through contaminated areas might come across sharps so puncture-resistant footwear with reinforced soles and uppers and prevent penetration from needles on the ground. Cut-resistant gaiters or shin guards can help those in waste collection, enforcement roles or emergency response situations.

Face and Eye Protection

Though it is rare, sharps injuries can involve splashes of contaminated fluids during handling and disposal. You can get safety glasses and googles if this poses a risk. In high-risk procedures like medical interventions or hazardous waste handling, a full face shield is available.

Choosing Your PPE

When selecting your PPE, you should consider:

• The level of risk.
• Comfort and fit.
• Compliance with UK Safety Standards.

Standards and Regulations for Sharps PPE in the UK

The UK has strict regulations and standards with respect to sharps and PPE. The overarching piece of legislation is the Health and Safety at Work Act 1974. This places a legal duty on employers to ensure the health, safety and welfare of employees, including those exposed to sharps risks. It mandates risk assessments and hazard control, provision of adequate PPE (that is appropriate, free to employees and of high-quality) and safe systems of work.

Another important piece of legislation is the Control of Substances Hazardous to Health (COSHH) Regulations 2002. Because needlestick injuries can expose workers to bloodborne pathogens, employers must identify and control biological hazards associated with sharps, provide adequate training for employees and ensure PPE is suitable for preventing contamination and exposure.

A third piece of legislation to consider is the Personal Protective Equipment at Work Regulations 2022. Key provisions in this legislation requires PPE to be suitable for the task and comply with British and European safety standards. It also mandates that employees receive training on the correct use, storage and maintenance of PPE.

Finally, the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 specifically address sharps injuries in the healthcare sector. They impose additional legal requirements like safe sharps policies, reporting and recording of sharps injuries and post-exposure procedures.

British and European Standards for Sharps PPE

PPE that’s designed to protect against sharps injuries must comply with specific safety standards. These are:

BSN EN 388:2016 – Protective Gloves Against Medical Risks

This is the most relevant standard for needle-resistant gloves. It assesses puncture resistance, cut resistance, abrasion resistance and tear resistance.

PPE is tested on a 1-4 scale for puncture resistance. Higher numbers indicate better protection. Some gloves also include ISO 13997 cut resistance ratings A-F. Levels D, E and F are suitable for high-risk environments.

BS EN ISO 13997 – Blade Cut Resistance

This provides and additional cut resistance measure using a force-based test. It ensures the PPE is effective against sharp edges of scalpels and broken glass.

BS EN 420:2003+A1:2009 – General Requirements for PPE Gloves

This standard covers ergonomics, fit, comfort and non-toxicity. It ensures gloves don’t cause allergic reactions or impair dexterity.

BS EN 141126:2003 – Protective Clothing Against Infectious Agents.

This is relevant for healthcare, laboratory and waste management workers exposed to contaminated sharps. It specifies PPE materials that resist bacteria, viruses and bloodborne pathogens.

Employer safety requirements

Employers have a legal and ethical duty to protect their workers from sharps injuries. This includes but goes beyond providing PPE. Here are the requirements:

1. Conducting Risk Assessments – A thorough risk assessment should identify exposure risks, assess injury likelihood and implement control measures.
2. Providing and Maintaining PPE – Employers must supply appropriate, high-quality PPE at no cost to employees. There should also be regular PPE inspections, replacements of damaged or worn PPE and proper storage and cleaning of reuseable PPE.
3. Implementing Safe Handling and Disposal Procedures – Employers must enforce clear protocols and policies. These should be audited regularly.
4. Training Employees – Training must be comprehensive and cover the risks, correct use of PPE, safe handling techniques and incident reporting.
5. Reporting and Post-Incident Management – Employers must have a clear policy. It must detail immediate first aid, incident reporting systems and access to medical support.
6. Compliance with UK Legislation – Employers must ensure that their workplace complies with UK laws.

Final Thoughts on Needles and Sharps PPE

Needlestick and sharps injuries post a significant risk to workers across various industries like healthcare, waste management, law enforcement, veterinary services, tattoo parlours and custodial settings. These environments involve frequent exposure to sharp instruments, which increases the likelihood of accidental injuries and potential exposure to bloodborne pathogens like Hepatitis B and C and HIV.

To minimise the risk, both employers and employees must follow strict safety protocols, including conducting and following risk assessments, providing and wearing appropriate PPE, handling sharps safely and complying with UK regulations.

Proper use of PPE like needle-resistant gloves, protective clothing and safety devices will significantly reduce the risk of puncture injuries.

In the event of a sharps injury, a worker should immediately:

1. Encourage bleeding.
2. Clean the wound thoroughly with soap and water.
3. Apply an antiseptic and cover the wound with a sterile dressing.
4. Report the injury appropriately.
5. Seek medical advice.