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November 2009, Vol 99, No. S3 | American Journal of Public Health S710-S717
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2008.150169

RESEARCH AND PRACTICE

Sharps Injuries and Other Blood and Body Fluid Exposures Among Home Health Care Nurses and Aides

Margaret M. Quinn, ScD, Pia K. Markkanen, ScD, Catherine J. Galligan, MS, David Kriebel, ScD, Stephanie M. Chalupka, EdD, APRN, Hyun Kim, ScD, Rebecca J. Gore, PhD, Susan R. Sama, ScD, RN, Angela K. Laramie, MPH and Letitia Davis, ScD

At the time of the study, Margaret M. Quinn, Pia K. Markkanen, Catherine J. Galligan, David Kriebel, Hyun Kim, Rebecca J. Gore, and Susan R. Sama were with the Department of Work Environment, University of Massachusetts, Lowell. Stephanie M. Chalupka was with the Department of Nursing, University of Massachusetts, Lowell. Angela K. Laramie and Letitia Davis are with the Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston.

Correspondence: Correspondence should be sent to Margaret M. Quinn, ScD, Department of Work Environment, University of Massachusetts Lowell, 1 University Ave, Lowell, MA 01854 (e-mail: margaret_quinn{at}uml.edu). Reprints can be ordered at http://www.ajph.org by clicking on the "Reprints/Eprints" link.

Objectives. We quantified risks of sharp medical device (sharps) injuries and other blood and body fluid exposures among home health care nurses and aides, identified risk factors, assessed the use of sharps with safety features, and evaluated underreporting in workplace-based surveillance.

Methods. We conducted a questionnaire survey and workplace-based surveillance, collaborating with 9 home health care agencies and 2 labor unions from 2006 to 2007.

Results. Approximately 35% of nurses and 6.4% of aides had experienced at least 1 sharps injury during their home health care career; corresponding figures for other blood and body fluid exposures were 15.1% and 6.7%, respectively. Annual sharps injuries incidence rates were 5.1 per 100 full-time equivalent (FTE) nurses and 1.0 per 100 FTE aides. Medical procedures contributing to sharps injuries were injecting medications, administering fingersticks and heelsticks, and drawing blood. Other contributing factors were sharps disposal, contact with waste, and patient handling. Sharps with safety features frequently were not used. Underreporting of sharps injuries to the workplace-based surveillance system was estimated to be about 50%.

Conclusions. Sharps injuries and other blood and body fluid exposures are serious hazards for home health care nurses and aides. Improvements in hazard intervention are needed.






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