The sting of sharp objects: Low risk for kids, but little community awareness

Multiple studies have suggested that the risk of bloodborne virus transmission through a community-acquired needlestick—mainly HIV, hepatitis B (HBV), and C (HCV)—is exceedingly low. However, lack clear safety protocols public education beyond laboratory, hospital, clinic settings may be needlessly contributing to improper disposal needles, syringes, other sharps an inflated perception viral risk. At most health care sites, standardized cascade analysis preventive therapy kicks in after needlestick injury (or, less commonly, cut with contaminated scalpel). A blood sample is routinely collected as baseline measure for communicable diseases. months-long surveillance period begins, immunoglobulins or antivirals initiated. These became formalized 1980s 1990s greater awareness laboratory workers, whom needlesticks occur seconds minutes they withdraw needle from patient. The potential during fine-needle aspiration has been documented cytopathology laboratories well. survey 63 pathologists New Delhi, India, found 90% reported stick injuries at some point their career.1 study noted hollow-bore needles used can confer more because convey referred patients are not generally screened HBV, HCV economic constraints. considerably lower clinic, hospital but research points wide gaps knowledge how properly dispose what do case accidental injury. In small 2018 study, researchers only 59% diabetes receiving endocrinology disposing pen designated box puncture-resistant container home.2 led by Li Huang, MD, then medical resident Stony Brook University Hospital York, anonymously surveyed approximately 150 diabetes. Nearly one-third said had never received any formal training on sharps. Perhaps unsurprisingly, those who form guidance, whether nurse another source, were significantly likely report correct practices. Nine participants household. Even proper failsafe: incidents included 5 prior training. Dr. Huang her colleagues concluded emphasis provider-patient part routine could help reduce “Our suggests there many missed opportunities educate methods over course care,” wrote. Education, awareness, towns cities varied enormously Some restaurants, coffee shops, parks begun installing containers bathrooms accessible areas, often pressure local residents. 2019, team nursing business students British Columbia Institute Technology Burnaby, Canada, developed Vancouver Safe Sharps Disposal Education Plan city,3 particular focus educating children, guardians, teachers. Among project’s motivations was fact “an overall about safe one leading stigma residents toward sharps.” Over past year, COVID-19 pandemic exacerbated opioid epidemic homelessness, both which cited factors needlesticks. same time, financially strapped communities fewer resources regularly check safely discarded spaces. biggest shortfall, however, exceptionally low acquiring disease settings. systematic 2014 literature review Australian researchers, 17 published 24-year period, uncovered 1 HBV community (in Republic Georgia).4 handful separate reports 2 additional infections Spain Australia) 3 (also Australia). Overall, these 6 cases involved child, 4-yearold boy chronic infection. did find HIV injury, recent review, 2018, no cases.5 “The bottom line out-of-hospital incredibly risk,” Andrew Riordan, now consultant pediatric infectious diseases immunology Alder Hey Children’s National Health Service Foundation Trust Liverpool, United Kingdom, CytoSource. 53 children Birmingham Heartlands 8-year Riordan his uncover single infection.6 They also identify postexposure prophylaxis (PEP) would advised. From than 1500 covered including Riordan’s 4-week regimen recommended 13% cases. “I wouldn’t say PEP dangerous just risks benefit,” said. remain active longer HIV. No effective yet exists exposure, multiple drugs available rare event transmitted infection develops. highest nonimmunized person “virtually eliminated” (the vaccine plus anti-HBV immunoglobulin) statement paper Canadian Paediatric Society careful out theoretically possible under right circumstances.5 so, society agreed far surpasses reality. “Although actual such extremely low, parents results much anxiety. Evaluation, counselling, follow-up child needed,” read. society’s specific recommendations “community programs should place keep places, areas where play, free needles.” Advocates argued establishing exchange injection drug users, recommendation Society, further number injuries. Research exchanges, highly controversial misperception encourage illicit use, among users well thereby offer protection wider community. harm reduction programs, Charleston, West Virginia, affixed barcodes distributed clean track them aid decision-making needlestick. October 2020 incident previously, young stuck unlabeled distribution program; this uncertainty triggered evaluation police investigation. test made public, rising linked use Charleston’s Kanawha County concerned county federal officials. combination proactive education, initiatives spare similar ordeal.