Needle Sticks Injuries (NSIs) and Hepatitis B Vaccination status among Health Care Workers (HCWs) at Asia’s Largest Trauma Care Centre in Bengaluru

Abstract

Background: Needle stick injuries (NSIs) are the most common workplace-related health hazards responsible for the transmission of blood-borne pathogens among the HCWs where safety measures have not already been established. Injuries mostly occur during needle recapping, operative procedures, blood sample collection, intravenous line administration and poor waste disposal practices. Following NSIs, more than 20 blood-borne pathogens can be transmitted through body fluids. However, the most common diseases that can be potentially transmitted through body fluids are HIV, HBV, and HCV. Moreover, among the three important pathogens transmitted through NSIs, only HBV has an effective vaccine. The HBV vaccination coverage among HCWs has also been generally less, putting them at greater risk for HBV infections. This study aims to analyze the swing of voluntary reporting of NSIs among HCWs and also the HBV vaccination status among those HCWs reporting NSIs in our tertiary health-care center. Materials and Methods: A retrospective study was conducted between January 2018 and March 2020 at Asia’s Largest Trauma Care Centre in Bangalore. A standard proforma was filled by all HCWs reporting NSIs and a record of the same was maintained. Testing for HIV, hepatitis B virus surface antigen (HBsAg) and HCV was provided to the HCWs and also to the sources. HIV testing, HBsAg testing, and HCV testing were done by using rapid standard kits. All the tests were performed and interpreted according to the manufacturer's instructions. The testing for HIV 1 and 2 was done according to the National AIDS Control Organization Guidelines. The HCWs were tracked up to 6 weeks, 3 months, and 6 months for HIV and at 3 months and 6 months for HBV and HCV, consecutively after guidance, counseling and appropriate interventions. Results: A total of 34 incidents of NSIs were reported between January 2018 and March 2020 in that 11 were reported in 2018, 17 and 06 in 2019 and 2020 respectively. Majority of the HCWs 50 % had complete course of HBV vaccination, 41.17% had incomplete (1 or 2 doses) and 8.82% had not taken any course of HBV vaccination. Conclusion: The study disclosed that the collective prevalence of NSI among HCWs was high. The inadequate training of HCWs among the health care facilities might make HCWs more susceptible to injury. Therefore, the current study recommends the following measures to reduce NSIs - adequate training, simulation training to mimic everyday situations of junior staff, compulsory HBV vaccination for all the HCWs, System in place for reporting, adequate first aid facility and provision of safe working environment.