Sharps, Splash, Bite and Needlestick Injuries

Policy for the Management of Needlestick, or other "Sharps" Injuries, and Splash Incidents with Potentially Infected Material

University Policy Statement OHS 2/03

This policy details the procedures to be followed when any incident occurs that may expose University staff, students or visitors to potentially infectious materials in laboratories or other workplaces.
It should be read in conjunction with Occupational Health Service Policy 1/01 – Immunisation, and the Occupational Health Service Policy 1/03, Taking blood samples from colleagues or students for research and teaching.

1. Exposure to human blood or tissue carries a potential risk of contracting a blood-borne infection such as Hepatitis B, Hepatitis C, and human immunodeficiency virus (HIV). Although the risk of acquiring infection in this way is low, the universal precautions detailed in UGN S1/95 for people working with human blood or tissue should be scrupulously observed to minimise it. In summary:

needles and sharps should be handled with care, and handling kept to a minimum
users of needles or other sharps are responsible for their disposal
never re-sheath, bend or break needles before disposal
dispose of syringes and needles as a unit
never carry used sharps or re-use equipment
sharps disposal containers must be available at the point of use
discard sharps containers when three-quarters full
never clear areas where sharps may be present without hand protection
wear goggles if there is a risk of splashing

2. Incidents which potentially expose individuals to blood-borne infection include:

(a) Any injury which is percutaneous (i.e. the skin is broken by a needle, instrument or bite) or mucocutaneous (a splash to eye, nose, mouth or broken skin) and which also

(b) involves exposure to human blood, amniotic fluid, cerebrospinal fluid, breast milk, pericardial fluid, peritoneal fluid, pleural fluid, saliva, synovial fluid, semen, vaginal secretions, unfixed human tissue, any other visibly bloodstained fluid or exudates from burns or skin lesions.

Individuals who may be so exposed include laboratory staff, students, visitors, security patrolmen, parks staff, first-aiders, medical students and research nurses.

3. This policy also covers: other infections e.g. tuberculosis or malaria and, infection by other routes e.g. inhalation or ingestion. Also:

Prion protein may be absorbed through intact skin.
Animal bites that penetrate the skin should be treated as potentially infectious.
The potential for an organism to cause human infection may be increased through genetic modification.

4. The University requires that all individuals whose work potentially puts them at such risk be registered with the University Occupational Physician. Such registration is compulsory. The information on the registration form will be used by the Occupational Health Service (OHS) to initiate and maintain appropriate health surveillance. As regards Hepatitis B immunisation and associated immune response checking, the University Occupational Physician will further advise individuals who do not respond to immunisation.

5. It is the responsibility of the Head of Department to ensure that a risk assessment of the work has been made, and documented, by the supervisor of the group before any potentially infectious material is used. Contingency plans for accidents and incidents in work involving infectious pathogens or high risk genetically modified micro-organisms must be written and brought to the attention of all individuals who may be affected. Additional control measures may be needed for people at increased risk of infection because of, for example, pre-existing disease, compromised immunity, pregnancy or the effects of medication.

6. It is also the responsibility of the Head of Department to ensure that all those potentially exposed to infectious material are familiar with this policy and are aware of the importance of reporting incidents of potential contamination and of seeking urgent advice as in paragraph 7. (With certain pathogens, e.g. human immunodefficiency virus, prophylactic treatment must be given within a relatively short time to be effective.)

7. Immediately after any exposure to potentially infectious material:

(a) Puncture or other wounds should be encouraged to bleed vigorously under cold, running water, using soap.

(b) Wounds must not be sucked, squeezed or scrubbed because this may cause tissue trauma and encourage the spread of infection.

(d) Splashes to the eyes (after first removing contact lenses), broken skin or mouth, should be washed immediately and liberally with water.

(e) The OHS should be contacted immediately on 01865 (2)82676 (normal OHS hours are 08.30 to 17.00 hrs on weekdays).

(f) At other times, or if there is difficulty contacting the OHS, immediately telephone the on-call microbiologist via the John Radcliffe Hospital switchboard (01865 741166) or in the case of an injury such as an animal bite go to the Accident and Emergency Department at the John Radcliffe Hospital.

(g) If the incident occurs "off-site" (outside of Oxfordshire for the purpose of this policy) during working hours, the contact procedure should be as above (paragraph (e)). However, if the incident occurs "off-site" and outside of working hours, the individual should contact the nearest hospital with an Accident and Emergency Service for further immediate advice.

(h) Always inform the OHS of the incident by the next working day so that any necessary follow up health surveillance and support can be initiated.

(i) All such events must be reported as soon as possible to the immediate supervisor, and an accident form completed and sent to the University Safety Office; supervisors should endeavour to ensure the confidentiality of the individual concerned.

(j) Details of the source of the potentially infected material should be retained, including patient details if appropriate, to facilitate any necessary follow up. If blood will be required from another person for testing, the source must be aware of any tests which may be done and have first given written informed consent. The injured party should not seek this consent themselves but should involve a senior clinician responsible for the person (if a patient) or contact the OHS.

8. Any such incident should be reviewed within the department where it occurred to ensure prevention of a recurrence. The relevant written risk assessment should be reviewed.

9. Immediate action after exposure to infectious material (76kb) should be displayed clearly in all places of work where potential exposure to potentially infected material may occur.
January 2003