Needlestick infections

There is widespread misconception that sharps or needlestick infections are associated only with the bloodborne virus Hepatitis B and HIV, and that since no such infections have been recorded among waste handlers this is something of a minor hazard and that the risk of infection is almost non-existent.  Not so.

The bloodborne virus infections Hepatitis B and HIV, and the much more common Hepatitis C are the main risks and it is these that are often associated with sharps injury. Under-reporting of injuries, lack of comprehensive occupational health services and follow-up epidemiological study of ancillary workers and waste handlers perhaps explain the absence of proven cases but do not lessen the ever-present risk.

Other infections are actually more common that those with bloodborne virus agents. Any cut or stab wound from a dirty item, or one inflicted through soiled clothing or contaminated skin surfaces can result in infection. These ‘septic’ wounds are actually quite common, and occur also from contamination of pre-existing cuts and grazes. Linking these generally minor infections to an occupational source is almost impossible but the evidence does suggest a much higher incidence of skin and soft tissue infections on the hands and forearms, and legs, among clinical waste handlers that those working in other parts of the waste sector.

Good standards of hygiene are essential, to report and clean, cover or treat even minor wounds or pre-existing lesions. PPE use and care in handling of wastes are basic precautions though too often standards of performance are low.

Skin and soft tissue infections, or worse, are by no means trivial. Lost day injuries are a nuisance to employers and may result in cash loss to employees. More seriously, an untreated hand injury with infection can have a devastating impact to employment future due to permanent loss of function. I have seen two such infections, in hospital ancillary workers, who suffered deep infections – septic wounds requiring extensive surgery – while handling bagged wastes.

Just about any bug can be transmitted by sharps injury and those who focus solely on the bloodborne virus infections, and then comment on the lack of reported cases in the waste industries, do great disservice to those at risk.

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