There is a foolhardy and sadly widely held opinion that only the three bloodborne viruses – HIV, Hepatitis B and Hepatitis C – can be transmitted by sharps injury. That is not so.

As well as simple pyogenic (septic) infection that may be severe – I am aware of one such case that resulted from a grazed forearm and resulted in many days in intensive care and weeks of follow-up to save the life of a hospital porter injured while clearing clinical waste sacks. The list of infections transmitted by sharps injury, usually a needlestick, is remarkably long. Most follow laboratory incidents, but if a needle or other sharps item can transmit infection to a laboratory worker there is a strong chance that the same outcome might arise if a similar sharps injury occurs as a consequence or an error in disposal.

As we have previously noted the use of sharps by farmers and their stockmen, and by vets servicing those farms, is surprisingly liberal and likely to be largely unregulated, at least in disposal.

In a brief report in the latest BMJ (Necrosis from needlestick injury with live Actinobacillus pleuropneumoniae porcine vaccine. BMJ 2011;343:d6261 doi: 10.1136/bmj.d6261) an experienced veterinary surgeon suffered a sharps injury to his thumb while he was injecting pigs subcutaneously with live vaccine. Despite extensive treatment including plastic surgery which was necessary on three occasions to replace damaged skin and underlying tissues caused by the resulting local infection it took 6-7 months to reach a satisfactory outcome though there was some residual loss of feeling in his thumb.

Only one case of course, but the national herd receives many live vaccine vaccinations and the sharps waste from this vast operation is high risk.