The consequences of a sharps injury can be grave. Though the incidence of seroconversion is fortunately low there are still many transmission events of HIV, Hepatitis B and Hepatitis C, as well as other infections ranging from the more obscure virus agents, malaria parasites and bacterial pathogens causing a nasty wound infection.

Needlestick protocols list first essential first aid measures that include allowing the would be bleed freely, without squeezing, and then washing thoroughly but not aggressively using soap and water. Seek immediate medical attention at the nearest A&E unit. Do not delay, and do not get fobbed off by a receptionist or triage nurse who insists that the service is only for serious injuries. That is wrong – a needlestick IS serious, very serious, and needs urgent specialist attention.

Protocols for the use of post-exposure prophylaxis that would combine Hepatitis B immune globulin and combination anti-retrovirus drugs depends of the circumstances of infection. The depth of injury raises the likelihood of transmission; also rated as high risk injuries are those involving an injury from a needle used with a known positive individual or from an unknown individual.

Since most sharps injuries in waste handlers will fall into this high risk category, detailed review from a specialised infectious diseases physician and long-term follow-up are essential. Some counselling or psychiatric support may be necessary, for the injured individual and for a partner, as the impact of anxiety and post-traumatic stress may be profound, indeed possibly life-changing even if infection transmission does not occur.

At this stage, compensation comes to the fore. Many solicitors advertise that they will take sharps injury cases. Indeed, so many solicitors are advertising this as a specialty service that it may suggest that the number of injuries is far higher than we would like to believe.

But how much is a sharps injury payout? A receent Freedom of Information (FoI) invesigation by The Courier revealed that councils in Tayside and Fife have paid out nearly £1.5 million in compensation to staff injured at work over the past five years. Of that, two workers were paid £2,250 and £3,500 respectively after needlestick accidents. We do not know the circumstances of those claims or the details of the incidents, but it is interesting to compare the value of those payouts with the £342 and £566 paid to victims of assault  and/or battery, and one employee was paid £40,000 after falling at work (in 2006). In 2009, one member of staff in a city primary school was awarded just under £7,000 after being manhandled – and astonishing 2 ½ times more than for a sharps injury!