The cost of a sharps injury can be great – at worst, transmission of a life-ending viral infection. However, it is important to look more generally at the cost of a sharps injury.

In the current edition of Healthcare Equipment & Supplies (HES) a comment concerning the cost of sharps injury gives cause for considerable concern.

EU Directive 2010/32/EU2, implementing the Framework Agreement On Prevention From Sharp Injuries In The Hospital And Healthcare Sector, which must be implemented into national law by EU member states by May 2013, mandates new worker safety standards. The directive specifically refers to “eliminating the unnecessary use of sharps by implementing changes in practice and on the basis of the results of the risk assessment, providing medical devices incorporating safety-engineered protection mechanisms.”

So far, so good. To date, around a third of NHS Trusts have implemented use of safety sharps, in part of in total, though for the majority of those it is only partial implementation (not counting the occasional use of a range of specialist needles for which a safety alternative is not readily available).

For most Trusts, this is still a difficult cost and it is not surprising that many choose the cheaper alternative rather that devices that are inherently safer. That results in the widespread use of passive safety devices that require users to flip a shield over the used needle, and of course human nature being as it is this sometimes does not happen and disposal-related injuries may remain unchanged.

Supported perhaps by the manufacturer, Harrogate and District NHS Foundation Trust calculated the cost of every sharps injury at £415. This included the occupational health staff time; HIV, Hepatitis B and Hepatitis C testing of source patient and staff; and post-exposure prophylaxis and Hepatitis vaccination. However, it did not include the hidden costs of lost staff time, training investment, recruitment, or of course the psychological impact on individuals affected, all of which should also be taken into account. The calculation also did not take into account any further costs should a member of staff contract a blood-borne virus from a needlestick injury.

Though it is important, and entirely correct, to list those issues that are so important but which are not included in the bottom line cost of £415 per sharps injury it is that modest sum that will be remembered. Sadly, this paints an entirely false picture of the impact of sharps injury, whether it occurs in the NHS of elsewhere. In the commercial sector, add the loss of a member of staff and the cost of recruitment on a temporary or permanent basis, and perhaps the cost of an HSE investigation with a possible improvement or prohibition notice. And of course all of those direct costs that accrue to the £415 bottom line will be marginal costs that for a waste management company would be substantially greater as the services of a private provider would be required at full commercial rates.

But of course the true cost of a sharps injury is far greater. It includes considerable anguish for the injured individual and their family group. Months of anxiety and a likelihood of clinical anxiety and post-traumatic stress. Add on the cost of a compensation claim. Ultimately, the cost may include a devastatingly severe infection.

The cost of a sharps injury might be costed, but as we have noted many times before on the Clinical Waste Discussion Forum it is always much much more than £415.