Sharps

Overview

Key points of note

• Avoid the use of sharps (e.g. needles, scalpels) wherever possible
• Justify the use of sharps involving hazardous materials (e.g. chemicals or materials containing biological agents) as part of a prior written risk assessment
• All users of sharps, such as needles and scalpels, to be instructed on safe handling practices to follow as part of on-the-job training
• Never recap or resheath a needle unless absolutely necessary
• Dispose of needles immediately after use
• Use 'single use' scalpels, avoiding the need to change the blade
• Report all sharps accidents with the potential for exposure to hazardous infectious agents immediately to the Occupational Health Advisor (Ext. 2026 / 2020)

Injuries & infections from sharps

Glass or sharps have been responsible for a number of injuries to laboratory workers in this department. Most sharps accidents have resulted in relatively minor injuries involving the use of non-hazardous substances. However, sharps accidents can cause serious injuries, or illness as a result of infection.

The use of sharps and glass items should be avoided wherever possible, especially in biohazard containment laboratories handling infectious microorganisms or materials (e.g. blood and human tissues) which may contain them. Sharps injuries involving the use of blood or human tissues can lead to life threatening infections such as Hepatitis B, Hepatitis C and HIV.

Most incidents involving the use of sharps can be avoided with good management systems in place. This includes good initial instruction and training on correct procedures to follow (for example, good practices to follow for handling needles), along with ongoing supervision and monitoring.

Injury prevention

Prevention / control of sharps injuries

In order to avoid or minimise the likelihood of accidents arising as a result of poor working practices, strong>all individuals using sharps should be aware of, and apply, the following standard working practices when handling glass, needles and other sharps. All users of sharps must also be instructed on these practices as part of their local on-the-job training / safety induction.

Avoiding needlestick injuries

Needlestick injuries usually occur as a result of poor handling techniques or incorrect disposal, the latter often affecting someone other than the original user. When an individual sustains a sharps injury from a sharp of unknown source it can be particularly worrying if it is not possible to trace the source of the item and allay fears of infection with HIV, Hep. B etc. For these reasons it is important to apply the following practices when using needlesticks:

• use a needle or sharp item only if it is necessary to do so and only for the purpose it was designed
• use safer alternatives if practicable and proportionate to risk e.g. use of plastic-ware; blunt needles; automatic spring activated needle guards, or needle-less medication / vaccination injectors or systems
• dispose of needles directly into a dedicated sharps bin at the point of use without detaching or re-sheathing the needle
• never place sharps in a plastic bag (e.g. autoclave bag) for disposal
• always adopt a safe system for re-sheathing or detaching a needle from the syringe if this is absolutely necessary
• handle needles with extreme care (avoid all actions which move a person’s body towards the point) and keep handling to a minimum
• transport needles or syringes in a sealed container
• do not put used needles and syringes on the bench or mixed with other items - only put them in something like a tray and make sure they are clearly visible
• do not re-use needles to ensure it is always known what a particular needle has been used for
• do not overfill sharps bins - use only until the contents reach the fill line marked on the side of the bin

When using needles to inoculate animals with infectious materials:

• wherever possible immobilise or restrain the animal to minimise any unexpected movement
• position hands carefully such that the needle is not pointed either towards your hands or the hands of anyone who may be assisting
• ensure you are not likely to be disturbed during the procedure- someone knocking on the door or making a sudden entry could cause you or the animal to jump so increasing the risk of needlestick injury
• if more than one person is carrying out the procedure, agree a safe system of work in advance to ensure the person holding the needle does not inadvertently injure the person assisting

Avoiding glass injuries

Injuries from broken glass are often sustained while inserting pipettes into pipetting aids or Pasteur pipettes into teats; attaching glass to or removing glass from rubber or plastic tubing; removing 'frozen' stoppers from glass bottles; breaking glass tubing; and handling or washing up broken glassware. These injuries may be largely avoided by instruction in correct techniques and by ensuring glassware is in good condition (without chips or cracks) before use.

• use plastic alternatives to glass wherever possible
• repair or throw away broken or chipped glassware
• when handling glass items avoid applying force or excessive pressure in case the item slips or gives way suddenly and breaks
• carry glass items in a box or something similar to minimise the risk of dropping them

Avoiding other cuts and abrasions

Cuts from scalpel, razor or other blades, sustained while cutting plastic tubes or tubing; opening packages; scraping off adhesive labels etc, frequently occur because of misuse of scalpel or razor blades which are not designed for any of these tasks.

• use only the correct tool for the job
• do not use scalpel blades and razor blades unless absolutely necessary, and if so, they should be handled with care
• wherever possible use single unit disposable scalpels rather than changing the blades on a re-useable holder
• where a blade is used in a holder, take particular care when changing the blade and avoid holding with fingers and applying force or excessive pressure in case it slips or gives way suddenly
• dispose of used scalpels, razors, blades etc in a dedicated sharps bin
• use labels that can be easily peeled-off avoiding the need for scraping etc

Accident procedure

Accident procedure for sharps injuries

1. First Aid

In the event of sustaining an accident resulting in a wound:

• immediately wash the wound liberally with soap and water but without scrubbing
• gently encourage free bleeding of puncture wounds but do not suck the wound
• dry the area and apply a waterproof dressing
• do not use antiseptics and skin washes - there is no evidence of their efficacy, and their effect on local defences is unknown.

In the event of a serious injury requiring immediate medical attention:

• attend the Accident and Emergency Department of the local hospital

2. Reporting

No infection risk (e.g. unused, clean sharp):

• report accident to line manager and complete accident report form

Infection risk (used dirty sharp- source unknown or known / also, human bite or scratch, mucous membrane splash):

• identify possible infection risk and retain any items involved in the accident - tracing the source of any infectious material will enable an informed assessment of the infection risk to be made and will help decide what further action (e.g. prophylactic treatment) should be taken
• seek immediate professional advice:
  • contact the University Occupational Advisor (ext. 2026 /2020) for professional advice on any action that may be necessary (e.g. deciding if post exposure prophylaxis and counselling is required)
  • attend the Accident and Emergency Department of the local hospital if the University Occupational Health Advisor is unavailable and immediate attention is considered necessary (note: it is still important that the University's Occupational Health Advisor is informed (ext. 2026/2020) of all sharps injuries even if an individual has attended the local A&E in the first instance)
• report accident to line manager and complete accident report form

3. Review of sharps accidents

All accidents and incidents that do occur should subsequently be reviewed by the individual(s) involved along with their line manager. The Departmental Safety Advisor will also be involved in the review process to ensure appropriate measures have been taken to avoid similar accidents occurring in the future. Any remedial action identified must be implemented and any lessons learnt communicated widely within the Department.