DEVICE-SPECIFIC RISK OF NEEDLESTICK INJURY IN ITALIAN HEALTH-CARE WORKERS

Objectives.-To identify the types of medical devices causing needlesti ck injuries among Italian health care workers, to document the device- specific injury rates and time trends for different hollow-bore needle s, and to compare injury rates from these devices with those reported in the United States. Design.-Longitudinal survey. Settings.-Twelve It alian acute care public hospitals. Methods.-Data were obtained from a multihospital surveillance database on the number of total injuries re ported in each device category. Hospitals provided the corresponding n umber of devices used annually for each needle type. Main Outcome Meas ure.-Number of needlestick injuries by type of hollow-bore needle per 100 000 devices used per year. Results.-A total of 2524 injuries from hollow-bore needles were reported. Disposable syringes/hypodermic need les accounted for 59.3% of injuries, followed by winged steel needles (33.1%), intravenous catheter stylets (5.4%), and vacuum-tube phleboto my needles (2.2%). Intravenous catheter stylets had the highest needle stick injury rate (15.7/100 000 devices used), and disposable syringes had the lowest needlestick injury rate (3.8/100 000). In contrast to the other devices, the injury rate from winged steel needles increased from 6.2 per 100 000 in 1990 to 13.9 per 100 000 in 1992. Conclusions .-The device-specific needlestick injury rates in Italy are similar to those reported in the United States, suggesting similar exposure expe rience in two countries. However, in contrast to the United States, ne edleless intravenous access is standard practice in Italy and thus eli minates one potential risk to Italian health workers. Implementation o f safer equipment, such as shielded or retracting needles, and continu ing training programs are needed to further reduce the hazards that he alth care workers face.