269:(FDA) have endorsed the adoption of blunt-tip suture needles for suturing fascia and muscle. Hollow-bore needles pose a greater risk of injury than solid needles, but hollow-bore needle injuries are highly preventable: 25% of hollow-bore needle injuries to healthcare professionals can be prevented by using safer needles . Gloves can also provide better protection against injuries from tapered-tip as opposed to sharp-tipped needles. In addition, a Cochrane review showed that the use of two pairs of gloves (double gloving) can significantly reduce the risk of needle stick injury in surgical staff. Triple gloving may be more effective than double gloving, but using thicker gloves does not make a difference. A Cochrane review found low quality evidence showing that safety devices on IV start kits and venipuncture equipment reduce the frequency of needlestick injuries. However, these safety systems can increase the risk of exposure to splashed blood. Education with training for at-risk healthcare workers can reduce their risk of needlestick injuries. The
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objectively. Even though glove perforations can be objectively measured, it is still unclear what the relation is between glove perforations and needlestick injuries. Another problem is underreporting of needlestick injuries. It is estimated that half of all occupational needlestick injuries are not reported. Additionally, an unknown number of occupational needlestick injuries are reported by the affected employee, yet due to organizational failure, institutional record of the injury does not exist. This makes it difficult to determine what the exact risk of exposure is for various medical occupations. Most studies use databases of reported needlestick injuries to determine preventable causes. However this is different from establishing an exposure risk.
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changed so that they are less likely to lead to a sharps injury such as blunt or taper-point surgery needles and safety engineered scalpels. Needleless connectors (NCs) were introduced in the 1990s to reduce the risk of health care worker needlestick injuries. The second is to start using safe working practices such as the hands-free technique. The third line of prevention is increased personal protective equipment such as the use of two pairs of gloves. In addition to these preventive approaches, implementation measures are necessary because the measures are not universally taken up. To achieve better implementation, legislation, education and training are necessary among all health care workers at risk.
444:(GAO) determined that requiring hospitals to use safety-engineered needles would result in substantial savings due to the reduction in needlestick injuries requiring treatment. Costs of needlestick injuries include prophylaxis, wages and time lost by workers, quality of life, emotional distress, costs associated with drug toxicity, organizational liability, mortality, quality of patient care, and workforce reduction. Testing and follow-up treatment for healthcare workers who experienced a needlestick injury was estimated at $ 5,000 in the year 2000, depending upon the medical treatment provided. The
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1.8%, but newer, larger surveys have shown only a 0.5% transmission rate. The overall risk of HIV infection after percutaneous exposure to HIV-infected material in the health care setting is 0.3%. Individualized risk of blood-borne infection from a used biomedical sharp is further dependent upon additional factors. Injuries with a hollow-bore needle, deep penetration, visible blood on the needle, a needle located in a deep artery or vein, or a biomedical device contaminated with blood from a terminally ill patient increase the risk for contracting a blood-borne infection.
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the percentage of reports. Physicians are particularly likely to leave a needlestick unreported, citing worries about loss of respect or a low risk perception. Low risk perception can be caused by poor knowledge about risk, or an incorrect estimate of a particular patient's risk. Surveillance systems to track needlestick injuries include the
National Surveillance System for Healthcare Workers (NaSH), a voluntary system in the northeastern United States, and the Exposure Prevention Information Network (EPINet), a recording and tracking system that also gathers data.
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injuries, 40.0 for perforations (95% CI, 19.2-83.5; 15 studies), and 5.8 for administrative injuries (95% CI, 2.7-12.2; 5 studies). Self-report probably overestimates the real risk and administrative data underestimate the risk considerably. Perforation data are probably the most valid indicators. Considering that the perforation rates provided here are much lower than the self-reported injuries used to calculate the burden of disease due to sharps injuries by the WHO, these calculations should be revised.
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of the syringes. Blood on any sharp instrument may be infectious, whether or not the blood is fresh. HIV and the hepatitis C virus (HCV) are only viable for hours after blood has dried, but the hepatitis B virus (HBV) is stable even when dried. The risk of hepatitis B transmission in the community is also increased due to the higher prevalence of hepatitis B in the population than HIV and the high concentration of HBV in the blood.
53:
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surgical setting, especially in abdominal operations, blunt-tip suture needles were found to reduce needle stick injuries by 69%. Blunt-tip or tapered-tip suture needles can be used to sew muscle and fascia. Though they are more expensive than sharp-tipped needles, this cost is balanced by the reduction in injuries, which are expensive to treat. Sharp-tipped needles cause 51–77% of surgical needlestick injuries. The
115:, such as those of the eyes, with blood or body fluids, but needlestick injuries make up more than 80% of all percutaneous exposure incidents in the United States. Various other occupations are also at increased risk of needlestick injury, including law enforcement, laborers, tattoo artists, food preparers, and agricultural workers.
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who use injecting drugs can receive sterile syringes and injection equipment. Preventing the transmission of blood-borne disease requires sterile syringes and injection equipment for each unique injection, which is necessarily predicated upon access and availability of these materials at no cost for those using them.
111:(HIV). In healthcare and laboratory settings globally, there are over 25 distinct types of blood-borne diseases that can potentially be transmitted through needlestick injuries to workers. In addition to needlestick injuries, transmission of these viruses can also occur as a result of contamination of the
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In the United States, approximately half of all needlestick injuries affecting health care workers are not reported, citing the long reporting process and its interference with work as their reason for not reporting an incident. The availability of hotlines, witnesses, and response teams can increase
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The risk of hepatitis C seroconversion is estimated at 0.3–0.74%. Immunoglobulin and antivirals are not recommended for hepatitis C PEP. There is no vaccine for the hepatitis C virus (HCV); therefore, post-exposure treatment consists of monitoring for seroconversion. There is limited evidence for the
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and 10% having symptoms. Higher rates of hepatitis B vaccination among the general public and healthcare workers have reduced the risk of transmission; non-healthcare workers still have a lower HBV vaccination rate and therefore a higher risk. The transmission rate of hepatitis C has been reported at
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estimated that in 2000, 66,000 hepatitis B, 16,000 hepatitis C, and 1,000 HIV infections were caused by needlestick injuries. In places with higher rates of blood-borne diseases in the general population, healthcare workers are more susceptible to contracting these diseases from a needlestick injury.
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Mast EE, Weinbaum CM, Fiore AE, Alter MJ, Bell BP, Finelli L, Rodewald LE, Douglas JM, Janssen RS, Ward JW (2006). "A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the
Advisory Committee on Immunization Practices
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Needle exchange programs are an effective way of decreasing the risk associated with needlestick injuries. These programs remove contaminated syringes from the street, reducing the risk of inadvertent transmission of blood-borne infections to the surrounding community and to law enforcement. A study
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In the event that needlestick prevention programs are not put in place in a given community, a 1994 study suggests an alternative for "high risk" areas. The study proposed the implementation of a vaccination effort to give children a routine prophylaxis against hepatitis B to prevent the development
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Needlestick injuries that occur in children from discarded needles in community settings, such as parks and playgrounds, are especially concerning. While the exact number of needlestick injuries in children in the US is unknown, even one injury in a child is enough to cause public alarm. Studies in
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found that only 43.4% reported a needlestick injury they received; 42% of which occurred during their evening shift. Most of the needlestick injuries experienced by these workers occurred in their first 5 years of employment. In New York City, a study found a rate of 38.7 exposures (needlesticks and
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and for less experienced people; fatigue, high workload, shift work, high pressure, or high perception of risk can all increase the chances of a needlestick injury. During surgery, a surgical needle or other sharp instrument may inadvertently penetrate the glove and skin of operating room personnel;
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The
Coalition for Safe Community Needle Disposal estimates there are over 7.5 billion syringes used for home medical care in the United States. This large amount of home medical syringes has added to the problem of non-healthcare related needlestick injuries due to mishandling and improper disposal
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In the United States, the
Needlestick Safety and Prevention Act of 2000 and the subsequent Bloodborne Pathogens Standard of 2001 require safer needle devices, employee input, and records of all sharps injuries in healthcare settings. In the US, nonsurgical needlestick injuries decreased by 31.6% in
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Among healthcare workers, nurses and physicians appear especially at risk; those who work in an operating room environment are at the highest risk. An investigation among
American surgeons indicates that almost every surgeon experienced at least one such injury during their training. More than half
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Another large group at risk are nurses but their frequency of exposure is much less than in surgeons. Their main risk comes from the use and disposal of injection syringes. The same prevention approaches can be implemented here. There are many so-called safety engineered devices such as retractable
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as a response from the injecting-drug community to an influx of hepatitis B. Spurred to urgency by the introduction of HIV/AIDS, needle syringe programs quickly became an integral component of public health across the developed world. These programs function by providing facilities in which people
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programs (SSPs) or needle exchange programs (NEPs) have also proven to reduce the number of needles discarded in public areas. According to the CDC, these programs are effective in the prevention of HIV, and they help reduce the risk of infection with HCV. Additionally, in 2004, the
Environmental
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There are a number of ways in which needlestick injuries could be prevented. First and foremost, increased education in the community is vital. It is especially important to educate kids while they are young. Studies of injuries from discarded needles have reported that the average age of children
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found that a case of infection by blood-borne pathogens could cost $ 1 million for testing, follow-up, and disability payments. An estimated $ 1 billion annually is saved by preventing needlestick injuries among healthcare workers in the US, including fees associated with testing, laboratory work,
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It is difficult to establish correct figures for the risk of exposure or the incidence of needlestick injuries. First of all it is difficult to observe a needlestick injury, either in oneself or in other persons. Glove perforations in surgeons are considered a reasonable proxy that can be measured
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Data almost universally confirm the value of needle exchange programs, which substantially decrease the risk of HIV among injectable drug users and do not carry unintended negative consequences. US states that publicly fund exchange programs are associated with reduced rates of HIV transmission,
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have relatively low rates of injury. A systematic review of 45 studies of sharps injuries in surgical staff found that sharps injuries occur once in 10 operations per staff member. Per 100 person-years, the injury rate in surgical staff was 88.2 (95% CI, 61.3-126.9; 21 studies) for self-reported
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for PEP as soon as possible, preferably within three days of exposure. There is no vaccine for HIV. When the source of blood is known to be HIV positive, a 3-drug regimen is recommended by the CDC; those exposed to blood with a low viral load or otherwise low risk can use a 2-drug protocol. The
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The group most at risk are surgeons and surgical staff in the operating room who sustain injuries from suture needles and other sharps used in operations. There are basically three complementary approaches to prevention of these sharps injuries. The first one is the use of tools that have been
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Needlestick injuries are among the top three injuries that occur among material-recovery facility workers who sort through trash to remove recyclable items from the community-collected garbage. Housekeeping and janitorial workers in public sites, including hotels, airports, indoor and outdoor
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Some studies have found that safer needles attached to syringes reduce injuries, but others have shown mixed results or no benefit. The adherence to "no-touch" protocols that eliminate direct contact with needles during use and disposal greatly reduces the risk of needlestick injuries. In the
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The risk of hepatitis B (e antigen positive) seroconversion is estimated at 37–62%, significantly more than other blood borne pathogens. After exposure to the hepatitis B virus (HBV), appropriate and timely prophylaxis can prevent infection and subsequent development of chronic infection or
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Increasing recognition of the unique occupational hazard posed by needlestick injuries, as well as the development of efficacious interventions to minimize the largely preventable occupational risk, encouraged legislative regulation in the US, causing a decline in needlestick injuries among
545:, laborers, and agricultural workers. There is no standard system for collecting and tracking needlestick injuries in the community, which makes it difficult to measure the full impact of this problem. Law enforcement workers, like healthcare workers, under-report needlestick injuries. In
180:. Though some affected people have worsened anxiety during repeated testing, anxiety and other psychological effects typically abate after testing is complete. A minority of people affected by needlestick injuries may have lasting psychological effects, including
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In cases where an injury was sustained with a clean needle (i.e. exposure to body fluids had not occurred), the likelihood of infection is generally minimal. Nonetheless, workers are often obligated to report the incident as per the facility's protocol regarding
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injured is between five and eight years. In one study, 15% of injuries occurred in children pretending to use drugs. Therefore, children should be taught at a young age about the risks of handling needles and the correct actions to take if they find a syringe.
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found that needlestick injury rates among
Hartford police officers decreased after the introduction of a needle exchange program: six injuries in 1,007 drug-related arrests for the 6-month period before vs. two in 1,032 arrests for the 6-month period after.
1520:
Hasak, Jessica M.; Novak, Christine B.; Patterson, Jennifer Megan M.; Mackinnon, Susan E. (1 February 2018). "Prevalence of
Needlestick Injuries, Attitude Changes, and Prevention Practices Over 12 Years in an Urban Academic Hospital Surgery Department".
94:
or other sharp object that has been in contact with blood, tissue or other body fluids before the exposure. Even though the acute physiological effects of a needlestick injury are generally negligible, these injuries can lead to transmission of
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increased availability of sterile syringes among injecting drug users, and increased provision of health and social services to users. States that do not fund needle exchange programs are associated with increased rates of HIV/AIDS.
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estimated annual global needlestick injuries at 2 million per year, and another investigation estimated 3.5 million injuries yearly. The
European Biosafety Network estimated 1 million needlestick injuries annually in Europe. The US
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The risk of HIV transmission with a skin puncture is estimated at 0.3%. If the status of the source patient is unknown, their blood should be tested for HIV as soon as possible following exposure. The injured person can start
216:, or alternatively, employee failure to use provided equipment, increases the risk of occupational needlestick injuries. Needlestick injuries may also occur when needles are exchanged between personnel, loaded into a
3124:
Bramson, J; Des
Jarlais, DC; Arasteh, K; Nugent, A; Guardino, V; Feelemyer; Hodel D (2015). "State laws, syringe exchange, and HIV among persons who inject drugs in the United States: History and effectiveness".
3202:
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Stringer, Bernadette; Haines, A. Ted; Goldsmith, Charles H.; Berguer, Ramon; Blythe, Jennifer (2009). "Is use of the hands-free technique during surgery, a safe work practice, associated with safety climate?".
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scalpel injuries tend to be larger than a needlestick. Generally, needlestick injuries cause only minor visible trauma or bleeding; however, even in the absence of bleeding the risk of viral infection remains.
1148:
Rachiotis, G; Papagiannis, D; Markas, D; Thanasias, E; Dounias, G; Hadjichristodoulou, C (2012). "Hepatitis B virus infection and waste collection: Prevalence, risk factors, and infection pathway".
1820:"Blunt-Tip Surgical Suture Needles Reduce Needlestick Injuries and the Risk of Subsequent Bloodborne Pathogen Transmission to Surgical Personnel: FDA, NIOSH and OSHA Joint Safety Communication"
517:
the five years following the passage of the Needlestick Safety and Prevention Act. However, this legislation did not affect surgical settings, where injuries increased 6.5% in the same period.
2805:
Papenburg J, Blais D, Moore D, Al-Hosni M, Laferrière C, Tapiero B, Quach C (2008). "Pediatric injuries from needles discarded in the community: epidemiology and risk of seroconversion".
554:
human bites) per 10,000 police officers. In Tijuana, Mexico, 15.3% of police officers reported ever having a needlestick injury, with 14.3% reporting a needlestick within the past year.
357:. All of these drugs can have severe side effects. PEP may be discontinued if the source of blood tests HIV-negative. Follow-up of all exposed individuals includes counseling and
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Thompson, Brenda; Moro, Pedro L.; Hancy, Kattrina; Ortega-Sánchez, Ismael R.; Santos-Preciado, José I.; Franco-Paredes, Carlos; Weniger, Bruce G.; Chen, Robert T. (June 2010).
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Mittal, María Luisa; Beletsky, Leo; Patiño, Efraín; Abramovitz, Daniela; Rocha, Teresita; Arredondo, Jaime; Bañuelos, Arnulfo; Rangel, Gudelia; Strathdee, Steffanie A. (2016).
967:
Phillips, EK; Conaway, M; Parker, G; Perry, J; Jagger, J (2013). "Issues in Understanding the Impact of the Needlestick Safety and Prevention Act on Hospital Sharps Injuries".
212:. Injuries also commonly occur during needle recapping or via improper disposal of devices into an overfilled or poorly located sharps container. Lack of access to appropriate
176:. These effects can cause self-destructive behavior or functional impairment in relationships and daily life. This is not mitigated by knowledge about disease transmission or
361:
for at least six months after exposure. Such tests are done at baseline, 6 weeks, 12 weeks, and 6 months and longer in specific circumstances, such as co-infection with HCV.
1958:"Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis"
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Canada have reported 274 injuries from needlesticks in children with the majority being boys (64.2%) and occurring from needles discarded in streets and/or parks (53.3%).
1374:
2175:
Jones, L; Pickering, L; Sumnall, H; McVeigh, J; Bellis, MA (2010). "Optimal provision of needle and syringe programmes for injecting drug users: A systematic review".
750:
Tarigan, Lukman H.; Cifuentes, Manuel; Quinn, Margaret; Kriebel, David (1 July 2015). "Prevention of needle-stick injuries in healthcare facilities: a meta-analysis".
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After a needlestick injury, certain procedures can minimize the risk of infection. Lab tests of the recipient should be obtained for baseline studies, including HIV,
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Four U.S. states have banned the disposal of any syringes into the trash, requiring the use of waste collection centers, mail-back programs, or other alternatives.
3061:"HIV Infection, Risk, Prevention, and Testing Behaviors among Persons Who Inject Drugs – National HIV Behavioral Surveillance: Injection Drug Use, 20 U.S. Cities"
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Slater, Karen, Cooke, Marie, Fullerton, Fiona, et al. Peripheral intravenous catheter needleless connector decontamination study-Randomized controlled trial.
282:
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2125:
Wodak, A; Cooney, A (2006). "Do needle syringe programs reduce HIV infection among injecting drug users: A comprehensive review of the international evidence".
3267:
3257:
1956:
Kuhar, DT; Henderson, DK; Struble, KA; Heneine, W; Thomas, V; Cheever, LW; Gomaa, A; Panlilio, AL; US Public Health Service Working, Group (September 2013).
378:(OSHA) estimates 5.6 million workers in the healthcare industry are at risk of occupational exposure to blood-borne diseases via percutaneous injury. The US
286:
270:
3080:"Are needle and syringe programmes associated with a reduction in HIV transmission among people who inject drugs: a systematic review and meta-analysis"
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needles, needle shields/sheaths, needle-less IV kits, and blunt or valved ends on IV connectors. The use of extra gloves is less common among nurses.
289:. Unless already known, the infectious status of the source needs to be determined. Unless the source is known to be negative for HBV, HCV, and HIV,
473:
346:
2219:"Effectiveness of structural-level needle/syringe programs to reduce HCV and HIV infection among people who inject drugs: A systematic review"
3304:
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MacDonald, M; Law, M; Kaldor, J; Hales, J; Dore, G (2003). "Effectiveness of needle and syringe programmes for preventing HIV transmission".
375:
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Pruss-Ustun, A (2005). "Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers".
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More outreach programs for addiction treatment and infection prevention programs for injection drug users would be very beneficial. Public
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Aspinall, EJ; Nambiar, D; Goldberg, DJ; Hickman, M; Weir, A; Van Velzen, E; Palmateer, N; Doyle, JS; Hellard, ME; Hutchinson, SJ (2014).
1843:
Tarigan, LH; Cifuentes, M; Quinn, M; Kriebel, D (2015). "Prevention of needle-stick injuries in healthcare facilities: a meta-analysis".
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710:
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342:
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recreational venues, theaters, retails stores, and schools are at daily risk of exposure to contaminated syringes. A small study of
1368:"Sharps injuries among hospital workers in Massachusetts, 2010: findings from the Massachusetts Sharps Injury Surveillance System"
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Nevertheless, the US government has explicitly prohibited federal funding for needle exchange programs since 1988, as part of the
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78:
17:
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704:"The National Surveillance System for Healthcare Workers (NaSH) Summary Report for Blood and Body Fluid Exposure (1995–2007)"
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2217:
Abdul-Quader, AS; Feelemyer, J; Modi, S; Stein, ES; Briceno, A; Semaan, S; Horvath, T; Kennedy, GE; Des Jarlais, DC (2013).
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Mischke, Christina; Verbeek, Jos H.; Saarto, Annika; Lavoie, Marie-Claude; Pahwa, Manisha; Ijaz, Sharea (1 January 2014).
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Bloodborne Infectious Diseases: HIV/AIDS, Hepatitis B, Hepatitis C. (30 September 2016). Retrieved 16 March 2017, from
1465:"Gloves, extra gloves or special types of gloves for preventing percutaneous exposure injuries in healthcare personnel"
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drug policy in that country. Needle exchange programs have therefore been sparsely implemented in the United States.
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350:
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1922:"Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease".
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Kirchner, B (2012). "Safety in ambulatory surgery centers: Occupational Safety and Health Administration surveys".
441:
338:
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Makary, MA; Al-Attar, A; Holzmueller, CG; Sexton, JB; Syin, D; Gilson, MM; Sulkowski, MS; Pronovost, PJ (2007).
1993:
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1095:"Occupational safety: Selected cost and benefit implications of needlestick prevention devices for hospitals"
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213:
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Verbeek, Jos (2018). "Incidence of sharps injuries in surgical units, a meta-analysis and meta-regression".
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drug, or performing any procedure involving sharps, accidents can occur and facilitate the transmission of
382:(CDC) estimates more than 600,000 needlestick injuries occur among healthcare workers in the US annually.
3345:
2680:"Prevalence and correlates of needle-stick injuries among active duty police officers in Tijuana, Mexico"
1316:
Wald, J (2009). "The psychological consequences of occupational blood and body fluid exposure injuries".
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The prevention of needlestick injuries should focus on those health care workers that are most at risk.
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Hepatitis B carries the greatest risk of transmission, with 10% of exposed workers eventually showing
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398:. Within the medical field, specialties differ in regard to the risk of needlestick injury: surgery,
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290:
177:
148:
2916:
Wyatt R, Sodroski J (1998). "The HIV-1 envelope glycoproteins: fusogens, antigens, and immunogens".
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1131:
1035:"Blunt versus sharp suture needles for preventing percutaneous exposure incidents in surgical staff"
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1675:"Reducing needle stick injuries in healthcare occupations: an integrative review of the literature"
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99:, placing those exposed at increased risk of infection from disease-causing pathogens, such as the
2044:"Devices for preventing percutaneous exposure injuries caused by needles in healthcare personnel"
1579:"Devices for preventing percutaneous exposure injuries caused by needles in healthcare personnel"
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Needlestick injuries occur in the healthcare environment. When drawing blood, administering an
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Anderson JM (2008). "Needle stick injuries: prevention and education key. (Clinical report)".
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are tied off while still connected to the needle. Needlestick injuries are more common during
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is a recommended method for collecting needles while reducing the risk of needlestick injuries
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2009:
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Parantainen, Annika; Verbeek, Jos H.; Lavoie, Marie-Claude; Pahwa, Manisha (1 January 2011).
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172:, anxiety about disclosure or transmission to a sexual partner, trauma-related emotions, and
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in Mexico City found that 34% reported needlestick injuries while working in the past year.
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911:"Needlestick injuries among health care workers: Occupational hazard or avoidable hazard?"
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Protection Agency came up with a number of program options for safe disposal including:
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of needlestick injuries that occur during surgery happen while surgeons are sewing the
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2475:"New Study Quantifies Needlestick Injury Rates for Material RecoveryFacility Workers"
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Elmiyeh, B; Whitaker, IS; James, MJ; Chahal, CA; Galea, A; Alshafi, K (July 2004).
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of the illness in the event that a child encounters an improperly disposed needle.
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1780:"Precautions Advised to Prevent Needlestick Injuries Among US Healthcare Workers"
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There are indirect and direct costs associated with needlestick injuries. The US
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What Every Worker Should Know: How to Protect Yourself From Needlestick Injuries
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549:, 30% of police reported needle sticks. A study of 1,333 police officers in the
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Moore JP (1997). "Coreceptors: implications for HIV pathogenesis and therapy".
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2519:"Analysis: The impact of needle, syringe, and lancet disposal in the community"
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Laramie, AK; Davis, LK; Miner, C; Pun, VC; Laing, J; DeMaria, A (March 2012).
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870:"Epidemiology of occupational injury among cleaners in the healthcare sector"
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303:
217:
104:
3196:
2346:"Surgeons' concern and practices of protection against bloodborne pathogens"
1234:"Needle-stick injuries in the National Health Service: a culture of silence"
886:
869:
273:(NIOSH) has a campaign (Stop Sticks) to educate at-risk healthcare workers.
3263:
3253:
3146:
3105:
2994:
2976:
2826:
2818:
2773:
2721:
2695:
2552:
2460:
2330:
2287:
2252:
2196:
2146:
2102:
2069:
1981:
1864:
1805:
1764:
1710:
1656:
1612:
1550:
1506:
1442:
1339:
1267:
1215:
1169:
1076:
988:
944:
895:
849:
779:
671:
168:
The psychological effects of occupational needlestick injuries can include
3043:
2945:
2872:
2596:
2379:
1935:
1691:
3247:
3138:
3096:
3079:
3025:
2571:"Community-based programs for safe disposal of used needles and syringes"
1206:
1189:
1094:
656:
411:
140:
136:
3326:
Canadian Centre for Occupational Health and Safety: Needlestick Injuries
3179:
1889:
1856:
763:
2575:
Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
2322:
1746:
1161:
419:
399:
242:
225:
1729:
Boden, LI; Petrofsky, YV; Hopcia, K; Wagner, GR; Hashimoto, D (2015).
3278:
International Healthcare Worker Safety Center, University of Virginia
2480:. Environmental Research & Education Foundation. 28 August 2018.
618:
546:
415:
3311:
OSHA Bloodborne Pathogens Workplace Safety Standards and Regulations
1957:
127:
While needlestick injuries have the potential to transmit bacteria,
1973:
1147:
980:
144:
128:
52:
293:(PEP) should be initiated, ideally within one hour of the injury.
285:(HAV IgM, HBsAg, HB core IgM, HCV) and for immunized individuals,
245:. A protective cap (pink) protects the needle after it is removed.
46:
Percutaneous injury, percutaneous exposure incident, sharps injury
808:"California's nurse-to-patient ratio law and occupational injury"
2569:
Macalino GE, Springer KW, Rahman ZS, Vlahov D, Jones TS (1998).
2343:
3191:
3123:
2734:
2447:
Tatelbaum, MF (2001). "Needlestick safety and prevention act".
2344:
Patterson, JM; Novak, CB; Mackinnon, SE; Patterson, GA (1998).
1187:
812:
International Archives of Occupational and Environmental Health
395:
391:
132:
3321:
OSHA Standard – Bloodborne Pathogens Training for handling BBP
3077:
2737:"Needlestick injuries among sanitation workers in Mexico City"
2677:
2216:
1419:
1032:
908:
537:
Many professions are at risk of needlestick injury including
2568:
2174:
1955:
1842:
1731:"Understanding the hospital sharps injury reporting pathway"
1519:
1093:
Office, U. S. Government Accountability (17 November 2000).
749:
3060:
2804:
2089:
1728:
1462:
1231:
966:
2666:. Centers for Disease Control and Prevention. 4 May 2015.
909:
Wicker, S; Ludwig, A; Gottschalk, R; Rabenau, HF (2008).
108:
3254:
Preventing Needlestick Injuries in Health Care Settings
2616:
1291:
EPINet Multihospital Sharps Injury Surveillance Network
2085:
805:
3268:
National Institute for Occupational Safety and Health
3258:
National Institute for Occupational Safety and Health
271:
National Institute for Occupational Safety and Health
3169:
3007:
1365:
806:
Leigh, JP; Markis, CA; Iosif, A; Romano, PS (2015).
3291:
https://www.cdc.gov/niosh/topics/bbp/emergnedl.html
3067:. Centers for Disease Control and Prevention. 2012.
2898:https://www.cdc.gov/niosh/topics/bbp/disposal.html
2413:"Needlestick Safety and Prevention Act. H.R. 5178"
2041:
323:use of antivirals in acute hepatitis C infection.
1293:. International Healthcare Worker Safety Center.
1190:"Needlestick Injuries among surgeons in training"
337:antivirals are taken for 4 weeks and can include
27:Accidental puncture of skin causing contamination
3332:
3316:NIOSH Bloodborne Infectious Diseases Topic Page
3301:Bloodborne Pathogens and Needlestick Prevention
3273:NIOSH Bloodborne Infectious Diseases Topic Page
347:Non-nucleoside reverse transcriptase inhibitors
3305:Occupational Safety and Health Administration
2915:
2892:
2890:
1373:. Massachusetts Department of Public Health.
1287:"Needlestick and Sharp-Object Injury Reports"
470:The examples and perspective in this section
376:Occupational Safety and Health Administration
2800:
2798:
2442:
2440:
2259:
2958:
2564:
2562:
2392:
2308:
2124:
2048:The Cochrane Database of Systematic Reviews
1962:Infection Control and Hospital Epidemiology
1845:Infection Control and Hospital Epidemiology
1630:
1628:
1626:
1624:
1622:
1469:The Cochrane Database of Systematic Reviews
1143:
1141:
1039:The Cochrane Database of Systematic Reviews
969:Infection Control and Hospital Epidemiology
752:Infection Control and Hospital Epidemiology
609:
343:nucleotide reverse transcriptase inhibitors
339:nucleoside reverse transcriptase inhibitors
3055:
3053:
3008:Wyatt JP, Robertson CE, Scobie WG (1994).
2887:
2523:Journal of Diabetes Science and Technology
2087:(ACIP). Part II: Immunization of adults".
1672:
601:Residential waste special pick-up programs
598:Household hazardous waste collection sites
488:, or create a new section, as appropriate.
380:Centers for Disease Control and Prevention
51:
3095:
3033:
2984:
2795:
2755:
2711:
2684:Journal of the International AIDS Society
2630:
2586:
2542:
2446:
2437:
2369:
2337:
2242:
2059:
2042:Lavoie, M; Verbeek, JH; Pahwa, M (2014).
1795:
1754:
1700:
1690:
1602:
1496:
1257:
1205:
1066:
934:
885:
867:
863:
861:
859:
839:
504:Learn how and when to remove this message
3296:OSHA Bloodborne Pathogen Standard (BBPS)
2961:"Needle stick injuries in the community"
2846:
2844:
2559:
1634:
1619:
1238:Journal of the Royal Society of Medicine
1138:
524:
236:
163:
3050:
2512:
2510:
2508:
2506:
2504:
2502:
2395:Journal of Controversial Medical Claims
2311:American Journal of Industrial Medicine
2265:
2081:
2079:
1777:
1771:
1735:American Journal of Industrial Medicine
1361:
1359:
1357:
1150:American Journal of Industrial Medicine
1099:United States General Accounting Office
14:
3333:
3248:http://www.gao.gov/products/GAO-01-60R
3119:
3117:
3115:
3010:"Out of hospital needlestick injuries"
2658:
2656:
2654:
2652:
2650:
2612:
2610:
2608:
2606:
2516:
2212:
2210:
2208:
2206:
2170:
2168:
2166:
2164:
2120:
2118:
2116:
2114:
2112:
2037:
2035:
2033:
2031:
1917:
1915:
1884:
1882:
1668:
1666:
1572:
1570:
1568:
1458:
1456:
1454:
1452:
1092:
1028:
1026:
856:
430:
2909:
2850:
2841:
2744:Revista Panamericana de Salud Pública
2268:American Journal of Infection Control
1951:
1949:
1947:
1945:
1724:
1722:
1720:
1576:
1423:American Journal of Infection Control
1281:
1279:
1277:
1227:
1225:
1183:
1181:
1179:
1024:
1022:
1020:
1018:
1016:
1014:
1012:
1010:
1008:
1006:
962:
960:
958:
956:
954:
745:
743:
741:
739:
737:
735:
733:
731:
520:
314:is recommended for added protection.
2619:International Journal of Drug Policy
2499:
2405:
2177:International Journal of Drug Policy
2076:
1354:
1315:
1088:
1086:
801:
799:
797:
698:
696:
694:
692:
456:
90:is the penetration of the skin by a
3112:
3071:
2647:
2603:
2203:
2161:
2109:
2054:(3. Art. No.: CD009740): CD009740.
2028:
1912:
1879:
1663:
1565:
1449:
1309:
1194:The New England Journal of Medicine
24:
3065:HIV Surveillance Special Report 11
2386:
1942:
1836:
1832:from the original on 22 July 2017.
1717:
1274:
1222:
1176:
1003:
951:
728:
617:were first established in 1981 in
25:
3372:
3165:
2783:from the original on 22 July 2018
2425:from the original on 3 March 2017
1996:from the original on 23 June 2019
1900:from the original on 15 July 2017
1297:from the original on 5 March 2016
1105:from the original on 4 March 2016
1083:
794:
716:from the original on 22 June 2017
689:
449:counseling, and follow-up costs.
122:
2588:10.1097/00042560-199802001-00019
2487:from the original on 7 June 2019
2362:10.1097/00000658-199808000-00017
2097:(RR-16). CDC: 1–33, quiz CE1–4.
461:
442:Government Accountability Office
3001:
2952:
2757:10.1590/S1020-49892010000600009
2728:
2671:
2467:
2302:
1812:
1513:
1413:
1392:
1380:from the original on 8 May 2016
1319:Disability & Rehabilitation
667:Scalpel § Scalpel injuries
595:Home needle destruction devices
364:
2061:10.1002/14651858.CD009740.pub2
1595:10.1002/14651858.cd009740.pub3
1481:10.1002/14651858.CD009573.pub2
1051:10.1002/14651858.CD009170.pub2
915:Wiener Klinische Wochenschrift
902:
452:
317:
296:
182:post-traumatic stress disorder
13:
1:
2938:10.1126/science.280.5371.1884
2641:10.1016/s0955-3959(03)00133-6
682:
446:American Hospital Association
306:. The mainstay of PEP is the
232:
214:personal protective equipment
2965:Paediatrics and Child Health
2664:"Access to sterile syringes"
2189:10.1016/j.drugpo.2010.02.001
1825:Food and Drug Administration
1535:10.1097/sla.0000000000002178
310:; in certain circumstances,
276:
267:Food and Drug Administration
263:American College of Surgeons
109:human immunodeficiency virus
7:
2865:10.1126/science.276.5309.51
1673:Yang, L; Mullan, B (2011).
645:
484:, discuss the issue on the
10:
3377:
2535:10.1177/193229681100500404
2280:10.1016/j.ajic.2018.10.003
1930:(RR-19). CDC: 1–39. 1998.
1649:10.1016/j.aorn.2012.08.010
1583:Cochrane Database Syst Rev
1435:10.1016/j.ajic.2009.02.014
1408:10.1016/j.ajic.2019.11.030
1250:10.1177/014107680409700705
868:Alamgir, H; Yu, S (2008).
312:hepatitis B immunoglobulin
135:, the risk of contracting
3173:
2235:10.1007/s10461-013-0593-y
2139:10.1080/10826080600669579
1332:10.1080/09638280902874147
927:10.1007/s00508-008-1011-8
832:10.1007/s00420-014-0977-y
589:Syringe exchange programs
586:Drop-off collection sites
371:World Health Organization
291:post-exposure prophylaxis
241:Blood being drawn with a
178:post-exposure prophylaxis
149:World Health Organization
68:
59:
50:
42:
37:
3283:10 February 2012 at the
1797:10.1161/01.cir.101.3.e38
615:Needle exchange programs
610:Needle exchange programs
551:Denver Police Department
414:have high risk, whereas
195:
1402:2020;48(9):1013–1018.
1400:Am. J. Infect. Control.
435:
18:Accidental needle stick
3127:J Public Health Policy
2819:10.1542/peds.2008-0290
2696:10.7448/IAS.19.4.20874
1126:Cite journal requires
530:
326:
246:
1890:"Stop Sticks – NIOSH"
887:10.1093/occmed/kqn028
874:Occupational Medicine
628:Hartford, Connecticut
528:
283:acute hepatitis panel
240:
164:Psychological effects
3356:Occupational hazards
3256:, an alert from the
3139:10.1057/jphp.2014.54
3026:10.1136/adc.70.3.245
2977:10.1093/pch/13.3.205
2959:Moore D. L. (2008).
1207:10.1056/NEJMoa070378
482:improve this section
472:may not represent a
334:antiretroviral drugs
210:blood-borne diseases
147:is the highest. The
119:healthcare workers.
97:blood-borne diseases
3289:Worker Information
2930:1998Sci...280.1884W
2903:25 May 2020 at the
2581:(Supp 1): S111–19.
1857:10.1017/ice.2015.50
1778:SoRelle, R (2000).
1692:10.5402/2011/315432
824:2015IAOEH..88..477L
764:10.1017/ice.2015.50
431:Society and culture
404:otorhinolaryngology
351:protease inhibitors
308:hepatitis B vaccine
287:HB surface antibody
190:occupational safety
3346:Industrial hygiene
3097:10.1093/ije/dyt243
2323:10.1002/ajim.20230
2020:has generic name (
1747:10.1002/ajim.22392
1162:10.1002/ajim.22057
592:Mail-back programs
560:sanitation workers
531:
521:Outside healthcare
247:
88:needlestick injury
79:Infectious disease
75:Emergency medicine
38:Needlestick injury
3243:
3242:
2924:(5371): 1884–88.
2350:Annals of Surgery
2223:AIDS and Behavior
1577:Reddy, V (2017).
1523:Annals of Surgery
921:(15–16): 486–92.
514:
513:
506:
408:internal medicine
355:fusion inhibitors
105:hepatitis C virus
101:hepatitis B virus
92:hypodermic needle
84:
83:
32:Medical condition
16:(Redirected from
3368:
3171:
3170:
3159:
3158:
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3099:
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2158:
2133:(6–7): 777–813.
2127:Subst Use Misuse
2122:
2107:
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2074:
2073:
2063:
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1589:(11): CD009740.
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1500:
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543:waste collectors
509:
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113:mucous membranes
62:sharps container
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3367:
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3341:Medical hygiene
3331:
3330:
3285:Wayback Machine
3244:
3239:
3238:
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2905:Wayback Machine
2895:
2888:
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2632:10.1.1.636.9789
2625:(5–6): 353–57.
2615:
2604:
2567:
2560:
2517:Gold K (2011).
2515:
2500:
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1828:. 30 May 2012.
1818:
1817:
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1326:(23): 1963–69.
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579:syringe service
575:needle disposal
539:law enforcement
523:
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3177:
3175:
3174:Classification
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3166:External links
3164:
3161:
3160:
3111:
3070:
3049:
3014:Arch Dis Child
3000:
2951:
2908:
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2840:
2794:
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2690:(4S3): 20874.
2670:
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2449:Pain Physician
2436:
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2336:
2317:(6): 482–490.
2301:
2274:(4): 448–455.
2258:
2229:(9): 2878–92.
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1974:10.1086/672271
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652:Needle spiking
647:
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640:zero tolerance
611:
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511:
476:of the subject
474:worldwide view
469:
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319:
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298:
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265:(ACS) and the
234:
231:
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170:health anxiety
165:
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157:seroconversion
131:, viruses and
124:
123:Health effects
121:
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40:
39:
31:
26:
9:
6:
4:
3:
2:
3373:
3362:
3359:
3357:
3354:
3352:
3349:
3347:
3344:
3342:
3339:
3338:
3336:
3327:
3324:
3322:
3319:
3317:
3314:
3312:
3309:
3306:
3302:
3299:
3297:
3294:
3292:
3288:
3286:
3282:
3279:
3276:
3274:
3271:
3269:
3265:
3262:
3259:
3255:
3252:
3249:
3246:
3245:
3235:
3231:
3230:
3226:
3224:
3220:
3219:
3215:
3213:
3209:
3208:
3204:
3200:
3198:
3194:
3193:
3189:
3185:
3184:
3181:
3176:
3172:
3156:
3152:
3148:
3144:
3140:
3136:
3133:(2): 212–30.
3132:
3128:
3120:
3118:
3116:
3107:
3103:
3098:
3093:
3090:(1): 235–48.
3089:
3085:
3081:
3074:
3066:
3062:
3056:
3054:
3045:
3041:
3036:
3031:
3027:
3023:
3020:(3): 245–46.
3019:
3015:
3011:
3004:
2996:
2992:
2987:
2982:
2978:
2974:
2971:(3): 205–10.
2970:
2966:
2962:
2955:
2947:
2943:
2939:
2935:
2931:
2927:
2923:
2919:
2912:
2906:
2902:
2899:
2893:
2891:
2882:
2878:
2874:
2870:
2866:
2862:
2858:
2854:
2847:
2845:
2836:
2832:
2828:
2824:
2820:
2816:
2813:(2): 487–92.
2812:
2808:
2801:
2799:
2779:
2775:
2771:
2767:
2763:
2758:
2753:
2750:(6): 467–68.
2749:
2745:
2738:
2731:
2723:
2719:
2714:
2709:
2705:
2701:
2697:
2693:
2689:
2685:
2681:
2674:
2665:
2659:
2657:
2655:
2653:
2651:
2642:
2638:
2633:
2628:
2624:
2620:
2613:
2611:
2609:
2607:
2598:
2594:
2589:
2584:
2580:
2576:
2572:
2565:
2563:
2554:
2550:
2545:
2540:
2536:
2532:
2529:(4): 848–50.
2528:
2524:
2520:
2513:
2511:
2509:
2507:
2505:
2503:
2483:
2476:
2470:
2462:
2458:
2455:(2): 193–95.
2454:
2450:
2443:
2441:
2421:
2414:
2408:
2400:
2396:
2389:
2381:
2377:
2372:
2367:
2363:
2359:
2356:(2): 266–72.
2355:
2351:
2347:
2340:
2332:
2328:
2324:
2320:
2316:
2312:
2305:
2297:
2293:
2289:
2285:
2281:
2277:
2273:
2269:
2262:
2254:
2250:
2245:
2240:
2236:
2232:
2228:
2224:
2220:
2213:
2211:
2209:
2207:
2198:
2194:
2190:
2186:
2183:(5): 335–42.
2182:
2178:
2171:
2169:
2167:
2165:
2156:
2152:
2148:
2144:
2140:
2136:
2132:
2128:
2121:
2119:
2117:
2115:
2113:
2104:
2100:
2096:
2092:
2091:
2082:
2080:
2071:
2067:
2062:
2057:
2053:
2049:
2045:
2038:
2036:
2034:
2032:
2023:
2018:|first9=
2011:
1995:
1991:
1987:
1983:
1979:
1975:
1971:
1968:(9): 875–92.
1967:
1963:
1959:
1952:
1950:
1948:
1946:
1937:
1933:
1929:
1925:
1918:
1916:
1899:
1895:
1891:
1885:
1883:
1874:
1870:
1866:
1862:
1858:
1854:
1851:(7): 823–29.
1850:
1846:
1839:
1831:
1827:
1826:
1821:
1815:
1807:
1803:
1798:
1793:
1789:
1785:
1781:
1774:
1766:
1762:
1757:
1752:
1748:
1744:
1741:(3): 282–89.
1740:
1736:
1732:
1725:
1723:
1721:
1712:
1708:
1703:
1698:
1693:
1688:
1684:
1680:
1676:
1669:
1667:
1658:
1654:
1650:
1646:
1643:(5): 540–45.
1642:
1638:
1631:
1629:
1627:
1625:
1623:
1614:
1610:
1605:
1600:
1596:
1592:
1588:
1584:
1580:
1573:
1571:
1569:
1560:
1556:
1552:
1548:
1544:
1540:
1536:
1532:
1529:(2): 291–96.
1528:
1524:
1516:
1508:
1504:
1499:
1494:
1490:
1486:
1482:
1478:
1474:
1470:
1466:
1459:
1457:
1455:
1453:
1444:
1440:
1436:
1432:
1429:(9): 766–72.
1428:
1424:
1416:
1409:
1405:
1401:
1395:
1376:
1369:
1362:
1360:
1358:
1349:
1345:
1341:
1337:
1333:
1329:
1325:
1321:
1320:
1312:
1296:
1292:
1288:
1282:
1280:
1278:
1269:
1265:
1260:
1255:
1251:
1247:
1244:(7): 326–27.
1243:
1239:
1235:
1228:
1226:
1217:
1213:
1208:
1203:
1199:
1195:
1191:
1184:
1182:
1180:
1171:
1167:
1163:
1159:
1156:(7): 650–55.
1155:
1151:
1144:
1142:
1133:
1120:
1104:
1100:
1096:
1089:
1087:
1078:
1074:
1069:
1064:
1060:
1056:
1052:
1048:
1044:
1040:
1036:
1029:
1027:
1025:
1023:
1021:
1019:
1017:
1015:
1013:
1011:
1009:
1007:
998:
994:
990:
986:
982:
978:
975:(9): 935–39.
974:
970:
963:
961:
959:
957:
955:
946:
942:
937:
932:
928:
924:
920:
916:
912:
905:
897:
893:
888:
883:
880:(6): 393–99.
879:
875:
871:
864:
862:
860:
851:
847:
842:
837:
833:
829:
825:
821:
818:(4): 477–84.
817:
813:
809:
802:
800:
798:
789:
785:
781:
777:
773:
769:
765:
761:
758:(7): 823–29.
757:
753:
746:
744:
742:
740:
738:
736:
734:
732:
712:
709:. CDC. 2011.
705:
699:
697:
695:
693:
688:
678:
677:Medical glove
675:
673:
670:
668:
665:
663:
660:
658:
655:
653:
650:
649:
643:
641:
636:
632:
629:
623:
620:
616:
607:
600:
597:
594:
591:
588:
585:
584:
583:
580:
576:
571:
567:
563:
561:
555:
552:
548:
544:
540:
535:
527:
518:
508:
505:
497:
494:February 2016
487:
483:
477:
475:
468:
459:
458:
450:
447:
443:
428:
424:
421:
417:
413:
409:
405:
401:
397:
393:
387:
383:
381:
377:
372:
369:In 2007, the
362:
360:
356:
352:
348:
344:
340:
335:
324:
315:
313:
309:
305:
304:liver disease
294:
292:
288:
284:
274:
272:
268:
264:
258:
254:
250:
244:
239:
230:
227:
223:
219:
218:needle driver
215:
211:
207:
203:
202:intramuscular
193:
191:
185:
183:
179:
175:
171:
161:
158:
153:
150:
146:
142:
138:
134:
130:
120:
116:
114:
110:
106:
102:
98:
93:
89:
80:
76:
73:
71:
67:
63:
58:
54:
49:
45:
41:
36:
30:
19:
3227:
3216:
3201:
3186:
3130:
3126:
3087:
3083:
3073:
3064:
3017:
3013:
3003:
2968:
2964:
2954:
2921:
2917:
2911:
2856:
2852:
2810:
2806:
2787:17 September
2785:. Retrieved
2747:
2743:
2730:
2687:
2683:
2673:
2622:
2618:
2578:
2574:
2526:
2522:
2489:. Retrieved
2469:
2452:
2448:
2427:. Retrieved
2407:
2398:
2394:
2388:
2353:
2349:
2339:
2314:
2310:
2304:
2271:
2267:
2261:
2226:
2222:
2180:
2176:
2130:
2126:
2094:
2088:
2051:
2047:
2010:cite journal
1998:. Retrieved
1965:
1961:
1927:
1923:
1902:. Retrieved
1893:
1848:
1844:
1838:
1823:
1814:
1787:
1783:
1773:
1738:
1734:
1682:
1679:ISRN Nursing
1678:
1640:
1637:AORN Journal
1636:
1586:
1582:
1526:
1522:
1515:
1472:
1468:
1426:
1422:
1415:
1399:
1394:
1382:. Retrieved
1323:
1317:
1311:
1299:. Retrieved
1290:
1241:
1237:
1197:
1193:
1153:
1149:
1119:cite journal
1107:. Retrieved
1042:
1038:
972:
968:
918:
914:
904:
877:
873:
815:
811:
755:
751:
720:10 September
718:. Retrieved
672:Sharps waste
637:
633:
624:
613:
604:
572:
568:
564:
556:
536:
532:
515:
500:
491:
471:
439:
425:
388:
384:
368:
365:Epidemiology
330:
321:
300:
280:
259:
255:
251:
248:
226:night shifts
199:
186:
167:
154:
126:
117:
87:
85:
29:
3303:, from the
3266:, from the
1904:27 February
1784:Circulation
1384:23 February
1301:25 February
657:Peggy Ferro
453:Legislation
412:dermatology
359:HIV testing
318:Hepatitis C
297:Hepatitis B
206:intravenous
141:hepatitis C
137:hepatitis B
107:(HCV), and
43:Other names
3335:Categories
3229:DiseasesDB
2807:Pediatrics
1790:(3): E38.
1109:30 October
683:References
420:pediatrics
400:anesthesia
353:(PIs), or
349:(NNRTIs),
345:(NtRTIs),
243:Vacutainer
233:Prevention
220:, or when
174:depression
2766:1020-4989
2704:1758-2652
2627:CiteSeerX
1543:0003-4932
1489:1469-493X
1059:1469-493X
772:1559-6834
619:Amsterdam
547:San Diego
486:talk page
416:radiology
341:(NRTIs),
277:Treatment
70:Specialty
3351:Injuries
3281:Archived
3155:12007017
3147:25590514
3106:24374889
2995:19252702
2901:Archived
2881:33262844
2835:12916388
2827:18676535
2778:Archived
2774:20721448
2722:27435711
2553:21880224
2482:Archived
2461:16902692
2420:Archived
2418:. 2000.
2331:16299710
2296:54487905
2288:30502112
2253:23975473
2197:20189375
2155:38282874
2147:16809167
2103:17159833
2070:24610008
1994:Archived
1990:17032413
1982:23917901
1898:Archived
1873:20953913
1865:25765502
1830:Archived
1806:10645936
1765:25308763
1711:22007320
1685:: 1–11.
1657:23107034
1613:29190036
1559:10024783
1551:28221166
1507:24610769
1498:10766138
1443:19647344
1375:Archived
1348:29903130
1340:19479544
1295:Archived
1268:15229257
1216:17596603
1170:22544469
1103:Archived
1077:22071864
997:25667952
989:23917907
945:18820853
896:18356143
850:25216822
788:20953913
780:25765502
711:Archived
646:See also
480:You may
129:protozoa
3260:(NIOSH)
3223:D016602
3044:8135572
3035:1029753
2986:2529409
2946:9632381
2926:Bibcode
2918:Science
2873:9122710
2853:Science
2713:4951532
2597:9663633
2544:3192588
2429:15 July
2380:9712573
2371:1191469
2244:6509353
2000:25 June
1936:9790221
1894:cdc.gov
1756:5077298
1702:3169876
1604:6491125
1259:1079524
1068:7387125
936:7088025
841:6597253
820:Bibcode
406:(ENT),
222:sutures
103:(HBV),
3361:Gloves
3307:(OSHA)
3212:E920.5
3153:
3145:
3104:
3042:
3032:
2993:
2983:
2944:
2879:
2871:
2833:
2825:
2772:
2764:
2720:
2710:
2702:
2629:
2595:
2551:
2541:
2491:6 June
2459:
2378:
2368:
2329:
2294:
2286:
2251:
2241:
2195:
2153:
2145:
2101:
2068:
1988:
1980:
1934:
1871:
1863:
1804:
1763:
1753:
1709:
1699:
1655:
1611:
1601:
1557:
1549:
1541:
1505:
1495:
1487:
1441:
1346:
1338:
1266:
1256:
1214:
1168:
1075:
1065:
1057:
995:
987:
943:
933:
894:
848:
838:
786:
778:
770:
410:, and
396:fascia
392:muscle
143:, and
133:prions
3234:31976
3151:S2CID
2877:S2CID
2831:S2CID
2781:(PDF)
2740:(PDF)
2485:(PDF)
2478:(PDF)
2423:(PDF)
2416:(PDF)
2401:: 12.
2292:S2CID
2151:S2CID
1986:S2CID
1869:S2CID
1555:S2CID
1378:(PDF)
1371:(PDF)
1344:S2CID
993:S2CID
784:S2CID
714:(PDF)
707:(PDF)
196:Cause
3218:MeSH
3207:9-CM
3143:PMID
3102:PMID
3040:PMID
2991:PMID
2942:PMID
2869:PMID
2823:PMID
2789:2019
2770:PMID
2762:ISSN
2718:PMID
2700:ISSN
2593:PMID
2549:PMID
2493:2019
2457:PMID
2431:2016
2376:PMID
2327:PMID
2284:PMID
2249:PMID
2193:PMID
2143:PMID
2099:PMID
2090:MMWR
2066:PMID
2022:help
2002:2019
1978:PMID
1932:PMID
1924:MMWR
1906:2016
1861:PMID
1802:PMID
1761:PMID
1707:PMID
1683:2011
1653:PMID
1609:PMID
1587:2017
1547:PMID
1539:ISSN
1503:PMID
1485:ISSN
1473:2014
1439:PMID
1386:2016
1336:PMID
1303:2016
1264:PMID
1212:PMID
1166:PMID
1132:help
1111:2015
1073:PMID
1055:ISSN
1043:2016
985:PMID
941:PMID
892:PMID
846:PMID
776:PMID
768:ISSN
722:2017
577:and
436:Cost
418:and
3250:GAO
3203:ICD
3197:W46
3188:ICD
3135:doi
3092:doi
3030:PMC
3022:doi
2981:PMC
2973:doi
2934:doi
2922:280
2861:doi
2857:276
2815:doi
2811:122
2752:doi
2708:PMC
2692:doi
2637:doi
2583:doi
2539:PMC
2531:doi
2366:PMC
2358:doi
2354:228
2319:doi
2276:doi
2239:PMC
2231:doi
2185:doi
2135:doi
2056:doi
1970:doi
1853:doi
1792:doi
1788:101
1751:PMC
1743:doi
1697:PMC
1687:doi
1645:doi
1599:PMC
1591:doi
1531:doi
1527:267
1493:PMC
1477:doi
1431:doi
1404:doi
1328:doi
1254:PMC
1246:doi
1202:doi
1198:356
1158:doi
1063:PMC
1047:doi
977:doi
931:PMC
923:doi
919:120
882:doi
836:PMC
828:doi
760:doi
626:in
394:or
327:HIV
204:or
145:HIV
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