04.04.2013 14:30 Age: 4 yrs

Healthcare and other workers at risk of psychiatric trauma from needlestick injuries shows new research

Released: 5 April 2013

A new study published today in the scientific journal Occupational Medicine has found that those who experience needlestick injuries can suffer persistent and substantial psychiatric illness or depression.

Needlestick or ‘sharps’ injuries are a daily risk to nurses, medical and health ancillary workers. The physical health effects of a needlestick injury are well known but this new research has demonstrated the mental health consequences of sharps injuries. The researchers found that those affected suffered psychiatric trauma that is similar in severity to trauma caused by other events such as road traffic accidents. This had a major impact on work attendance, family relationships and sexual health. The duration of the psychiatric symptoms were linked to the length of time the person injured by the sharp had to wait for blood test results.

Although sharps injuries mostly occur in healthcare settings, many other employees are also at risk including prison and police officers, park wardens, street cleaners and refuse collectors, tattoo artists and others who may come across carelessly or maliciously discarded hypodermic needles. A sharp contaminated with infected blood can transmit more than 20 diseases including hepatitis B, C and human immunodeficiency virus (HIV). This transmission risk causes worry and stress to the estimated 100,000 people who experience a needlestick accident every year.

Professor Ben Green who undertook the research said, “The psychological aspects of needlestick injuries are often overlooked. The chances of physical damage  - infection and so on - are what are focused on by society, but these risks are in reality very small. The main health implication of needlestick incidents is probably psychiatric injury caused by fear and worry.”

A number of case histories illustrate the types of psychiatric problems the individuals in their study had experienced:

Case history 1

Rachel, a thirty six year old health care worker in an accident and emergency department was emptying a clinic bin. She was replacing a bag when a needle, which had been incorrectly disposed of, pierced her leg. She was immediately shocked and worried and tried to make it bleed. She talked to the doctor on duty and he tried to reassure her that they hadn’t had any knowingly infected patients in but she was not reassured. She was worried that she had been exposed to an infectious disease such as HIV or hepatitis or another disorder and underwent a course of injections over the next week, which gave her diarrhoea. The injections then moved to monthly. She also had to have regular blood tests to check on whether she had seroconverted and was suffering from hepatitis B or C or HIV. She received the all clear from blood tests approximately six months later. Her anxiety gradually subsided thereafter.

Case history 2

Sarah, a 45-year-old coach driver was checking her coach at the end of her shift when she saw a dislodged seat. She attempted to shift the seat back into place, but was stuck by a hypodermic syringe that had been left under the seat. The needle went through the palm of her hand. She developed an adjustment disorder characterised by low mood and anxiety, intrusive thoughts about the possibility of getting AIDS, poor sleep, reduced appetite and hence weight loss which alarmed her further and absent libido. Her symptoms resolved on reassurance after final satisfactory blood tests at six months.

Case history 3

Rashid, a forty- year old postal worker was emptying a letterbox when a needle that had been discarded in the letterbox went into the ball of his thumb. He looked at the needle in his hand and instantly thought about ‘HIV’. He embarked upon a series of tests, associated with tearfulness, anxiety, restless sleep and loss of interest or pleasure in normally pleasurable pastimes. He avoided sex with his wife for six months until his tests were finally clear. This led to arguments in their relationship. Even after professional reassurance he still is not worry free and says: “I am not altogether reassured even now, no one can guarantee things 100% - I try to block it out and not think or talk about it”.

The Society of Occupational Medicine called for a much greater awareness of the psychiatric and physical effects of needle stick injuries. Workers who experience a needle stick injury need fast access to occupational health support, rapid results from blood tests and access to psychological support where appropriate. Occupational health specialist can help employers by undertaking a risk analysis and preventing and minimizing exposure.

“Needlestick injuries are a significant problem affecting a wide range of employees, both inside and outside healthcare settings.  Employers should not overlook the anxiety faced by employees worried about the possibility of contracting an infection such as hepatitis or AIDS.” said Dr Richard Heron, President of the Society of Occupational Medicine. “We need to reduce the incidence of needle stick injuries by raising awareness, education and making safer equipment available but we also need to ensure that people have rapid access to post-exposure support  - including psychological help if needed.”

 Psychiatric consequences of needlestick injury

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