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POST 00708E : ACCIDENTAL NEEDLESTICK Follow-up on Posts 00701E and 00706E 21 August 2004 _______________________________ Amber Hogan ( from the United States discusses preventive measures of accidental needlesticks. _______________________________ Best practices for preventing exposures to contaminated sharps include the institution of a hierarchy of controls which is more protective than what the WHO recommends. These elements are fundamental to the practice of industrial hygiene and community health throughout the world. 1. Substitution - if injections can be avoided and replaced with other means of delivery - this, obviously (but less of an option with immunization, more so with curative injections), is the best means of prevention 2. Engineering Controls - this includes the use of safer medical devices designed to reduce exposures to contaminated sharps - in the US, Canada, Japan, EU, Australia and New Zealand - these are very viable options and policies either exist or are being promulgated that support use of these safer devices. Self-sheathing needles, retracting needles, etc. 3. Work Practices - that must be used in concert with engineering controls (if available). This includes immediate disposal of contaminated sharps in a container, proper injection technique, NOT recapping, no hands passing, etc. These work practices are designed to protect not only the care giver, but also the patient, and the community downstream. Standard precautions are included here - assumption that all blood, all body fluids, all contaminated devices have the presence of HCV, HIV, HBV, etc. (standard precautions are more protective than universal precautions and were instituted back in the 1990s by the CDC). 4. Personal Protective Equipment - gloves, eye protection, etc. (if appropriate). PPE should be used always as a means of standard precautions, and if any or all of the above can't be used. Immunizations for flu, HBV, etc - are of course intrinsic to prevention strategies, but not included in the hierarchy, as they are separate and sure means of disease prevention. Amber Hogan Global Safety Policy BD Corporate Franklin Lakes, NJ - USA ______________________________________________________________________________ Visit the TECHNET21 Website at You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de coopération internationale en santé et développement, Québec, Canada ( ______________________________________________________________________________

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