Prevention from Sharp Injuries in the Hospital Sector: An Italian National Observatory on the Implementation of the Council Directive 2010/32/EU before and during the COVID-19 Pandemic

Gabriella De Carli; Alessandro Agresta; Maria Giuseppina Lecce; Patrizia Marchegiano; Gianpaolo Micheloni; Dimitri Sossai; Giuseppe Campo; Paola Tomao; Nicoletta Vonesch; Sara Leone; Vincenzo Puro; The Studio Italiano Rischio Occupazionale da Hiv Siroh Group

doi:10.3390/ijerph191711144

Prevention from Sharp Injuries in the Hospital Sector: An Italian National Observatory on the Implementation of the Council Directive 2010/32/EU before and during the COVID-19 Pandemic

Int J Environ Res Public Health. 2022 Sep 5;19(17):11144. doi: 10.3390/ijerph191711144.

Affiliations

¹ UOC Infezioni Emergenti e Riemergenti e CRAIDS, Dipartimento di Epidemiologia, Ricerca Preclinica e Diagnostica Avanzata, INMI L. Spallanzani-IRCCS, 00149 Rome, Italy.
² Ufficio IV-Direzione Generale della Prevenzione del Ministero della Salute, 00144 Rome, Italy.
³ SC Servizio Prevenzione e Protezione Aziendale, Azienda Ospedaliero-Universitaria di Modena, 41124 Modena, Italy.
⁴ Servizio Medicina del Lavoro, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy.
⁵ U.O. Servizio Prevenzione e Protezione, Ospedale Policlinico San Martino, 16132 Genova, Italy.
⁶ INAIL-Sezione Sistemi di Sorveglianza e Gestione Integrata del Rischio, Dipartimento di Medicina, Epidemiologia, Igiene del Lavoro ed Ambientale, 00144 Rome, Italy.
⁷ INAIL-Laboratorio Rischio Agenti Biologici, Dipartimento di Medicina, Epidemiologia, Igiene del Lavoro ed Ambientale, 00078 Monte Porzio Catone, Italy.
⁸ UOC Epidemiologia Clinica, Dipartimento di Epidemiologia, Ricerca Preclinica e Diagnostica Avanzata, INMI L. Spallanzani-IRCCS, 00149 Rome, Italy.

Abstract

Sharp injuries, determining the risk of bloodborne infections and psychological distress in healthcare workers, may be prevented by a set of strategies, legally enforced in Europe through the Directive 2010/32/EU. To assess its level of implementation in Italy, a national survey was conducted in 2017 and again in 2021, evaluating the progress and possible drawbacks of the COVID-19 pandemic. Altogether, 285 safety managers and 330 nurses from a representative sample of 97 and 117 public hospitals were interviewed using a standardized questionnaire. Knowledge of the Directive requirements decreased significantly, with <60% of participants answering correctly in 2021, and nurses' attendance in specific courses dropped to 25% in 2021 compared to 54% in 2017. Over 75% of hospitals introduced multiple safety-engineered devices (SED), though total replacement occurred in <50% of cases; routine SED availability increased for blood collection (89%) and venous access devices (83%). Incorrect behaviors in handling sharps decreased significantly over time. Nurses' HBV vaccination coverage was high (89% in both surveys); in the last year, 97% were vaccinated against COVID, and 47% against influenza. Average annual injuries per hospital did not increase significantly (32 in 2021 vs. 26 in 2017). In 2017, nurses' perceived safety barriers were working in emergency situations (49%) and lack of resources (40%); in 2021, understaffing (73%), physical fatigue (62%), and handling difficulties while wearing full protective equipment (59%). Safety measures were implemented in Italian hospitals, and although the average injuries per hospital did not show a decrease, these measures could have helped protect healthcare workers during the pandemic, mitigating its potential impact on the increase in situations at risk of injury.

Keywords: COVID-19; accident prevention; accident prevention/legislation and jurisprudence; bloodborne pathogens; health personnel; needlestick injuries; nurses; safety-engineered devices; sharps injuries; vaccination.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
COVID-19* / prevention & control
Health Personnel
Hospitals, Public
Humans
Italy / epidemiology
Needlestick Injuries* / epidemiology
Pandemics / prevention & control

Grants and funding

This research was funded by: Ministero della salute: Ricerca Corrente IRCCS-Linea 1-progetto 2; Programma CCM 32/2018 “Modello integrato per la valutazione dell’impatto dell’esposizione ai fattori di rischio fisico chimico e biologico sulla salute e la sicurezza degli operatori sanitari”; Istituto Nazionale per l’Assicurazione Contro Gli Infortuni sul Lavoro: BRIC ID 27/2019 “Studio degli aspetti organizzativi, immunologici e di genere per la prevenzione, diagnosi, sorveglianza e gestione dei rischi biologici occupazionali nel personale sanitario: un approccio integrato e personalizzato” and an unrestricted grant by Becton-Dickinson.