Willingness to pay to avoid sharps-related injuries: a study in injured health care workers

Injuries caused by sharp medical devices are common among health care workers and may result in the transmission of human immunodeficiency virus and hepatitis C virus.

The direct medical costs associated with treating these injuries are well characterized but fail to capture the costs of such intangible factors as worker anxiety and distress. The objective of this study was to estimate these intangible costs.

Subjects included health care workers reporting sharps-related injuries to 2 hospital occupational health services.

A contingent valuation approach was used to assess willingness to pay to avoid sharps-related injuries among recently injured health care workers. Workers were presented with the option of paying out of pocket for a hypothetical injury-prevention device. The median amount of money subjects were willing to pay was estimated with logistic regression, and multivariable regression was performed to assess confounding by worker characteristics and circumstances surrounding injuries.

Study interviews were conducted for 116 subjects; median time from injury to interview was 3 days (range, 0-15). Most subjects were women (73%), and most were nurses (44%) or trainees (32%). The crude median amount subjects were willing to pay to avert injury was $850 (US); when adjusted for patient risk status (human immunodeficiency virus and hepatitis C virus status), and working with an uncooperative patient at the time of injury, median amount increased to $1270.

The high median amount subjects were willing to pay to avoid a sharps-related injury suggests that the costs of "intangible" aspects of worker injury, such as anxiety and distress, may equal costs associated with the medical evaluation of these injuries. These costs should be incorporated in economic analyses of sharps-injury prevention.