Healthcare worker safety is a pre-requisite for injection safety in developing countries

Unsafe injection practices, including the re-use of unsterile needles and syringes, are commonplace in developing country health settings, and contribute substantially to the global burden of blood-borne viral disease. Unsafe injection practices place at risk not only patients, but also healthcare workers, who practice universal precautions inconsistently and are commonly exposed to blood in the course of their work. Global awareness of the link between unsafe injection practices and the burden of blood-borne viral disease was slow to emerge but has grown in the recent years. In 1999, the World Health Organization (WHO) established the Safe Injection Global Network (SIGN), which advocates a range of interventions for the promotion of injection safety. As well as exhorting healthcare workers to use a new needle and syringe for every injection, they should also be encouraged and supported to protect themselves from exposure to blood. It is argued here that promoting the occupational safety of healthcare workers in developing countries is an essential and currently under-valued component of the response to the problem of unsafe injection practices. Protecting healthcare workers from occupational infection with blood-borne viruses has a range of potential benefits, including safer injection practices for patients and less discrimination against people with HIV/AIDS. There is an urgent need for organisational commitment to the occupational safety of healthcare workers in developing countries, along with the provision of training in injection safety and universal precautions, adequate supplies of personal protective equipment, and hepatitis B vaccination.