The Urban Emergency Department: A Potential Increased Occupational Hazard for Sharps-related Injuries

Health care workers are at risk for sharps-related injuries while working in the clinical arena. The authors sought to quantify and compare the frequency of these injuries for all health care personnel between the urban and community emergency department (ED).

A retrospective review was performed on the institutional human resources database of all self- or supervisor-reported sharps-related injuries that occurred to ED personnel in a single health system from January 2010 through September 2014. The health system was composed of a single urban academic Level I trauma center and seven community EDs, two of which were academic Level III trauma centers. Each sharps-related injury was reviewed for site of injury, job class, and type of instrument causing the injury.

There were 171 sharps-related injuries reported during 447,986 urban and 1,350,623 community patient visits. Of the 171 injuries, 44.4% occurred to physicians, 39.2% to nurses, 12.9% to support staff, and 3.5% to physician assistants. Injuries occurred more frequently at the urban academic medical center when compared to the pooled community sites: 20.3 per 100,000 patient visits (n = 91) versus 5.9 per 100,000 patient visits (n = 80), respectively (odds ratio = 3.43, 95% confidence interval = 2.54 to 4.63, p < 0.001). They also occurred more frequently at the urban site when individually compared to each community site.

Physicians accounted for the largest proportion of health care workers reporting sharps-related injuries. These injuries occurred more frequently in the urban ED than in the community EDs.