EXPO-S.T.O.P. 2016 and 2017 blood exposure surveys: An alarming rise

The annual Exposure Survey of Trends in Occupational Practice (EXPO-S.T.O.P.), conducted by the Association of Occupational Health Professionals in Healthcare, provides a U.S. national overview of sharps injuries (SIs) and mucocutaneous exposures (MCEs). This study presents the 2016 and 2017 surveys.

An 18-item survey was distributed to Association of Occupational Health Professionals in Healthcare members and colleagues and requested total SIs and MCEs; SI in nurses, doctors, and surgery; staffed beds; teaching status; full-time equivalent staff (FTE), nurse FTE, and average daily census (ADC).

In 2016, 170 hospitals reported 10,271 exposures (72.9% SIs); in 2017, 224 hospitals reported 12,672 exposures (74.4% SIs). In 2016, SI rates were 27.0 per 100 ADC, 2.3 per 100 FTE, and 2.8 per 100 nurse FTE. Of the total SIs, 36.4% were nurses, 35.6% were doctors, and 39.0% occurred during surgery. In 2017, the respective SI rates were 27.7 per 100 ADC, 2.5 per 100 FTE, and 2.7 per 100 nurse FTE. Of the total SIs, 37.6% were nurses, 32.7% were doctors, and 39.9% occurred during surgery. In 2016, MCE rates were 11.2 per 100 ADC and 0.82 per 100 FTE, and in 2017, MCE rates were 9.6 per 100 ADC and 0.87 per 100 FTE. Teaching hospitals had higher rates than nonteaching hospitals.

EXPO-S.T.O.P. SI rates have risen year-on-year for 3 years and now match 2001-2005 levels.

There is an urgent need for aggressive SI-reduction strategies, including leadership support, safety-engineered devices (SED) training/education, and adoption of safer, less user-dependent SED. Further research on SI mechanisms, SED effectiveness, and reduction strategies is required.