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Sharps Injuries Among Medical Trainees and Attending Physicians
Stephen D Kasteler1, Michelle Reid2, Peter C Lee3
1S.D. Kasteler is currently an occupational medicine physician and a Major, U.S. Air Force, JBSA-Lackland, Texas. At the time of writing, he was chief resident, Occupational and Environmental Medicine Residency Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, and Air Force Institute of Technology, Wright-Patterson Air Force Base, Ohio; ORCID: https://orcid.org/0000-0001-7928-4779 .
Purpose:
Sharps injuries are a particularly concerning occupational hazard faced by physicians and are largely preventable. This study compared the proportion and rate of sharps injuries among medical trainees with those among attending physicians by sharps injury characteristics.
Method:
The authors used data reported to the Massachusetts Sharps Injury Surveillance System from 2002-2018. Sharps injury characteristics examined were department where injury occurred, device, purpose or procedure for which device was used or intended, presence of sharps injury prevention feature, who was holding the device, and how and when the injury occurred. Global chi-square was used to assess differences in the percent distribution of sharps injury characteristics between physician groups. Joinpoint regression was used to evaluate trends in injury rates among trainees and attendings.
Results:
From 2002-2018, 17,565 sharps injuries among physicians were reported to the surveillance system, 10,525 of which occurred among trainees. For attendings and trainees combined, sharps injuries occurred most in operating and procedure rooms and most often involved suture needles. Significant differences in sharps injuries were found between trainees and attendings with respect to department, device, and intended purpose or procedure. Sharps without engineered sharps injury protections accounted for approximately 4.4 times as many injuries (13,355, 76.0%) as those with protections (3,008, 17.1%). Among trainees, sharps injuries were highest in the first quarter of the academic year and decreased over time, while sharps injuries among attendings had a very slight, significant increase.
Conclusions:
Sharps injuries are an ongoing occupational hazard faced by physicians, particularly during clinical training. Further research is needed to elucidate the etiology of the observed injury patterns during the academic year. Medical training programs need to implement a multipronged approach to prevent sharps injuries, including increased use of devices with sharps injury prevention features and robust training on safe handling of sharps.
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