Between April 2000 and March 2002 (24 months), the Canadian Needle Stick Surveillance Network (CNSSN) gathered data from 12 hospitals or health authorities that voluntarily reported information. This data identified that the number of reported exposures from blood and body fluid was approximately 15.3 per 100 beds each year. In cases specifically related to percutaneous injuries, the estimate was 12.9 per 100 beds each year. Other data further reports approximately 3.2 injuries per 100 full-time equivalent (FTE) staff (Nguyen, Paton and Koch, 2003) and research conducted in Montreal hospitals estimates as many 12 injuries per FTE each year (Robillard and Roy, 1995).

Within the overall exposure data, some job-specific exposure rates appear to be significantly higher. Data from a variety of blood and body fluid exposure sources indicate that the following job categories are among the most exposed (CNSSN; Perry, Parker and Jagger, 2005; Laramie and Davis, 2004):

• Nursing occupations
• Medical doctors, residents and students
• Phlebotomists/clinical lab technologists
• Sterilization and surgical attendants

Ontario WSIB data, in Figure 2, identifies similar results with nursing occupations having the greatest number of reported exposures. Physician-related exposures are not represented in WSIB data as, for the most part, they are not covered by the WSIB. Their exposure data is often captured in data collection systems or through study surveys.

Figure 2 – Occupations Experiencing Punctures from Needle Sticks, 1998 to 2006

As a group, physicians, including specialists and surgeons, have an alarming risk of sharps-related injuries and are reported by many sources to have among the highest rates of injury (CNSSN; Perry, Parker and Jagger, 2005; Laramie and Davis, 2004). Researchers in Montreal noted that physicians and surgeons were poor performers regarding sharps safety, prompting the researchers to remark that “education to physicians is needed” (Robillard and Roy, 1995).

As mentioned at the outset, one of the greatest problems with analysis of blood and body fluid exposures and sharps injuries is the general lack of good reporting. While it is clear from the WSIB data presented in Figure 1 that the reporting of injuries is on the rise, one can still expect that under-reporting remains a problem. Studies suggest anywhere from 30% to 90% of incidents go unreported. In their research in Montreal, Robillard and Roy found that as many as half of the exposures went unreported through official channels.

A study at a medical centre in California (Radecki, Abbott and Eloi, 2000) found that, among respondents of a confidential survey, 71% had an exposure but only 9% reported the incident. The top three reasons cited for not reporting were:

• Reporting would not change outcome
• There was not enough time
• Occupational health services were too far away

In efforts to encourage better reporting of sharps incidents, it is obvious that educating people about the need to report all incidents is very important. It should be noted that researchers have found that sites where reporting was highest occurred within organizations that provided the best service to exposed workers (Robillard and Roy, 1995).