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Preventing Needlesticks with safer Needles

UNISON's Needle Safety at Work campaign has been credited with re-awakening a wider interest in reducing needlestick injuries, an increased awareness of "safer needles" in the UK and a significant improvement in the reporting of needlestick injuries.

UNISON is the largest union in the United Kingdom with 1.3 million members, 440,000 of whom are healthworkers. Whilst our largest occupational grouping is nurses we represent all members of the health team excepting Medics. Our campaign has been aimed at all healthworkers who receive needlesticks as well as those at risk from drug related litter.

The campaign began in response to the 1996 National Audit Office report "Health and Safety in Acute NHS Hospital Trusts in England", which showed needlestick injuries on a par with manual handling at 16% of all accidents. Consequently UNISON ran two short campaigns on sharps boxes and the provision of Hepatitis B vaccination for all appropriate staff.

During 1997 we became aware of a campaign in the United States of America to introduce legislation for the provision of safer needles. One of our sister unions in the US, the Service Employees International Union (SEIU) was at the forefront.

Learning from the US, using our own imagery and adapting materials from the SEIU, UNISON launched a UK wide campaign in the autumn of 1998.

Why focus on safer needles?

Previous campaigns have targeted improved infection control, better management or training to reduce exposure to blood borne pathogens, all of which are of crucial importance. However, whilst these methods can remove human error, they cannot remove the primary risk - the needle or sharp itself. Technology that removes the necessity for a needle by changing drug delivery methods, using needleless IV systems or retractable, self blunting or shielded devices can remove the risk.

The legal basis for their introduction into the UK is unquestionable. Regulation 7 of the Control of Substance Hazardous to Health Regulations 1999 makes it clear that risks from biological agents must be eliminated or, where this is not possible, control methods including using equipment with so called "engineering controls" (such as safer needles) should be used to minimise risk, where reasonably practicable.

The real argument used against safer needles in the UK is financial. Some safer needles do cost significantly more, but the range of safer needles and their different cost has not been properly understood by purchasers. There has also yet to be a rigorous Cost Benefit Analysis, because of the potential variables - the different risk situations, varying needle prices, costs of testing patients and exposed staff, record keeping, staff cover and replacement costs, compensation and ultimately the costs of treatment. Never mind the trauma that health workers suffer whilst waiting for their results or the pressure on home life that has fractured many a relationship. At the start of our campaign compensation for a "straightforward" downstream injury was around £1,000, it is now up to £3-5,000. The Doctor who developed a needle phobia after a needlestick got £465,000. How much compensation will a worker infected with HEP C or HIV receive?

As well as producing guidance on safer needles (see below), UNISON has raised the issue with Ministers and the Department of Health's NHS Executive. We look forward to further guidance from the NHSE and NHS in Scotland. We have also sought to widen the issue across Europe and, via our Trade Secretariat the European Public Services Union, made our materials available to sister unions.

UNISON will continue to lead the campaign for safer needles in the UK. We see no reason why our colleagues in the US should have access to greater protection than UK workers.

Jon Richards UNISON Health Group
j.richards@unison.co.uk

UNISON has produced guidance notes entitled " Safer Needles - Questions and Answers," and "Evaluating Safer Needles". We also produce a health circular with a list of manufacturers/distributors of safer needles, whose products we have seen.
These can be found on UNISON's website under: workplace advice :advisory briefings: needlestick injuries.

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