Sharps Exposure and Bloodborne Pathogens
Research Areas:
Health care workers continue to be exposed to the serious and sometimes life threatening risk of blood-borne infections in a wide variety of occupations and health care settings. An estimated 600,000 to 800,000 needlestick injuries occur annually (EPINet, 1998; Henry & Campbell, 1995), about half of which go unreported (EPINet, 1998; Roy & Robillard, 1995). It is estimated that each year more than 1,000 health care workers will contract a serious infection, such as hepatitis B or C virus or HIV from a needlestick injury. An estimated 50 to 247 health care workers are infected with HCV each year from work-related needlesticks (Sepkowitz, 2005). At an average hospital, workers incur approximately 30 needlestick injuries per 100 beds per year (EPINet, 1998). Nursing staff incur most needlesticks--44 percent of reported needlestick and sharp object injuries involve nurses (EPINet, 2001b).
Center researchers are examining the relationship between exposure to blood borne pathogens and work organization among RNs in the acute care and home care work setting and homecare Personal Care Assistants across five states. Descriptive epidemiology has documented the prevalence of blood exposure among RNs across settings and among non-certified PCAs in IL and WI. Center research is also studying the effectiveness of employer and worker targeted interventions to prevention blood exposure in the home care workplace.
Grants:
Blood Exposure and Primary Prevention in the Home Care Setting, CDC/NIOSH 2004-2008. The
major objectives of this project are to evaluate risk factors for needlesticks in the home
health care workplace and to develop and test an intervention for prevention of needlesticks.(PI)
Jane Lipscomb,(Co-PI) Kate McPhaul, Jeffrey Johnson, Jeanne Geiger Brown, Alison Trinkoff,
Karen Kauffman (R01 OH008237-01)
Extended Work Schedules and Workplace Injury in Nurses, CDC/NIOSH 2001-2005. The major objective of this project is to investigate the relationship between extended work schedules, musculoskeletal pain/disorders and needlestick injuries via a longitudinal mailed survey of registered nurses. (PI) A. Trinkoff, Co-investigators: Jeanne Geiger-Brown, Carles Muntaner, Jane Lipscomb (R01 OH007554-01)
Do Organizational Factors Influence both Patient and Worker Safety? Agency for Healthcare Research and Quality (AHRQ) 2001-2004. This is a study using administrative data to relate staffing to adverse patient outcomes and worker injuries (most of which are musculoskeletal) in hospitals and nursing homes. (PI) A. Trinkoff, (Co-PI) Meg Johantgen, Carles Muntaner (R01 HS011990).
MSDs in Nurses: Organization and Physical Work Factors. CDC/NIOSH1998-2001. The major goals of this project are to examine the effects of a number of work organization factors, prevention efforts and managed care penetration on the incidence and prevalence of work-related neck, shoulder and back pain/disorders among registered nurses working in both institutional and home care settings. (PI) A. Trinkoff,, (Co-PI) Jeanne Geiger-Brown, Carles Muntaner, Jane Lipscomb (R01 OH03702)
Publications:
Zanoni, J., Kauffman, K., McPhaul, K., Nickels, L., Hayden, M., Glassman, M., Vega, L., Sokas, R., Lipscomb, J. Personal Care Assistants and Blood Exposure in the Home Work Environment: Focus Group Findings Progress in Community Health Partnerships: Research, Education, and Action (in press, 2007).
Trinkoff, A.M., Le, R., Geiger-Brown, J., Lipscomb, J. A. Work schedule, needle use, and needlestick injuries in registered nurses. Infection Control and Hospital Epidemiology, 28:156-164, 2007.
Trinkoff, A., Geiger-Brown, J., Caruso, C.C., Lipscomb, J., Johantgen, M., Nelson, A., Sattler, B., Selby, V. Personal Safety for Nurses. (Invited and peer-reviewed). Chapter 26 in: Ronda Hughes, R., (Ed.) Advances in Patient Safety & Quality – an Evidence-based Handbook for Nurses. Published by Agency for Healthcare Research and Quality, 2006.
Trinkoff, A., Le, R., Geiger-Brown, J., Lipscomb, J., Lang, G. The longitudinal relationship of long work hours and mandatory overtime to MSD in Nurses. American Journal of Industrial Medicine, 49: 964-971, 2006.
Trinkoff, A.M., Johantgen, M., Muntaner, C., Le, R. The relationship between staffing and worker injury in nursing homes. American Journal of Public Health. 95(7): 1220-1225, 2005.
Geiger-Brown, J., Trinkoff, A.M., Rempher, K., McPhaul, K., Brady B., Lipscomb, J.A., Muntaner, C. Inclination to report work-related injuries among nurses. AAOHN Journal, 52(1): 16-22, 2004.
Johantgen, M., Trinkoff, A., Gray-Siracusa, K., Muntaner, C. & Nielsen, K. Using state administrative data to study nonfatal worker injuries: Challenges and opportunities. Journal of Safety Research, 35(3): 309-315, 2004.
Lipscomb, J., Trinkoff, A., Geiger-Brown, J. & Brady, B. Health care system changes and reported musculoskeletal disorders among registered nurses. American Journal of Public Health, 94(8): 1431-1435, 2004.
Nielsen, K. & Trinkoff, A.M. Applying ergonomics to nurse computer workstations. CIN: Computers Informatics Nursing, 21(3):150-157, 2003.
Trinkoff, A.M., Brady, B. & Nielsen, K. (2003). Workplace prevention and musculoskeletal injuries in nurses. Journal of Nursing Administration, 33: 153-158, 2003.
Trinkoff, A.M., Lipscomb, J., Geiger-Brown, J., Storr, C. & Brady, B. Perceived physical demands and reported neck, shoulder and back problems in nurses. American Journal of Preventive Medicine, 24(3): 270-275, 2003.
Lipscomb, J., Trinkoff, A.M., Geiger-Brown, J. & Brady, B. Work schedule and musculoskeletal problems in nurses. Scandinavian Journal of Work and Environmental Health, 28: 394-401, 2002.
Trinkoff, A.M., Lipscomb, J.A., Geiger-Brown, J. & Brady, B. Musculoskeletal problems of the neck, shoulder, and back and functional consequences in nurses. American Journal of Industrial Medicine, 41(3), 170-178, 2002.
Trinkoff, A.M. Taking care of our own. (editorial). Outpatient Surgery Magazine II (5), 96, May, 2001.
Trinkoff, A.M., Storr, C.L., Lipscomb, J.A.. Physically demanding work and inadequate sleep, pain medication use, and absenteeism in registered nurses. Journal of Occupational and Environmental Medicine, 43(4), 355-363, 2001.
Trinkoff, A.M., Lipscomb, J., Murphy, M., Brady, B. Does your neck hurt? Shoulder ache? Is your back killing you? New study may offer some answers. New York State Nurses Association Newsletter. July/August, 1999.
Partners:
- University of Illinois at Chicago School of Public Health
- Service Employees International Union (SEIU) Local 880 (IL)
- Service Employees International Union (SEIU) Local 150 (Milwaukee, WI)
- Academy for Educational Development (AED)
- Addus Healthcare
Other reports:
Testimony:
Health care workers are at extremely high risk of MSD, especially for back injuries. Health care workers are also over-represented for upper extremity MSDs among Workers Compensation claims (Silverstein et al., 2002). In 2001, US registered nurses had 108,000 work-related MSDs involving lost work time, a rate similar to construction workers (BLS, 2002). In 2003, the incidence rate for nonfatal occupational injuries, many of which are MSDs, was 7.9 per 100 full time equivalents (FTEs) for hospital workers (BLS, 2003). Definitions for MSD vary, though most include pain in the affected body region (e.g., back or neck) for a specified duration or frequency (Bernard et al., 1997), along with other related symptoms such numbness and tingling (Kuorinka et al., 1987). Measurement of MSD also varies from study to study, with many studies relying on self-report and others requiring seeking care or obtaining testing or clarification/diagnosis by a clinician (Bernard et al., 1997). In a review of evidence, the Institute of Medicine indicated that there was strong evidence of a relationship between nursing home staffing and back injuries (Wunderlich et al., 1996). In a recent study of the relationship of health care worker injuries to staffing in nursing homes, findings indicated that staffing levels were significantly related to health care worker injury rates in nursing homes across 3 states (Trinkoff et al., 2005).