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Sharps Safety and Needlestick Injuries: An Ongoing Challenge

Key Takeaways

  • Despite regulatory progress since the Needlestick Safety and Prevention Act of 2000, sharps injuries remain a significant occupational risk, with CDC data showing hundreds of thousands of incidents occurring annually through the mid-2020s.
  • Since 2020, sharps injury prevention efforts have evolved, shifting from a primary focus on device adoption to greater emphasis on workflow design, training consistency, reporting, and safety culture.
  • More than two decades after major legislative action and over five years after the first World Patient Safety Day in 2019, sharps safety continues to require a multi-layered approach that combines safety-engineered devices with administrative and leadership support.

At a Glance: Where Things Stood in 2020

Where do things stand in 2020 with regard to needlestick injuries and sharps safety? Unfortunately, these injuries remain a serious problem in today’s health care environment.

Mary J. Ogg, MSN, RN, CNOR, senior perioperative practice specialist with the Association of Perioperative Registered Nurses, says that sharps injuries decreased initially after passage of the Needlestick Safety and Prevention Act due to the introduction of sharps injury prevention devices.

“But recent epidemiological data suggests that injuries from sharps injury prevention devices are on the rise,” she says, noting that injuries occur prior to activation of the safety feature. Emergency physician Michael Sinnott, MBBS, FACEM, FRACP, who is also the co-founder of medical device manufacturer Qlicksmart, cites research indicating that there are 32 sharps-related injuries for every 100,000 suture needles purchased, 12.6 sharps-related injuries for every 100,000 scalpel blades purchased, and 2.65 sharps-related injuries for every 100,000 needles purchased.

During his keynote presentation at the World Health Organization’s First Global Patient Safety Day in 2019, Sinnott outlined a five-step safety program for preventing sharps injuries: 

  1. Awareness
  2. Regulatory support
  3. Safety equipment
  4. Administrative actions
  5. Management support.

When sharp objects can’t be eliminated, safety-engineered devices such as blunt sutures, safety scalpels, safety syringes, and needles can help eliminate sharps injuries.

Update: Where Things Stand Now

Today, needlestick injuries and other sharps-related incidents remain a persistent occupational risk in health care, despite widespread use of safety-engineered devices and stronger regulatory guidance. 

What the Latest CDC and WHO Data Shows

According to the Centers for Disease Control and Prevention (CDC), an estimated 385,000 sharps injuries occur each year among hospital-based healthcare workers in the United States, with broader estimates reaching 600,000 to 800,000 annually when outpatient and long-term care settings are included. 

Why Sharps Injuries Still Occur

More recent analyses show that many injuries occur during routine handling, before activation of safety mechanisms, or during disposal, rather than from device malfunction alone. As a result, current sharps-injury prevention guidance places greater emphasis on workflow design, training consistency, and organizational safety culture, alongside device selection (Source: CDC). 

Globally, the WHO estimates that more than 2 million occupational needlestick injuries occur each year, reinforcing that sharps safety remains a widespread challenge across health care systems, particularly in high-demand clinical environments (Source: WHO). 

A Multi-Layered Approach to Sharps Safety

When sharp instruments cannot be eliminated, safety-engineered options (including blunt suture needles, safety scalpels, and needle-safety syringes) remain essential. However, current guidance underscores that devices alone are insufficient; meaningful risk reduction depends on proper activation, safe disposal practices, ongoing education, innovations in sharps disposal management, and visible leadership support.

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