Needlestick injuries – what’s the risk?

It would appear that the risks from needlestick injuries are not as high as first thought, according to an an article in the June edition of the Journal of Paediatrics & Child Health and recently reported in Australian Doctor (July 2002). A study at Melbourne’s Royal Children’s Hospital of 50 children (total incidence over 32 months) who had community needlestick injuries found none had contracted HIV, HVB or HVC.

The authors found that the 36 children who were tested three months or more after the incident did not seroconvert although HIV could remain viable in a syringe for four weeks, HVC for five months and HVB for 12 months. Although parents of children with needlestick injuries could be reassured, the authors believed that hepatitis B prophylaxis and serological testing were still important. The recommended testing schedule for hepatitis B, hepatitis C and HIV is at six weeks, 12 weeks and six months post presentation.

The recommended prophylaxis for suspected HVB exposure was hepatitis B immunoglobin within 72 hours – for immediate cover lasting several weeks – and a course of three hepatitis B vaccine injections for long standing immunity. The authors state that in previous studies on needlestick injuries there was only one case where hepatitis B was contracted, although the child was exposed to HIV and did not seroconvert to the virus.

The authors said that the incidence of needlestick injuries occurring in public recreation places had important health implications, and that it was likely that many cases were not reported. They believe that the potential risk of contracting hepatitis B or C from community acquired needlestick injuries was probably higher than for HIV because their prevalence was higher, there were higher viral titres in blood and they survived longer in the environment.