Home' Inclean : INCLEAN Jan-Feb 2016 Contents 30 INCLEAN January/February 2016
By Dr Denis
well over 20
years ago when I
a medical science
degree. In order
to graduate as a
pathologist I needed to complete a subject
entitled ‘blood bank’. At the end of each
laboratory session we were all required to
place our testing equipment in a large plastic
tub. Much of the equipment was made of
glass such as test tubes and beakers and they
were of course full of blood supplied by the
nearby hospital from numerous patients.
By the end of the class the tubs were full
of blood and the main rule was that no
broken glass instruments were to be placed
into the tub. The laboratory technician’s
role was to clean up after class and standard
latex medical grade gloves were used.
Unfortunately one evening a broken test
tube had been placed in the blood bath
and the technician received a cut while her
hands were in the tub fully immersed in the
mixture of blood.
This was my first encounter with work
related injury and little did I know then
that I would eventually pursue a career in
safety – in fact back then ‘safety’ wasn’t the
buzz field that it has become over the last
decade. It was, however, a very significant
experience because the late 80s seen
extensive media campaigns about the AIDS
virus and the importance of safe sex and not
Some may remember the ‘grim reaper’
was the main character used in such
television and print based campaigns –
it was all very direct high impact and
Apparently that laboratory technician did
not contract any virus from the exposure.
However, as many would be aware it does
take time for the human body to raise certain
detectable antibodies to a virus. I would
imagine the time period between exposure
and confirmation of a negative outcome
would have been extremely psychologically
taxing on the laboratory technician.
There is always the possibility a cleaner
will be exposed to such risk from rubbish
handling and cleaning. It is important that
risk management strategies are in place
with an aim to best control the hazard and
its risk. It is also important appropriate
equipment is available to aid in controlling
the risk and that systems are in place post
injury to manage the injury physiologically
Cleaner safety: the serious risks
of needle stick injury
Needle stick maliciously hidden
in a hand towel dispenser
The lessons we can take away from
this is that no matter how qualified and
experienced one becomes, extreme care
must be taken when handling needle
sticks. If Karen had of been more careful
in discarding her needle stick then maybe
she would have seen the infected needle
stick extruding from the sharps container.
In addition to this it is obvious that the
hospital itself could have engaged sharps
containers of a better design, functionality
I recall an incident where a cleaner had
removed a plastic garbage bag from a bin
and while carrying it to her trolley she
felt a scratch on her forearm. Upon closer
examination a needle stick had been placed
in the bin and its needle tip had passed
through the bag. The cleaner was sent
for immediate medical attention and was
Point in case...
Karen Daley was a registered nurse
with over 20 years’ experience.
She had just accessed the vein of a
patient in an emergency room of a
major U.S . teaching hospital. While
applying pressure to the injection
site with her left hand, she reached
back with her right hand to dispose
of the needle stick in a box mounted
high on a wall when she felt a prick
in her finger. The prick was from a
needle stick that had been caught
in the containers drop down lid and
was extruding from the container
because it was full.
About nine months after the
incident Karen become very ill, it was
then she recalled the needle stick
incident and upon testing she learned
that she had been infected not only
with the human immunodeficiency
virus (HIV) but also Hepatitis C.
This negatively affected her nursing
career in addition to its adverse
physiological, psychological, social
and economical impacts.
offered psychological counselling.
Cleaners must remain fully aware of this
hazard and the sad reality that some people
will dispose of needle sticks irresponsibly
and sometimes even place them maliciously
with an aim to deliberately cause infection.
This rule must be heavily emphasised during
training. Cleaners must remain especially
aware when working within toilet areas as
items such as toilet paper and hand towel
dispensers are known sources of malicious
needle stick incidents. Essential work, health
and safety measures should include:
• Training of cleaners and consideration of the
need for immunisation of cleaners where a
workplace is assessed as requiring such.
• Provision of equipment and personal
protective equipment (PPE) to safely
discard of needle sticks.
• A program which includes baseline
testing, post exposure medical treatment,
counselling, and medical surveillance.
Many believe that training is the
cornerstone of the risk management process
and it is certainly a crucial preventative
requirement in relation to this hazard.
On a final note, in relation to the
competency based training of cleaners,
always try to take into account that adult
learners remember 10 percent of what they
hear, 51 percent of what they see and hear
and 92 percent of what they see, hear and
become involved in.
*Denis Boulais is national risk manager
for Broadlex Services Pty Ltd,
Needle stick irresponsibly
thrown in a garbage bin
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