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Unique question: Tagging gun HIV transmission
May 14, 2012

Hi there,

I am very surprised that this question has not been addressed on this site before, as I think it is really important. It pertains to the HIV transmission risk when using a tagging device (tagging gun) to attach tags to clothing in a retail setting. These tagging guns are present and used in basically every retail clothing store in the country, and probably the world over, yet nobody seems to question their safety. Every retail store I have personally worked in had them, and never once was I informed of their capacity to transmit bloodborne pathogens such as HIV. I searched online, and the only information I was able to find on this subject was an Oxford study conducted in 1999 (occmed.oxfordjournals.org/content/49/1/47.full.pdf) that determined that the risk was small, but present. However, as I said, I havent found anything posted about it in the thirteen years since. Is this because the risk of HIV transmission via being pierced with a shared tagging gun needle is, realistically, not present? Basically, they have a semi-hollow needle through which a barbed plastic fastener is projected into the price tag and the fabric, attaching the tag to the clothing. The following is from the study mentioned above: The devices for inserting the nylon tags have a number of features in common. 1. The instrument has a sharp, wide bore, hollow needle which is detachable from a handheld device with a trigger. 2. The needle has a slot cut along its length. 3. Squeezing the trigger propels a barbed nylon thread down the hollow needle. In use, the hollow needle is inserted, simultaneously, through a garment and a price ticket. The trigger is squeezed. The nylon tag, shaped much like an arrow, is forced along the grooved needle until its barbed end projects on the opposite side of the material. The needle is then withdrawn, leaving the tag and price ticket attached. The 'gun' is automatically primed for the next attachment. The perception of hazard is that an individual, whose blood is infective, might pierce the hand or other part of the body and that infected blood could be retained in the hollow needle. There is then an opportunity for a second person, using the same instrument, to accidentally pierce the skin and become infected. I understand that hollow needles are much more worrisome than solid needles, like safety pins or thumbtacks, since the blood doesnt have access to air which would render the virus inactive. Although the study says the needle in the tagging gun is hollow, it isnt quite. That is to say, it isnt like a hypodermic needle, which is entirely closed except for the opening on the tip. Tagging gun needles have a slit along the entire length which is about 1/3 as wide as the needle itself when viewed from above. I assume this would allow air in to deactivate the virus present in any blood retained on it. The study decided that the overall risk was as follows: The transmission of HIV by a single percutaneous transmission from a known HIV positive source is, overall, 1 in 300, and the risk is increased considerably if the injury is deep or blood is visible on the device. It was assumed that if the source individual had an AIDS-related disease he/she would not be engaged in this kind of physical work but the overall risk of transmission was assessed at not less than 1 in 300. Thus the overall risk of transmission of HIV from a piercing wound using this tagging device would be around 1 in 150,000. This calculation does not allow for decay of the virus infectivity in the needles, due to time elapsed between inoculation injuries, and this may further reduce the risks of transmission. I assume the italicized portion reduces the risk even further, but how much? Every expert on here seems to agree that HIV doest survive outside the body for more than a few minutes at best. Would this hold true for HIV present in a very small amount of blood retained in the semi-hollow needle of a tagging gun? If someone were to accidentally pierce themselves with one of these, I doubt much blood at all would be transferred to the needle in the millisecond in which it is actually in the persons flesh. Such a tiny amount of blood would realistically dry nearly instantaneously and render the virus inactive, right? I spoke with a physician about this, and she said that in order for there to be even a small possibility of transmission via a tagging gun of this sort, an HIV+ individual would have to pierce his/herself, get a reasonable amount of blood on the needle, and then immediately turn around and pierce the other person. Would you agree? I have many friends in retail who work with and around such devices, and I am horrified that this risk is basically unknown amongst the vast majority of retail workers, and that there arent widespread precautions for working with them. After all is said and done, would you say that HIV transmission via such a tagging device is feasible? 1 in 150,000 is not a high risk to begin with, and that is even before taking into account the virus being rendered inactive by time and oxygen exposure. Is the situation described by the physician the only way realistic HIV could be passed on by such a device? Thank you for your patience, as I said before, I feel this is important to address given the extraordinarily widespread use of such devices in retail stores worldwide, and the amount of retail workers who may be unknowingly placing themselves at risk if such a risk is realistic.

Response from Dr. Wohl

Tell me again how this could lead to infection? I t would take the tagging of an HIV+ person followed by immediate application of the same needle to an uninfected person. How and why would such a thing happen? Even the most trigger happy salesperson could hardly be imagined to go on a tagging spree of self and co-workers.

The same could be said of any sharp object of sufficient heft and gauge. I am not sure why retail workers would be at any greater risk than anyone else who uses sharp objects.

DW



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