A Silent Epidemic of Needle Injuries

Medical students in surgery residency have a high risk of needlestick injuries, potentially exposing them to hepatitis C, HIV, and other blood-borne infections, a new study suggests.

Of the 699 recent medical school graduates surveyed who were enrolled in surgery residency at 17 medical centers, 59 percent reported sustaining a needlestick injury. The median number of such accidents was two. Of 89 residents whose most recent injury occurred in medical school, "47 percent did not report the injury to an employee health office," wrote Dr. Martin A. Makary, an associate professor of surgery and health policy at Johns Hopkins University, and colleagues.

The most common reason cited for not reporting needlesticks was the amount of time and paperwork required. Hospitals and medical schools make it difficult to report the incident and seek preventive treatment, Makary said. Medical students are often given mundane tasks, such as injections, IV lines, biopsies, and sutures. If they are to be graded on their overall performance, inexperienced students who get stuck might forego reporting.

"Not only are we putting them at the front lines, but when they do sustain a needlestick, we have a culture that does not encourage them to speak up and get the care they need," said Makary. "They're being evaluated for a grade which determines what job they get when they finish."

Hospitals should simplify the system for reporting and treatment, Makary said. For instance, many hospitals require a supervisor's signature before accessing treatment. Such injuries frequently occur during a busy shift, when reporting them is difficult.

The full report, "Needlestick Injuries Among Medical Students: Incidence and Implications," was published in Academic Medicine (2009;84(12):1815-1521).

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