Authors: M.L. Buswell MD, M. Hourigan, A. Nault & J. Bender PhD.
Journal of Agromedicine. St. Paul, Minnesota. June 9, 2014
Veterinary medicine and agriculture have historically lacked needlestick injury (NSI) research, education, and mitigation due to the absence of zoonotic blood-borne pathogens and the “perceived” benign nature of the injury. However, depending on the procedure/pharmaceutical used, these injuries may include mild/severe bacterial or fungal infections, lacerations, local inflammation, vaccine/antibiotic reactions, amputation, miscarriage, and death. The objective of this report is to identify published case reports and case series/surveys on human needlestick exposure to veterinary biologics, and to review literature and educational documents describing needlestick prevention strategies for agricultural workers and veterinarians. An electronic database search was conducted using PubMed© and CABI©. Key search terms: PubMed© – “Needlestick Injuries” [MeSH] veterinar*, “Vaccination/veterinary” [MeSH]) AND “Occupational Exposure” [MeSH], “Vaccination/veterinary” [MeSH]) AND “Occupational Exposure” [MeSH]; CABI© – needlestick injuries.sh. Article inclusion criteria were those detailing NSI in agricultural workers only. Abstracts of all search results were read and relevant articles compiled into a RefWorks© database. References cited within articles were examined to locate additional articles. Fifty-six articles were identified. Literature consisted of case reports (n = 14), survey/case series articles (n = 11), prevention guidance documents (n = 6), and background articles (n = 25). Forty-eight cases were found. Twenty-four identified injury location: 13 (54.2%) NSI to the hands: three to the right, eight to the left, and two were not specified. Eight injuries were to the legs (33.3%): five to the right and three were not specified. Of the 48 cases, 11 (22.9%) involved oil-adjuvanted vaccines. The remaining products included: other vaccines, antibiotics, analgesics/sedatives, and hormones. Forty-six (95.8%) of 48 cases reported seeking medical attention. Of the 11 survey/case series articles: two focused on oil-adjuvant products, one on Brucellosis RB51 vaccine, three on tilmicosin, and five were non-specific. General recommendations from guidance documents included: proper animal restraint, avoid recapping needles, do not bend needles, do not put needle caps in your mouth, provide appropriate training, provide sharps containers, report injuries, seek medical attention. NSI in agriculture workers and veterinarians can result in injury and loss of work. It appears that NSI awareness is limited among workers. There is a need for comprehensive programs to prevent NSI on livestock operations.