Presented is the case of a nurse who had 4 occupational exposures to potentially infectious material between December 2020 and June 2022. In 2 of the cases, the source patient was unknown, so pharmacological HIV post-exposure prophylaxis was implemented (in 1 of these cases, the nurse developed weakness and increased dyspeptic symptoms, necessitating a change in the antiretroviral medications used). During the interview collection, the nurse reported that multiple exposures to potentially infectious material are common in her work environment, but most of these are not reported. This is supported by the results of several studies devoted to the problem of non-reporting of occupational exposures by health care workers. However, there is significant discrepancy in the results of these studies, which may be due to different methods. The authors of this article believe that after 10 years since the entry into force of the regulation of the Minister of Health standardizing procedures for dealing with injuries caused by sharp instruments used in the provision of health care services, a serious problem remains of non-reporting of cases by employees (resulting in a lack of post-exposure prophylaxis). The authors call for the introduction of a nationwide reporting system. There is also a need to increase the importance of prophylaxis of stabbings and to improve the quality of training of medical personnel in post-exposure prophylaxis procedures. Med Pr Work Health Saf. 2024;75(2):173-179.
Opisano przypadek pielęgniarki, u której między grudniem 2020 r. a czerwcem 2022 r. czterokrotnie wystąpiła ekspozycja zawodowa na materiał potencjalnie zakaźny. W 2 przypadkach pacjent źródłowy był nieznany, więc wdrożono farmakologiczną profilaktykę poekspozycyjną HIV (w jednym z tych przypadków u pielęgniarki wystąpiło osłabienie i nasilone objawy dyspeptyczne, co spowodowało konieczność zmiany stosowanych leków przeciwretrowirusowych). W czasie zbierania wywiadu pielęgniarka zgłosiła, że wielokrotne ekspozycje na materiał potencjalnie zakaźny są powszechne w jej środowisku pracy, jednak większość z nich nie jest raportowana. Potwierdzają to wyniki kilku badań poświęconych problemowi niezgłaszania przypadków ekspozycji zawodowych przez pracowników ochrony zdrowia. Ich wyniki są znacząco rozbieżne, co może wynikać z różnej metodyki. Autorzy niniejszego artykułu uważają, że po 10 latach od wejścia w życie rozporządzenia Ministra Zdrowia ujednolicającego procedury postępowania po zranieniu ostrymi narzędziami używanymi przy udzielaniu świadczeń zdrowotnych poważnym problemem pozostaje niezgłaszanie przypadków przez pracowników (skutkiem tego jest brak profilaktyki poekspozycyjnej). Autorzy postulują wprowadzenie ogólnopolskiego systemu raportowania. Konieczne jest również zwiększenie znaczenia profilaktyki zakłuć oraz poprawa jakości szkolenia personelu medycznego w zakresie procedur profilaktyki poekspozycyjnej. Med Pr Work Health Saf. 2024;75(2):173–179.

We report a case of occupational monkeypox virus infection from a needlestick injury in a healthcare worker in South Korea and review similar reports in the literature during 2022. Postexposure prophylactic treatment with a third-generation smallpox vaccine and antiviral agent tecovirimat inhibited local virus spread and alleviated lesion pain.

Postexposure prophylaxis using artemisinin-based combination therapy (ACT) was prescribed to a malaria-naive nurse who experienced an injury with a hollow needle previously used on a patient admitted for severe imported Plasmodium falciparum malaria (blood parasitemia 10.8%). Artemether-lumefantrine, four tablets twice daily for 3 days, was started 12 hours after exposure, and no side effects were reported. During the six following months, she only developed one episode of fever that was associated with pyelonephritis. Biological follow-up, based on blood smears, molecular biology, and serology, did not evidence P. falciparum malaria. This case suggests that ACT can prevent occupational P. falciparum malaria following needle-stick injury. We found evidence of only one other unpublished similar case where a Turkish resident doctor did not develop malaria after postexposure prophylaxis using ACT. Such a prophylaxis could be prescribed not only in case of occupational exposure to Plasmodium spp. in nonvector-borne laboratory-acquired infections but also following blood exposure in healthcare setting.

Animal injection-related needlestick injuries are a common occupational hazard for livestock workers and veterinarians. Although often unreported, these injuries can cause significant damage and may require extensive medical and surgical management. This case describes a 69-year-old farmer who accidentally injected his forearm while vaccinating cattle, resulting in a flexor compartment infection. Conservative management with oral and intravenous antibiotics was unsuccessful, and he required multiple surgical debridements for definitive treatment CONCLUSIONS:: Animal injection-related needlestick injuries can present unique challenges to orthopaedic surgeons. Important considerations include the injury location, needle type, vaccine volume and components, injection pressure, and environmental contaminants.

Increasing intensification in swine production has led to new and specialized technologies, but the occupational health and safety impacts are rarely quantified in the business plans for adoption. Needle-less injection has potential to increase productivity and eliminate needle stick injury in workers, but it is not clear whether these benefits offset high capital investment and potential increases in musculoskeletal loads. This economic evaluation employed probabilistic scenario analysis using injury, cost, and production data gathered from interviews with swine producers in Manitoba and Saskatchewan. After adoption of needle-less injection, rates of needle-stick injury went down with no measureable effect on upper limb musculoskeletal disorders, resulting in lower health and safety costs for needle-less injectors. Needle-less injection duration was 40% faster once workers acclimatized, but large start-up costs mean economic benefits are realized only after the first year. The incremental benefit cost ratio promoted adoption of needle-less injectors over conventional needles for the base case of a 1200 sow barn; the conventional method is beneficial for barns with 600 sows or less. Findings indicate that well-designed technologies have the potential to achieve the dual ergonomics goals of enhancing human wellbeing and system performance. We anticipate that the economic and decision models developed in this study can be applied to other new technologies in agriculture and animal production.

BACKGROUND: Despite the introduction of a range of safety policies and sharps equipment designed to protect healthcare workers, rates of percutaneous injuries from occupational exposure to sharps remains high. This study examined the availability and use of various types of sharps devices in a tertiary hospital emergency department, to understand clinician choice between non-safety and safety devices; and to document their safe and unsafe use of sharps.
METHODS: This mixed methods study consisted of areview of stock levels, a survey of staff usage, and a content analysis of semi-structured interview data to explore factors which impact on staff preferences for different sharps devices.
RESULTS: Staff identified a range of sharps risks, as well as barriers and enablers to the use of safety devices. Availability of, and preference for, familiar devices influenced choice of devices used in clinical practice, despite awareness of associated risks.
CONCLUSIONS: This understanding of equipment use and the factors that motivate such use have informed the first stage of the knowledge-to-action cycle. Knowledge translation, should include the development of policies to help reduce the risk of sharps injury. Culture change and ongoing skills development might help to overcome entrenched procedures and increase voluntary engagement with safer sharps.

Limited reconstructive options exist for soft tissue defects of the foot and ankle because of a lack of surrounding tissue. Although microsurgical free flaps have become a popular treatment modality for this anatomic region, pedicled muscle flaps can provide robust coverage of small foot wounds with significantly less donor site comorbidity. One such muscle is the abductor hallucis, which can be used as a proximally based turnover flap to cover medial hindfoot defects. However, complete distal disinsertion of the muscle may lead to loss of support over the medial arch and first metatarsophalangeal joint, leading to pes planus and hallux valgus. In this case report, we describe a modified technique of a split abductor hallucis turnover flap for a young patient with a chronic, traumatic medial heel wound complicated by calcaneal osteomyelitis. By preserving part of the muscle\'s distal tendinous attachment, this technique allows for adequate soft tissue coverage while maintaining long-term biomechanical function.

Needlestick accidents while handling of infectious material in research laboratories can lead to life-threatening infections in laboratory personnel. In laboratories working with the lymphocytic choriomeningitis virus (LCMV), the virus can be transmitted to humans through needlestick injury and lead to serious acute illness up to meningitis.
We report of a case of LCMV meningitis in a laboratory worker who sustained a penetrating needlestick injury with a LCMV-contaminated hollow needle whilst disposing of a used syringe into the sharps waste bin. Four days after needlestick injury the laboratory worker developed a systemic disease: 11 days after exposure, she was diagnosed with meningitis with clinical signs and symptoms of meningismus, photophobia, nausea and vomiting, requiring hospitalisation. The PCR was positive for LCMV from the blood sample. 18 days after exposure, seroconversion confirmed the diagnosis of LCMV-induced meningitis with an increase in specific LCMV-IgM antibodies to 1:10\'240 (day 42: 1:20\'480). Ten weeks after exposure, a follow-up titre for IgM returned negative, whereas IgG titre increased to 1:20\'480.
This is the first case report of a PCR-documented LCMV meningitis, coupled with seroconversion, following needlestick injury. It highlights the importance of infection prevention practices that comprise particularly well established safety precaution protocols in research laboratories handling this pathogenic virus, because exposure to even a small amount of LCMV can lead to a severe, life-threatening infection.

暂无摘要。

暂无摘要。