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Giuseppe Ippolito, MD; Gabriella De Carli, MD; Vincenzo Puro, MD; Nicola Petrosillo, MD; Claudio Arici, MD; Roberto Bertucci, MD; Luca Bianciardi, MD; Lucio Bonazzi, MD; Adriano Cestrone, MD; Marinella Daglio, MD; Massimo Desperati, MD; Mauro Francesconi, MD; Massimo Migliori, MD; Anna Monti, MD; Maria Carmela Perna, MD; Francesco Pietrobon, MD; Janine Jagger, MPH, PhD

JAMA. 1994;272(8):607-610.

Abstract
Objectives.
—To identify the types of medical devices causing needlestick injuries among Italian health care workers, to document the device-specific injury rates and time trends for different hollow-bore needles, and to compare injury rates from these devices with those reported in the United States.

Design.
—Longitudinal survey.

Settings.
—Twelve Italian acute care public hospitals.

Methods.
—Data were obtained from a multihospital surveillance database on the number of total injuries reported in each device category. Hospitals provided the corresponding number of devices used annually for each needle type.

Main Outcome Measure.
—Number of needlestick injuries by type of hollow-bore needle per 100000 devices used per year.

Results.
—A total of 2524 injuries from hollow-bore needles were reported. Disposable syringes/hypodermic needles accounted for 59.3% of injuries, followed by winged steel needles (33.1%), intravenous catheter stylets (5.4%), and vacuum-tube phlebotomy needles (2.2%). Intravenous catheter stylets had the highest needlestick injury rate (15.7/100 000 devices used), and disposable syringes had the lowest needlestick injury rate (3.8/100 000). In contrast to the other devices, the injury rate from winged steel needles increased from 6.2 per 100 000 in 1990 to 13.9 per 100000 in 1992.

Conclusions.
—The device-specific needlestick injury rates in Italy are similar to those reported in the United States, suggesting similar exposure experience in two countries. However, in contrast to the United States, needleless intravenous access is standard practice in Italy and thus eliminates one potential risk to Italian health workers. Implementation of safer equipment, such as shielded or retracting needles, and continuing training programs are needed to further reduce the hazards that health care workers face.

(JAMA. 1994;272:607-610)

Author Affiliations
From the Italian Study Group on Occupational Risk of HIV Infection, Lazzaro Spallanzani Hospital for Infectious Diseases, Rome (Drs Ippolito, De Carli, Puro, and Petrosillo); Ospedali Riuniti, Bergamo (Dr Arici); Ospedale Amedeo di Savoia, Turin (Dr Bertucci); Policlinico Le Scotte, Siena (Dr Bianciardi); Ospedale Maggiore C.A. Pizzardi, Bologna, and Arcispedale S. Maria Nuova, Reggio Emilia (Dr Bonazzi); Ospedale Civile, Cittadella, Padua (Dr Cestrone); Policlinico S. Matteo, Pavia (Dr Daglio); Ospedale Civile, Alessandria (Dr Desperati); Ospedale S. Sebastiano, Frascati (Dr Francesconi); Arcispedale S. Anna, Ferrara (Dr Migliori); Policlinico S. Orsola Malpighi, Bologna (Dr Monti); Ospedale L. Sacco, Milan (Dr Perna); Ospedale Ca'Foncello, Treviso (Dr Pietrobon), and Department of Neurosurgery, University of Virginia, Charlottesville (Dr Jagger).

Footnotes
Reprint requests to Centro di Riferimento AIDS, Roma 10, Ospedale L. Spallanzani, Via Portuense 292, 00149 Rome, Italy (Dr Ippolito).

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