Do Universal Precautions Reduce Needlestick Injuries?

To the Editor. ——The article by Wong et al¹ documents reductions in occupational exposures to blood and body fluids among physicians after the implementation of universal precautions (UPs). However, the investigators have misinterpreted their data relating to needlestick injuries. Although they found a 62% reduction in needlestick injuries when UPs were in effect, their data show that this difference was not statistically significant (P =.123, Mantel-Haenszel X²). This is not surprising in view of the small number of needlestick injuries reported during the study. Despite a lack of statistical significance, the investigators inappropriately concluded that "the implementation of UPs should reduce the risk of occupational human immunodeficiency virus (HIV) infection by the same rate [as needlesticks] (62%)...." Based on the study data alone, the correct conclusion is that the implementation of UPs should not be expected to reduce either needlestick injuries or the risk of HIV infection associated