Introduction

The use of sharps presents a very significant risk of personal injury to anyone coming into contact with them (often NOT the person who originally used them). Injuries can include cuts, severing of digits/limbs, needle-stick, infection, chemical/radiological poisoning. The use of sharps must therefore be avoided whenever possible. If this is not possible, substitution with safer alternatives and/or strict adherence to safe working and disposal practices must be observed by all persons using sharps. Please see the SLS policy on sharps safety for full details.

Working Safely

All staff have a responsibility to ensure that they and others are protected from harm as a result of work with sharps. Managers have additional responsibility for ensuring that their staff comply with this requirement.

A hierarchy of control measures must be adopted in all cases where the use of sharps is being considered.

1. Avoiding use of Sharps
2. Substituting for Safer Alternative, if possible, linked with...
3. Strict adherence to safe working procedures, always linked with...
4. Correct Disposal of Sharps
5. Action in Event of Injury

Avoiding use of Sharps

This must always be the first course of action to consider, even if it costs more. Not using a sharp will remove all the risk. Staff should continually evaluate alternatives to the use of sharps and introduce such alternatives whenever possible.

Examples include:

• Obtaining blood from SNBTS rather than taking from lab volunteers
• Using dialysis cassettes that can be loaded using normal pipette tips instead of needles
• Replacing glass Pasteur and graduated pipettes with plastic ones
  

Substituting for Safer Alternative

The distinction is made here between substituting the use of a sharp for a method that removes the need to use a sharp altogether (see above) and substituting for a safer alternative. The emphasis is on safer rather than safe, since a sharp is still used.

Examples include:

• Using a specially designed box opening tool with a guarded blade rather than an unguarded knife
• Using a wheel-type guillotine to cut paper rather than scissors or a knife
• Using a hypodermic needle with a shield or cover that slides or pivots to cover the needle after use instead of a bare needle (note that when such devices are to be used for medical purposes, consideration must be given to various operational factors. For more information, see HSE guidance (Health and Safety Executive, 2013)

In all cases where a safer sharp is used, it is vital that strict adherence to safe working procedures is ensured. Using a safer sharp still presents a hazard that must be controlled.

Safe Working Procedures

This is the least desirable of the hierarchy of control measures to use for the work process, since removing the sharp is a much safer measure. However, strict adherence to safe working procedures can significantly reduce the likelihood and severity of injury.

Key aspects of safe working practices are:

• Competence of the user is vital. The degree of competence required will vary according to the task and sharp being used, but may be significant and may require verification by examination
• Following the safe operating procedure for the sharp (consult the manufacturer's instructions)
• Use of appropriate personal protective equipment (PPE), such as puncture or cut resistant gloves and chain-mail gloves
• Safe storage of sharps (NOT in lab coat pockets)
• Safe disposal of sharps (next section)

Correct Disposal of Sharps

Sharps must be disposed of safely, both for the operative using the sharp and for anyone else who might otherwise come into contact with the sharp later.

The key points are:

• Needles must never be re-sheathed before disposal. This presents a very significant needlestick injury potential. Remember, needles are single use, disposable items
• Sharps must never be left unprotected (e.g. shelves, benches, drawers, pockets). Once used, they must be disposed of immediately
• Sharps must only be disposed of into a suitable "Sharps Safe" conforming to BS7230: 1990, UN3291
• Sharps safes must be assembled correctly (see manufacturer's instructions)
• Adequate numbers of appropriately sized sharps safes must be made available at the site of sharps use and these must be used according the manufacturer's  instructions
• Sharps safes must not be filled above the manufacturer's stated volume
• Sharps safes must be closed up (see manufacturer's instructions) immediately when at capacity and then sent for disposal via the approved route (see local rules)

Action in the Event of Injury

Taking the correct action is vital for reducing the potential for further injury resulting from the initial sharps incident.

The key steps are:

• Seek first aid assistance from a qualified first aider
• Encourage the wound to bleed so that material introduced into the body is expelled
• Wash the wound with soap and water, but avoid scrubbing. Dry and cover with a dressing
• If injury is serious or there is reason to believe that harmful chemical or biological agents might have been involved, seek immediate medical assistance (attend A&E or your GP)

Report the incident as soon as possible to SLS H&S staff.