A primer on sharps injuries

What are sharps?

Any object that can be used to cut the skin can be considered as "sharps". This includes, needles, lancets, scissors, blade and glass items. (Source: 1)

Sharp injuries

Sharps can create cuts or puncture the skin, potentially transmitting pathogens if the sharps are contaminated with infected blood or bodily fluids. For healthcare workers, sharp injuries pose as occupational hazards for healthcare workers due to their job requirements.

For example, in a 2005 study by WHO, it was estimated that 16000 hepatitis C (HVC), 66000 hepatitis B (HBV) and 1000 HIV infections may have occurred worldwide among healthcare workers in the year 2000 due to their occupational exposure to sharp injuries. (Source: 2)

In Singapore, Changi General Hospital reported a total of 441 self-reported sharp injuries from 2017-2021, of which doctors and nurses reported the highest number of sharp injuries. Although there were 51 source patients identified for HBV, HCV and HIV, no transmission of the viruses occurred. (Source: 3)

Similarly, Singapore General Hospital (SGH) reported a total of 1901 sharps injuries and splash exposures (SISE) over a ten-year period from 2005 - 2014. The average SISE incidence per year was reported to be 28.9 per 1000 healthcare workers, with doctors reporting the highest number of SISE at 43.7% followed by nurses at 37.7%.  (Source: 4)

Sharp injuries - When does it happen?

In SGH the most common documented locations of sharps injuries occurred in the general ward (43%) followed by the operating theatre (31%), and that the most common mechanism of sharps injury was during intraoperative procedures. It was also observed that the only area where nurses had a higher rate of sharps injuries than doctors was during intraoperative transfers of instruments and needles between doctors and nurses. (Source: 4)

In a 2008 report by the Massachusetts Department of Public Health, it was mentioned that 32% of sharps injuries reported by Massachusetts hospitals occurred in the Operating Room (OR). Of the reported incidents that occurred in the OR, 67% were among non-physician personnel (nurses, physician assistants, medical students and nurses' aides. (Source: 5)

Although scalpel blade injuries account for a lower percentage of injuries as compared to needlestick injuries (Source 6), scalpel blades are able to inflict deeper wounds as compared to needlesticks. (Source 7)

Sharp injuries - What can be done to minimise the risks?

Hands Free Technique (HFT)

One of the ways to reduce the risk of sustaining sharps injuries is through the use of HFT, where no two people touch the same sharp object at the same time. A 2009 study concluded that while the use of HFT reduces the risk of sharps incidents and is inexpensive to implement, there remains barriers to implementation such as resistance among healthcare workers. (Source 8)

Double Gloving

Although wearing sterile gloves has long since been a standard medical practice, gloves are still susceptible to cuts through wear and tear or injuries from sharps and instruments. This compromises the protective function of wearing gloves. Wearing a second pair of gloves protects the inner pair and addional protection. A review in 2002 found that wearing a second pair of gloves significantly reduces cuts to the innermost gloves and does not affect surgical performance. (Source 10)

Training & Education

It is important that healthcare workers have the correct training and education to reduce the chances of sustaining sharps injuries. Although a 2016 review concluded that there was low-quality evidence to support that education and training may reduce the incidence of sharp injuries, they also noted that training and education is still important due to the risk of severe blood-borne infections sustained from sharps injuries. (Source 11)

The Use of Safety Devices

A 1998 study, conducted over a period of 15 months in operating theatres found that a high proporation of sharps injuries were potentially preventable if safety devices were in use. (Source 12) 

The following table from a Swann-Morton article shows the argument for and against using safety devices (Source 7)

For Against
Reduced touchpoints; Safety engineered devices provide a clear path to the reduction of sharps injury given they are designed to reduce the number of touchpoints associated with sharps injury - specifically safe passing, removal and disposal. Patient safety; Surgeons feedback over concerns of the devices usability during surgery with the potential to obscure vision and reduce touch and feel.
Injury Reduction; Studies indicate that safety-engineered devices can play a key role inside the operating room. Cost; Safety engineered devices are more expensive than cheaper safety solutions such as HFPT / blade removal systems.
Technology; Feedback from surgeons has allowed the healthcare industry to improve the design and usability of safety-engineered products. Safety-engineered devices are now available using standard surgical handles for example to help promote an ergonomic feel. Activation and Training; Research provides evidence of sub-optimum activation rates as well as injury during attempted activation. Use of safety-engineered devices may require specialist staff training which provide logistical issues for hospitals and trusts.
Cost effectiveness; independent studies showing the overall cost effectiveness of these devices in preventing costly injuries. Alternatives; Related safety products and procedures such as HFPT provide comparably effective ways to reduce sharps injury without needing to invest in specific safety engineered devices.
Multi-use; procedures requiring multiple passing between surgeon and nurse can be supported more easily. Counterproductive; Safety engineered devices can be argued as being potentially counterproductive in that usage can increase hazards through misuse or from poor training and/or limited usage experience.
  Impact; Studies have shown that the impact from safety-engineered devices can be short-lived with injury rates returning to previous levels.

 

Qlicksmart BladeFlask (Click)

One such safety device that we have available here is the Qlicksmart BladeFlask scalpel blade remover. Using Qlicksmart BladeFlask together with a hands-free passing technique can prevent up to 5 times more injuries than a safety scalpel.

This easy-to-use solution provides a low cost alternative to safety scalpels for all scalpel users. The BladeFLASK scalpel blade remover has safely removed over 70 million contaminated scalpel blades, and have prevented over 150,000 injuries around the world.

 

Health Information Disclaimer

While we strive to provide accurate and helpful information, this blog post is not meant to replace professional medical advice.

Rely on official medical sources when seeking definitive answers about health conditions.

 

Sources

  1. Government of Canada, C.C. for O.H. and S. (2025) Needlestick and sharps injuries, Canadian Centre for Occupational Health and Safety. Available at: https://www.ccohs.ca/oshanswers/diseases/needlestick_injuries.html (Accessed: 20 March 2026). 
  2. Prüss‐Üstün, A., Rapiti, E. and Hutin, Y. (2005) 'Estimation of the global burden of disease attributable to contaminated sharps injuries among health‐care workers,' American Journal of Industrial Medicine, 48(6), pp. 482–490. https://doi.org/10.1002/ajim.20230.
  3. Oh, H., Mak, M. and Wu, T. (2023) 'SG-APSIC1163: A five-year review and analysis of sharp injuries in an acute-care hospital in Singapore,' Antimicrobial Stewardship & Healthcare Epidemiology, 3(S1), pp. s19–s20. https://doi.org/10.1017/ash.2023.59.
  4. Incidence and analysis of sharps injuries and splash exposures in a tertiary hospital in Southeast Asia: a ten-year review | SMJ (no date). http://www.smj.org.sg/article/incidence-and-analysis-sharps-injuries-and-splash-exposures-tertiary-hospital-southeast-asia.
  5. Daley, K. et al. (no date) Sharps injuries in the operating room, SHARPS INJURIES in the OPERATING ROOM MASSACHUSETTS SHARPS INJURY SURVEILLANCE SYSTEM DATA, 2004. Available at: https://www.mass.gov/doc/sharps-injuries-in-the-operating-room-2004-0/download (Accessed: 19 March 2026). 
  6. Watt, A.M. et al. (2008) 'Scalpel injuries in the operating theatre,' BMJ, 336(7652), p. 1031. https://doi.org/10.1136/bmj.39548.418009.80.
  7. Swann-Morton Limited (2021) Sharps Safety in Operating Rooms: A Review of Surgical Blades. https://www.swann-morton.com/view_reading.php?reading_id=19 (Accessed: March 20, 2026).
  8. Stringer, B. et al. (2009) 'Hands-Free technique in the operating room: reduction in body fluid exposure and the value of a training video,' Public Health Reports, 124(4_suppl1), pp. 169–179. https://doi.org/10.1177/00333549091244s119.
  9. Tanner, J. and Parkinson, H. (2002) 'Double gloving to reduce surgical cross-infection,' Cochrane Database of Systematic Reviews, 16(12), p. 571. https://doi.org/10.1002/14651858.cd003087.
  10. Cheetham, S. et al. (2016) 'Education and training for preventing sharps injuries and splash exposures in healthcare workers,' Cochrane Database of Systematic Reviews [Preprint]. https://doi.org/10.1002/14651858.cd012060.
  11. Jagger, J., Bentley, M. and Tereskerz, P. (1998) 'A study of Patterns and Prevention of blood exposures in OR personnel,' AORN Journal, 67(5), pp. 979–996. https://doi.org/10.1016/s0001-2092(06)62623-9.

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