Needlestick injuries during a mass vaccination campaign.

campaigns may be exposed to bloodborne pathogens in the event of a needlestick injury. In preparation for a mass immunization campaign, information was sought to decrease the number of needle-stick injuries. A literature search revealed no information pertaining to needlestick injuries occurring during mass vaccination campaigns. Other studies discussed the difficulty in obtaining information related to the frequency and reason for percutaneous injury in health care workers. 1,2 A questionnaire was designed to identify risk factors for needlestick injuries occurring during a mass vaccination campaign in York Region, Ontario. This paper describes the findings. METHODS In Ontario, a routine two-dose measles mass vaccination campaign was implemented in 1996 for all school-aged children (approximate York Region student population = 130,000). This was the first mass immunization campaign for the majority of York Region Health Services' nurses (a previous immunization campaign for hepatitis B was implemented by nine nurses in the Sexuality program). Prior to the campaign, a two-day " Skills Development Workshop " for nurses included information on sharps handling and sharps injury follow-up. Completing an " Incident Report " is mandatory by legislation of the Occupational Health and Safety Act and the Workers Compensation Act for all accidents including needlestick injuries. The " Incident Report " form would have been insufficient, however, to acquire information on needlestick injury risk factors. Therefore, a needlestick injury questionnaire was developed and provided to the nurses' team leaders. RESULTS During an 18-week period beginning February 1996, 63 nurses immunized 112,727 children in kindergarten to Grade 13 at 238 schools. Thirteen needlestick injuries were reported during the campaign which is the equivalent rate of 1 needle-stick injury per 8,671 vaccinations. Three accidents occurred in February, three in March, four in April, two in May and one in June. Vaccinations were provided during regular school hours between 8:30 a.m. to 2:30 p.m. Eight of the injuries occurred in the morning, four in the afternoon. All injuries occurred while immunizing students in grades 1 to 8. Seven of the accidents occurred prevacci-nation (with a sterile needle) and six post-vaccination (with a contaminated needle). Of the prevaccination accidents, two occurred while filling syringes and five immediately prior to vaccinating. Of the postvaccination accidents, four occurred immediately after vaccinating and two during disposal of used needles. Nine of the injuries were moderate (skin punctured, some bleeding) and four were superficial (little or no bleeding). No severe injuries (deep stick …