Needlestick injuries among sanitation workers in Mexico City.

Sanitation workers (SW) are exposed to a wide range of biological, chemical, and physical hazards. Needlestick injuries constitute a recognized physical hazard, but few studies have been conducted to document the magnitude of the problem among SW. Contaminated sharp objects can transmit bloodborne pathogens, such as human immunodeficiency (HIV), hepatitis B (HBV), and hepatitis C (HCV) viruses. Needles and syringes contaminated with HBV and HCV have been found in public recreational areas in South London, United Kingdom (1). Although transmission of such pathogens to sanitation workers and community members has not been demonstrated, there is the potential for infection. We were not aware of any prior study among SW in a developing country. Given this lack of information, we conducted a survey of needle-stick and sharps injuries among SW in Mexico City. In July–August 2003, a non-random, convenience sample of 69 SW was selected from 13 of the 16 Mexico City districts by finding and approaching sanitation vehicles during their daily rounds. Workers were identified and interviewed on the street, while working or during a break. Questionnaires determined the frequency of sustaining a needlestick injury at work, finding syringes with regular waste, vaccination status, and health care-seeking practices. Epi Info TM Version 3.3.2 (Centers for Disease Control and Prevention , Atlanta, Georgia, United States of America) was used for data entry, descriptive epidemiology, and analysis. The study was exempted from human subjects review by the Institutional Review Board of the Centers for Disease Control and Prevention because no personal identifiers were collected and no questions were considered sensitive. The study was approved by the Research Oversight Committee of the National Immunization Council, Mexico City, Mexico. Although the total sample of SW was 69, not all responded to every question; thus denominators vary among these results. Fifty (82%) of 61 respondents were employed by the municipal government. Twenty-five (38%) of 66 respondents worked on a truck; the remainder transferred waste from residences or small businesses into large barrels that were then emptied into trucks. Of the 69 SW interviewed, 13 (34%) reported 22 needlesticks (median = 1; range: 1–5) during the previous 12 months. Fourteen of these needlesticks were reported by 7 (10%) workers in the previous month. Sixty-six (96%) of the 69 SW had seen needles and syringes within waste at some time in the past, and 56 (81%) had seen them during the previous week. Fifty-five percent of SW …