The Association of Occupational Health Professionals in Healthcare (AOHP) recently released report of the EXPO-S.T.O.P. (EXPOsure Survey of Trends in Occupational Practice) 2016 and 2017 surveys in the AOHP Journal (Vol. 39, No. 1). AOHP's EXPO-S.T.O.P. is an electronic survey designed to ascertain the incidence of sharps injuries and mucocutaneous blood exposures among healthcare workers (HCWs) in U.S. healthcare facilities.
EXPO-S.T.O.P., the largest annual survey of its kind conducted in the United States, was initiated in 2011 to establish a nationally representative overview of blood and body fluid exposure. The 2016 survey, with facilities from 37 different states participating, is geographically the most extensive to date, and with 224 hospitals participating, EXPO-S.T.O.P. 2017 is the largest survey to date. AOHP publishes the survey results to provide healthcare facilities with up-to-date data on national exposure rates and trends to enable benchmarking and evidence-based decisions for their exposure-reduction strategies. In addition, the survey identifies the top 10 participating facilities with the lowest rates and, via these, has enabled other research to be published on successful exposure-reduction strategies.
“All blood exposures are potentially infectious and pose a serious occupational risk to HCW,” explains Linda Good, PhD, RN, COHN-S, survey co-author and Manager, Employee Occupational Health Services, Scripps Health, San Diego. “Trends documented by EXPO-S.T.O.P. show that a renewed vigor must be attained to protect HCW.”
The 2016 and 2017 overall results for all hospitals, as with the 2015 survey, document a significant increase in blood exposure incidence over the 2011 results.
“It is alarming that data from the last three surveys have shown a year-by-year significant increase in sharps injuries (SI), and that the 2017 rate is almost back to the 2001 rate,” describes survey co-author Terry Grimmond, BAgrSc, GrDpAdEd&Tr, Grimmond & Associates Microbiology Consultants, New Zealand, “These increasing rates validate that the significant decrease in sharps injuries in the years immediately following the Occupational Safety and Health Administration’s (OSHA’s) Needlestick Safety and Prevention Act of 2001 has not been sustained.”
“The OSHA law is clear,” says Good. “Employers and employees must strive to reduce exposures with the use of safety-engineered devices (SED) and staff training and must review their exposure control plan annually in pursuit of exposure reductions.”
Conclusions documented in the EXPO-S.T.O.P. 2016 and 2017 Report include:
- The significant rise in SI incidence with the 2016 and 2017 surveys indicates that current strategies have not been successful in reducing national SI rates.
- There is an urgent need to adopt more aggressive exposure reduction strategies.
- Large exposure databases, detailed databases of SI mechanisms, and research on SI mechanisms, SED effectiveness, and effective training are required, as well as continued publication of strategies proven to reduce exposure incidence.
“The recent rise in SI incidence is of urgent concern and should draw the attention of every healthcare institution," summarizes Grimmond. "An aggressive and relentless approach is now needed to achieve significant reductions in bloodborne pathogen exposure. A zero rate is difficult to achieve, but zero must always be our aim.”