Needle stick injuries during fine needle aspiration procedure: Frequency, causes and knowledge, attitude and practices of cytopathologists

BACKGROUND: There is no study available on the frequency, predisposing factors and outcome of needle stick injury (NSI) in cytopathologists who perform fine needle aspiration (FNA). AIM: To know the frequency, circumstances and sequlae of NSI sustained by cytopathologists, assess their knowledge about risks of NSI and attitudes and practices towards use of standard precautions and post-injury wound care. MATERIALS AND METHODS: Study design: cross sectional. Setting: Tertiary care teaching and non-teaching hospitals and private laboratories. Data collection method: Knowledge, attitude and practices survey using a questionnaire. RESULTS: Majority (90.5%) of the respondents have had NSI in their total career. In the previous year, more than half (71.4%) had at least one NSI (mean 3.2). NSI was the most common in index finger of non-dominant hand (59.6%) and occurred during step two of FNA procedure when the needle was being manipulated within the lump. The major predisposing factors were uncooperative patients (88.9%), small children (54%), deep masses (36.5%), hot humid climate (88.9%), heavy workload (76.2%) and poor administrative arrangement (54%). The adherence to standard precautions was not optimal (74.6%). None of them reported NSI to the authorities, nor investigated source patient or themselves. 82.5% of the respondents were not aware of any formal exposure reporting system in their hospital. CONCLUSION: Cytopathologists frequently experience NSI while performing FNA. Frequency of injury is also related to patient characteristics and work site factors. Education and motivation for adhering to standard precautions and post-exposure prophylaxis are often lacking.