• A M Anglim, J E Collmer, T J Loving, K A Beltran, B J Coyner, K Adal, J Jagger, N J Sojka, and B M Farr.
• University of Virginia Health Sciences Center, Charlottesville 22908, USA.
• Infect Control Hosp Epidemiol. 1995 Oct 1; 16 (10): 570-6.

ObjectivesTo investigate the cause of an outbreak of needlestick injuries (NSIs) in hospital employees.SettingA 700-bed university hospital.DesignOutbreak investigation, laboratory evaluation of a medical waste disposal device, cost analysis.MethodsEmployee health department records were reviewed of workers suffering sticks from needles piercing fiberboard-contaminated material containers (CMCs). A laboratory evaluation of needle-puncture resistance properties of the CMCs was performed using a testing apparatus. The cost of a hospital waste disposal program using fiberboard CMCs was compared with the cost of a program using rigid plastic (polypropylene) boxes.ResultsDuring 40 months of surveillance in 1986 and from 1989 to 1991, only one NSI had occurred from a needle piercing a CMC. During 9 months in 1993, 13 NSIs occurred due to needles piercing CMCs (P < .001). No clinical illness resulted from the NSIs. The outbreak was halted by a temporary change to plastic (polypropylene) boxes for sharps disposal ($4.92 to $23.33/cu ft) until receipt of a box with a newly designed solid fiberboard liner ($1.25/cu ft). CMC liners used during the epidemic had a mean needle puncture resistance of 527 g, as compared with 660 g for liners used before the outbreak (P < .001). The new solid fiberboard liner has a mean puncture resistance of 1,765 g. A program of waste disposal using fiberboard CMCs was found to cost approximately one-seventh the cost of a program using plastic boxes for disposal of infectious waste.ConclusionA program for infectious waste disposal using fiberboard CMCs can be safe and cost-effective if appropriate standards for puncture resistance are met.

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