Community-acquired needle stick injuries in Canadian children: Review of Canadian Hospitals Injury Reporting and Prevention Program data from 1991 to 1996.

OBJECTIVE To review community-acquired needle stick injuries (CANSIs) in children reported to a Canadian emergency room-based injury surveillance program. DESIGN Analysis of 1991 to 1996 CANSI records followed by chart review to determine use of prophylactic interventions and outcome information. SETTING The Canadian Hospitals Injury Reporting and Prevention Program network of 10 paediatric and six general hospitals. PATIENTS Nonoccupational injuries to patients younger than age 20 years involving used needles were reviewed. MAIN RESULTS Of 116 children injured, most were male (74%); the median age was 6.6 years. Needles were picked up before injury in 77% of the cases. Most injuries (78%) were from needles presumed to have been discarded by an injection drug user. Parks were the most common site of injury (21%). Six per cent of injuries occurred in medical settings. Treatment information was obtained for 71 (61%) patients. Only 1.7% had been immunized against hepatitis B virus before injury. Hepatitis B immune globulin and hepatitis B virus vaccine were given to 78% and 76% of children, respectively. None received human immunodeficiency virus prophylaxis. CONCLUSIONS Programs teaching needle avoidance may help prevent many CANSIs. The safety of outdoor, home and medical environments also needs to be ensured. Treatment guidelines for CANSIs will help ensure appropriate postinjury management.