The Scope of the Needlestick Crisis

Needlestick injuries (NSIs) remain one of the most widespread and under addressed occupational threats in healthcare. Despite decades of international guidance, clinical training, and advances in device engineering, over two million healthcare workers globally will suffer a sharps injury this year. These injuries expose clinicians to more than 20 bloodborne pathogens, including hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). The global pooled prevalence of NSIs among healthcare workers is estimated at 44.5%, with significantly higher rates reported in Africa (51%) and Southeast Asia, where up to 50% of nurses have been affected [1][2]. Surgical teams, emergency clinicians, and nurses are among the highest-risk groups, especially during needle recapping and disposal, when protection is often insufficient or absent.

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The Silent Epidemic: Underreporting and Cultural Normalization

The scale of NSIs is made worse by chronic underreporting. Many incidents go unrecorded due to fears of stigma, professional consequences, or the administrative burden of documentation. In high-pressure care environments, the normalization of occupational risk further suppresses reporting, creating a culture where minor injuries are viewed as part of the job. This dynamic is even more acute in low- and middle-income countries, where limited access to safety-engineered devices compounds the problem [3]. When underreporting becomes routine, institutions lose critical data that could inform better prevention strategies and delay necessary interventions after exposure.

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Human and Institutional Costs

The impact of NSIs extends far beyond the initial puncture. Clinically, healthcare workers face the risk of infection from HBV, HCV, HIV, and other transmissible pathogens. Psychologically, NSIs are associated with acute stress, anxiety, and in some cases, post-traumatic symptoms that can persist long after physical recovery [4]. Financially, the average global direct cost per sharps injury is approximately $747 USD, a figure that does not include long-term treatment, litigation, or productivity loss [5]. At a systems level, NSIs contribute to burnout, staff turnover, and gaps in patient care continuity, outcomes that burden already strained healthcare infrastructure.

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Why Safety Innovation Must Be Prioritized

Despite the preventable nature of most NSIs, institutional change has lagged. Research indicates that up to 80% of sharps injuries could be avoided through the consistent use of safety-engineered devices and adherence to updated protocols [6]. Yet many facilities continue to use outdated tools or rely on unsafe practices like two-handed recapping, particularly in regions where device access is limited or where staff have little influence over procurement decisions. Leadership must treat NSI prevention as a top-tier priority, not a compliance box to check.

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The Role of Innovation

Engineering plays a pivotal role in modern NSI prevention. KODA Ideaworks, for example, has developed HypoHolder, a Class I FDA-registered device designed to enable one-handed uncapping, recapping, and disposal of hypodermic needles. Created by surgical professionals, HypoHolder reflects a clinician-informed approach that aligns with sterile workflows and minimizes high-risk contact during the most hazardous phases of needle use. While not the only safety solution available, HypoHolder is emblematic of the kind of practical, workflow-compatible innovation that healthcare systems should prioritize.

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A Clinical Mandate, Not a Peripheral Concern

Needlestick injuries are not rare accidents or minor inconveniences, they are frequent, serious, and preventable clinical threats. Treating them as an inevitable part of practice undermines both clinician well-being and patient safety. To address this crisis, institutions must champion cross-sector collaboration, invest in safety technology, and enforce reporting and prevention protocols as a matter of routine clinical governance. Sharps safety must become a clinical standard, not a reactive afterthought.