Circumstances of Percutaneous Sharps Injuries in German Healthcare Workers—An Analysis of the Ten-Year Period from 2015 to 2024 Based on Accident Insurance Data
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsDear Authors,
First, I have a problem with the title, as it doesn't reflect the content of the manuscript. The authors don't analyze trends, and the causes of injuries are a marginal part of the content at the end of the results section of the article. Please adjust the title to reflect the content of the article.
Introduction presents the scale of the problem of sharps injuries among healthcare workers and the associated risk of blood-borne infections. The authors clearly discuss epidemiological data and emphasize the importance of using safety-engineered medical devices and legal regulations aimed at reducing the number of such incidents. The text provides a good introduction to research on the causes and frequency of these injuries in the healthcare system.
The authors present the methodology quite clearly.
Results:
Figure 1 is not sufficiently clear.
If the authors cite a higher incidence of injuries among women, they should specify the share of women working in specific sectors and then calculate the appropriate coefficients. Only then would it be possible to determine which gender is the cause. Currently, this is not entirely methodologically accurate.
Discussion:
The authors compare the results with other international studies and relate them to changes over time, which enhances the text's insightful insight. Also noteworthy is the discussion of the role of safety devices and the importance of training in reducing the number of injuries. However, the analysis is based in part on a relatively small sample and self-report data, which may impact the accuracy of the obtained results.
A separate section entitled "Limitations of the Study" would be useful.
Author Response
1) First, I have a problem with the title, as it doesn't reflect the content of the manuscript. The authors don't analyze trends, and the causes of injuries are a marginal part of the content at the end of the results section of the article. Please adjust the title to reflect the content of the article.
Comment Authors: We are grateful for this comment. As no trend was obvious in our data, it might be wise to chance the title. Now the title is: Circumstances of percutaneous sharps injuries in German healthcare workers – An analysis of the ten-year period from 2015 to 2024 based on accident insurance data
2) Introduction presents the scale of the problem of sharps injuries among healthcare workers and the associated risk of blood-borne infections. The authors clearly discuss epidemiological data and emphasize the importance of using safety-engineered medical devices and legal regulations aimed at reducing the number of such incidents. The text provides a good introduction to research on the causes and frequency of these injuries in the healthcare system.
Comment Authors: Thank you for this appreciative comment. No action required.
3) The authors present the methodology quite clearly.
Comment Authors: Thank you for this appreciative comment. No action required.
Results:
4) Figure 1 is not sufficiently clear.
Comment Authors: Thank you for this comment. We changed the figure. The revised figure 1 shows the number of reported injuries for each sector as a bar chart, separated by year.
5) If the authors cite a higher incidence of injuries among women, they should specify the share of women working in specific sectors and then calculate the appropriate coefficients. Only then would it be possible to determine which gender is the cause. Currently, this is not entirely methodologically accurate.
Comment Authors: Thank you for this thoughtful comment. Yes, we agree our sentence was not well phrased: “Women were affected by around 80% of PSIs. Among medical and dental assistants as well as nursing staff, women accounted for over 90% of PSIs”. We changed this sentence as its interpretation is not clear. Around 80% of the registered PSI concerned women. Among medical and dental assistants as well as nursing staff, 90% of PSIs concerned women. In the discussion we mention that our data do not allow to assess the risk of PSI depending on gender.
Discussion:
6) The authors compare the results with other international studies and relate them to changes over time, which enhances the text's insightful insight. Also noteworthy is the discussion of the role of safety devices and the importance of training in reducing the number of injuries. However, the analysis is based in part on a relatively small sample and self-report data, which may impact the accuracy of the obtained results.
Comment Authors: Thank you for this thoughtful comment. We agree with the reviewer. Our data have limitations. This is now more clearly presented in the limitation section. See comment 7.
7) A separate section entitled "Limitations of the Study" would be useful.
Comment Authors: We have accordingly introduced a separate section for limitations. Now we explain: It should be noted that the survey data concerning the circumstances of the injury consists on self-reported data. We have also added the following sentence: The analysis for the sector nursing homes is based on a small sample. The results are of limited relevance for this sector.
Reviewer 2 Report
Comments and Suggestions for AuthorsThe aim of the study was to analyze the incidence of percutaneous sharps injuries based on routine data from accident insurance registers and to analyze the circumstances and causes of needlestick injuries based on survey data. The information obtained from these two sources was analyzed accurately. However, reading the entire article leads me to make a few comments:
Information on the number of percutaneous sharps injuries by profession should be supplemented with data on the number of individuals in each profession. This would provide an overview of the frequency of such accidents in a given profession.
Similarly, one could attempt to estimate the frequency of percutaneous sharps injuries during the performance of specific medical procedures. This would provide information on the most risky procedures, which could be used during training.
The survey collected information on the circumstances of the accident, information on the device involved, and the activity performed at the time of the injury assessment. The interviewees also described the causes of the accident (high workload, time pressure, lack of attention, unexpected patient movement, distraction by surrounding activities, problems related to the sharps container, and problems related to the safety device). However, there is no timeline for the accident (hour of the day, time from the start of work to the accident). This information could be used to develop recommendations for improving work organization.
Author Response
1) The aim of the study was to analyze the incidence of percutaneous sharps injuries based on routine data from accident insurance registers and to analyze the circumstances and causes of needlestick injuries based on survey data. The information obtained from these two sources was analyzed accurately. However, reading the entire article leads me to make a few comments:
Comment Authors: Thank you for reading the manuscript and suggesting improvements.
2) Information on the number of percutaneous sharps injuries by profession should be supplemented with data on the number of individuals in each profession. This would provide an overview of the frequency of such accidents in a given profession.
Comment Authors: Thank you for this comment. We agree with the reviewer. However, the number of individuals in each profession giving rise to the claims of NSI is not known to us. Now, we mention this in the limitation section.
3) Similarly, one could attempt to estimate the frequency of percutaneous sharps injuries during the performance of specific medical procedures. This would provide information on the most risky procedures, which could be used during training.
Comment Authors: Thank you for this comment. We agree with the reviewer. However, the number of procedures giving rise to the claims of NSI is not known to us. Now, we mention this in the limitation section.
4) The survey collected information on the circumstances of the accident, information on the device involved, and the activity performed at the time of the injury assessment. The interviewees also described the causes of the accident (high workload, time pressure, lack of attention, unexpected patient movement, distraction by surrounding activities, problems related to the sharps container, and problems related to the safety device). However, there is no timeline for the accident (hour of the day, time from the start of work to the accident). This information could be used to develop recommendations for improving work organization.
Comment Authors: Thank you for this valuable comment. We agree with the reviewer. For PSI cases based on routine data, no information is available regarding the time of the injury during the work shift. However, the time from the start of work to the injury was assessed in the online survey. This data is added to the manuscript.
