Needle injuries to nurses and other staff at Veterans Affairs Department hospitals have dropped 19% amid heightened concerns about contracting AIDS or hepatitis from patients' blood, according to a study.
But congressional investigators said not all VA medical centers have invested in safer needles that can sharply reduce the risk of accidents.
The General Accounting Office, in a report prepared for Rep. Ron Wyden (D-Ore.), said VA officials aren't sure whether the drop in needle injuries is due to "universal" infection-control precautions, safer devices, underreporting of injuries or a combination of those factors.
It said 90 of the 158 VA medical centers spent $1.1 million in fiscal 1993 to purchase safer needles and other blood-gathering devices. Several VA medical centers that did not purchase safer devices are in areas with high numbers of patients who are infected with HIV, the virus that causes AIDS, it said.
The study was undertaken at the request of Mr. Wyden's House Small Business subcommittee on regulation, business opportunities and technology, which has conducted hearings in the past on medical workers' safety. Experts say as many as 1 million accidental needle sticks occur each year.
Most needle sticks occur during disposal or trash-handling; only one in four occurs while the worker is actually drawing blood.
VA medical centers treated 16,749 patients with HIV or AIDS in fiscal 1993, and the GAO estimated there were at least 71 needle injuries to VA workers involving HIV-infected blood.
But no VA worker has ever reported getting HIV or AIDS from a needle stick, the report said.
The risks of infection from an accidental puncture with a needle containing HIV-infected blood are just three-tenths of 1%. Nevertheless, the GAO estimated that one VA worker every five years is likely to become infected from a needle injury.
The risk of contracting hepatitis B is far greater for healthcare workers in general. The national Centers for Disease Control and Prevention estimate that 12,000 healthcare workers contract hepatitis B annually, and 250 die from the disease.
"Given that in 1992, 3,083 VA patients tested positive for hepatitis B and 6,613 tested positive for hepatitis C, VA healthcare workers are at obvious risk of acquiring the disease," the GAO said.
The VA's 130 acute-care medical centers reported 4,791 needle injuries in fiscal 1993, a 19% drop from 5,933 the year before.
Veterans Affairs Secretary Jesse Brown said the GAO report was "based on data that might have been more relevant a year ago or longer, but are outdated and misleading today."
Mr. Brown said the VA has already implemented an aggressive program to prevent needle sticks. He also questioned GAO estimates of workers' risk of becoming HIV-infected at various medical centers, based upon their caseloads of HIV-positive patients.