Sir, healthcare workers face dangerous and potentially life-threatening infections, particularly as a result of needlestick and other sharps injuries. Concern about infectious agents such as prions (CJD), bacteria (eg MRSA) and viruses (eg hepatitis viruses or HIV)1 – let alone others that are rare in the resource-rich world (such as Ebola) – has, for over 25 years, given rise to repeated advice to healthcare workers on infection control, and many reports have highlighted the hazards in dental practice which have been a major issue for dental nurses.2,3 Furthermore, the emotional impact of a needlestick injury can be profound, even when an infection proves not to have been transmitted.

Legislation in this area aims to achieve a safe working environment and prevent injuries to healthcare professionals and others caused by all medical sharps, including needle sticks. The prevention of sharps injuries was covered during this period in UK legislation and the Department of Health guidelines HTM01-05.4 Safe and effective sharps management has also been a feature of the dental practice inspection regimen and the Care Quality Commission (CQC) has been regulating primary dental care providers – both NHS and private – in England since April 2011. The UK and other Member states of the European Union also had until 11 May 2013 to implement the Council Directive 2010/32/EU Implementing the Framework Agreement on Prevention from Sharps Injuries in the Hospital and Healthcare Sector. Thus, the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 took effect then. These regulations are made under the Health and Safety at Work Act 1974, and they implement (in part) EC Directive 2010/32/EU as required under European law. It is also clear that employers have a duty to ensure the safety of their employees.2

It is, therefore, most disappointing that, in the 2014 survey conducted by the British Association of Dental Nurses, just over half of dental nurses in the UK and the Republic of Ireland had had a needlestick injury at some stage in their career.5 This is probably their major occupational hazard6 and a glance at the web shows this point has come to the attention of the legal profession.7 A huge body of evidence shows that most of these injuries are avoidable if healthcare workers are provided with the correct readily available protection and procedures.8 We have also recently published, in this Journal, a practical compendium of current guidelines on the management of needlestick injuries.9