A-319 INCIDENCE AND CAUSES OF NEEDLESTICK INJURIES CONNECTED WITH BLOOD COLLECTION IN SAUDI ARABIA: A NATIONAL SURVEY

Abstract

Needlestick injuries (NSIs) are a significant occupational risk for healthcare workers (HCWs), especially nurses, phlebotomists, and laboratory technicians. Globally, approximately 40–43% of HCWs experience at least one NSI, mainly during procedures with hollow-bore needles such as blood collection, injections, and improper disposal. These injuries expose HCWs to bloodborne pathogens, psychological stress, and financial costs, and are often underreported, with up to half not formally documented. In Saudi Arabia, annual NSI rates range from 11% to 24%, with nurses being most affected. However, limited data exist on NSIs across the different stages of venous blood collection in the country. The Preanalytical Working Group of the Saudi Society for Clinical Chemistry conducted an anonymous survey estimating the incidence and causes of NSIs before, during, and after venous blood collection. An anonymous online survey was conducted using Microsoft Forms from January 14 to 28, 2026, targeting HCWs involved in blood collection in 25 hospitals in cross Saudi Arabia. The 26-question survey explored occupation, experience, safety protocols, awareness of risks, NSI occurrence and timing, reporting practices, and use of safety devices. Data was summarized using counts and percentages in Microsoft Excel. Multivariable stepwise logistic regression was used to identify independent predictors, considering factors like work experience, daily venipuncture volume, and training frequency. Chi-square tests compared proportions. Statistical analyses were performed using MedCalc©, version 23.2.8, with p-values <0.05 considered significant. Among 164 HCWs (mostly nurses, 84.7%; laboratory technicians, 7.9%; phlebotomists, 3.6%), 72% (118/164) reported never experiencing an NSI, while 28% (46/164) had at least one during their career. Notably, 7.3% (12/164) reported experiencing NSIs in all three blood collection phases – before, and after. NSIs were most frequently reported after venipuncture, particularly during handling and disposal, with 20.1% (33/164) reporting such events. However, no phase showed a statistically higher incidence of NSIs (?²=0.146, df=1, p=0.7020). Stepwise logistic regression identified several independent predictors of NSI. HCWs with less than one year of experience had lower odds of NSI compared to their more experienced counterparts (OR 0.11, 95% CI 0.01–0.92, p=0.0421). In contrast, those who received only one-time training upon employment (OR 3.76, 95% CI 1.56–9.08, p=0.0032) and those performing 11–20 venipunctures per day (OR 6.95, 95% CI 1.27–38.20, p=0.0256) faced higher odds of NSI. The model showed acceptable discrimination with an AUC of 0.70 and adequate calibration (Hosmer–Lemeshow p=0.96). NSIs remain a relevant occupational risk among HCWs performing venous blood collection in Saudi Arabia, with nearly one-third reporting at least one lifetime NSI. Although NSIs occurred across all phases of blood collection, no single phase predominated, underscoring the need for comprehensive preventive strategies throughout the entire venipuncture process. The study identified that limited professional experience, infrequent training, and higher daily venipuncture rates are key risk factors for NSIs. These findings emphasize the importance of preventive strategies at every stage of blood collection. Structured training, safety-engineered devices, and workflow improvements may help reduce NSI risk and enhance healthcare worker safety.