To characterize disposal-related sharps injuries.

A three-part study including (a) descriptive analysis of disposal-related injuries in a l-year period, (b) 4:l matched case-control study of nurses injured while using sharps disposal containers, and (c) survey to solicit opinions of users of containers.

An 1,181-bed teaching hospital in New York City.

For epidemiologic analyses, persons with self-reported injuries identified via New York State and Occupational Safety and Health Administration forms and control nurses without self-reported injuries. For survey, convenience sample of hospital nurses, laboratory workers, and maintenance workers.

Circumstances of injuries determined by study questionnaires. Employee opinions obtained by questionnaires and discussions during small group sessions.

Three hundred sixty-one persons reported sharps injuries, of whom 72 (20%) had disposal-related injuries. Persons with disposal-related injuries included four hospital visitors and one patient. Of 67 disposal-related injuries among employees, 25 (37%) directly involved use of a sharps disposal container. Significant risk factors for injury included container height greater than 4 ft above the floor, distance less than 5 ft from site of sharp object use to nearest container, and lack of attendance at universal precautions inservice classes. Survey groups involved 69 employees who identified a variety of preferred features for sharps disposal containers.

Disposal of sharp objects is an important cause of sharps injuries. Ergonomic factors, worker education, and appropriate container design should be considered in injury prevention strategies. Relevant guidelines and regulations are lacking and are needed.