Unintentional Needlestick Injuries in Livestock Production: A Case Series and Review

Hand function following accidental automatic animal syringe injector injuries

Accidental self-injection injury is a common occurrence among veterinary and farm workers handling automatic syringe injectors. Most of the time, these injuries are asymptomatic or cause self-resolving mild symptoms, but these injuries may lead to significant morbidity. The aim of the study was to evaluate hand function after inadvertent injection of a poultry influenza or cholera vaccine in patients admitted to our department with infection. We retrospectively gathered data from admission to last follow-up. Functional assessment and physical exam of the hand were done at each stage by either an orthopedic resident or a fellowship-trained hand surgeon. The exam included evaluation of sensation using monofilament, joint range of motion using a goniometer, and a Quick DASH questionnaire. The study included 21 patients, all men, with a mean age of 33.4 years (range 23-44). Of the 21 patients only eight had attended all follow-ups. All patients had injury to the non-dominant hand. Seventeen of 21 of the cases had finger injuries, out of which 11 involved the thumb. The mean hospitalization time was 3.75 days (1-10). Of the 21 patients, seven underwent surgery to drain a collection during hospitalization. Seven out of eight patients had lowest disability scores on Quick Dash questionnaire. Three out of eight patients lost superficial sensation at the tip of the finger. The largest loss of range of motion was found in the distal interphalangeal joint in the finger or interphalangeal joint in the thumb, especially following surgical drainage. Of the eight patients presenting for follow-up, most had returned to the same job. Hand function was normal, as expressed in a DASH questionnaire. Sensory examination demonstrated that the sensation was almost unaffected over the injured finger. Range of motion of the joint closest to the injection site was usually the most impaired. Patients who underwent surgical drainage had a reduced range of motion.

Unintended Self-Inoculation with Bovine Paratuberculosis Vaccine Causing Granulomatous Dermatitis Positive for Acid-Fast Bacilli

Mycobacterium paratuberculosis causes Johne's disease in cattle, a chronic granulomatous enteritis for which a killed vaccine is commercially available. We present a case of a veterinarian who had an unintended needle-stick with injection of vaccine material. He developed a granulomatous dermatitis with acid-fast bacilli identified on pathology of affected tissue. It is important for health-care providers who care for patients at risk for unintended vaccine exposure to be aware of the possible sequelae after exposure and provide appropriate treatment based on the severity of the injury and subsequent tissue response.

Flexor Compartment Infection Secondary to Bovine Injection Needlestick Injury: A Case Report

CASE

Animal injection-related needlestick injuries are a common occupational hazard for livestock workers and veterinarians. Although often unreported, these injuries can cause significant damage and may require extensive medical and surgical management. This case describes a 69-year-old farmer who accidentally injected his forearm while vaccinating cattle, resulting in a flexor compartment infection. Conservative management with oral and intravenous antibiotics was unsuccessful, and he required multiple surgical debridements for definitive treatment CONCLUSIONS:: Animal injection-related needlestick injuries can present unique challenges to orthopaedic surgeons. Important considerations include the injury location, needle type, vaccine volume and components, injection pressure, and environmental contaminants.

Evaluating Swine Injection Technologies as a Workplace Musculoskeletal Injury Intervention: A Study Protocol

Intensification of modern swine production has led to many new technologies, including needleless injectors. Although needleless injectors may increase productivity (by reducing injection time) and reduce needlestick injuries, the effect on risk for musculoskeletal disorders is not clear. This project will compare conventional needles with needleless injectors in terms of cost, productivity, injury rates, biomechanical exposures, and worker preference. Muscle activity (EMG) and hand/wrist posture will be measured on swine workers performing injection tasks with both injection methods. Video recordings during the exposure assessments will compare the duration and productivity for each injection method using time-and-motion methods. Injury claim data from up to 60 pig barns will be analyzed for needlestick and musculoskeletal injuries before/after needleless injector adoption. Workers and managers will be asked about what they like and dislike about each method and what helps and hinders successful implementation. The information above will be input into a cost-benefit model to determine the incremental effects of needleless injectors in terms of occupational health, worker preference, and the financial “bottom line” of the farm. Findings will be relevant to the swine industry and are intended to be transferable to other new technologies in animal production.

The epidemiology of blood-contaminated needlestick injuries among veterinarians in Portugal

Needlestick injuries (NIs) are considered a substantial occupational health and safety hazard in contemporary health care practice. Unlike human medicine where much effort has been devoted to reduce the incidence of these events, the same aggressive approach has not been used in veterinary medicine. This study investigated the occurrence of blood-contaminated NIs in Portuguese veterinarians. Participants of a veterinary meeting were asked to complete a questionnaire-based survey. Univariate and multivariate logistic regression analyses were performed to produce predicted probabilities for NI episodes in veterinarians. From the total of 373 enrolled veterinarians, 293 (78.5%) reported having had at least one NI during their professional life. Veterinarians working with dogs were more likely to have experienced a NI (adjusted odds ratio [aOR]: 145.74, P < .001). The high level of NIs observed in these professionals shows that NIs are a potential occupational health problem in Portuguese veterinarians, with the possibility for transmission of haematogenous zoonosis.

Streptomyces cyaneus dermatitis in a dog

BACKGROUND

A nearly 4-year-old neutered male Australian Terrier was referred for a nodular pyogranulomatous mass of the right axilla. It had been poorly responsive to antibiotic therapy.

CASE REPORT

Based on filamentous Gram-positive organisms identified in earlier biopsy material, infection by an Actinomyces sp. was suspected and the dog showed clinical improvement on a trial of potentiated sulfonamides. Recurrence 5 months later prompted euthanasia, with Streptomyces cyaneus being cultured and confirmed by genetic sequencing of part of the 16 s ribosomal RNA gene.

CONCLUSION

Invasive Streptomyces spp. infections are uncommon in humans and animals, and isolations are sometimes considered to be contaminants, but the demonstration of the organism within the lesion in this instance indicates that the isolation of a Streptomyces sp. from veterinary cases should not always be considered as contamination, because this genus is clearly pathogenic.

Biologically hazardous agents at work and efforts to protect workers' health: a review of recent reports

Because information on biological agents in the workplace is lacking, biological hazard analyses at the workplace to securely recognize the harmful factors with biological basis are desperately needed. This review concentrates on literatures published after 2010 that attempted to detect biological hazards to humans, especially workers, and the efforts to protect them against these factors. It is important to improve the current understanding of the health hazards caused by biological factors at the workplace. In addition, this review briefly describes these factors and provides some examples of their adverse health effects. It also reviews risk assessments, protection with personal protective equipment, prevention with training of workers, regulations, as well as vaccinations.