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What is the risk of getting a disease from a used needle?


Starbucks employees are concerned about the danger of running out of used syringes discarded in store bathrooms.

More than 3,700 people had signed a petition requesting the safe disposal of syringes in store bathrooms starting Friday. The petition mentioned the fear of exposure to infectious diseases such as HIV, hepatitis C and hepatitis B, in the event that a Starbucks employee accidentally contacts a used needle when cleaning the bathroom or emptying garbage, something that several employees reported that happened.

Starbucks installed safe syringe disposal boxes at all of its stores in Seattle last year, and now responds to employee concerns by exploring how to reach more locations.

"At the end of the day, we want to make sure our partners are safe," said Starbucks spokesman Reggie Borges. "I do not think this is a problem unique to Starbucks," he added. "I think a lot of retail businesses are dealing with this."

Dr. Alysse Wurcel, a physician treating infectious diseases at Tufts Medical Center, praised the launch of the needle disposal box and said she "absolutely" believes there should be needle boxes in the store bathrooms.

"People who work at Starbucks did not enter this job thinking about these risks of exposure to health," said Wurcel, whose job includes responding to alerts that a patient may have been exposed to an infectious disease from a discarded needle.

While the boxes will undoubtedly help Starbucks employees feel safer at work, health experts say that the risk of contracting these diseases from an accidental needle stick is low.

"In medical school, they taught us that it's the law of the three," said Dr. Joshua Barocas, an assistant professor at the Boston University School of Medicine.

An unvaccinated person who is trapped with a contaminated syringe would have a 30 percent chance of getting hepatitis B, 3 percent of getting hepatitis C and 0.3 percent of getting HIV, he explained.

And even those figures come with warnings, Barocas said. "HIV notoriously does not survive outside the body for long," he said. "It does not hang on needles."

The hepatitis C virus, which is approximately 10 times more infectious than HIV, survives more time outside the body.

However, in the case of either of the two viruses, immediate exposure to a contaminated syringe, by sharing needles while injecting drugs, for example, represents a greater risk than contact with a needle that has been in a trash can. .

The calculations of the law of the three are based on the data of the punctures in the hospital where the blood is fresh, "said Robert Heimer, professor of epidemiology at the Yale School of Public Health, unlike when drug users. intravenously sharing needles, the average person will not immediately contact a discarded syringe.

"There is no measurable risk," Heimer concluded about encountering a used needle in a cafeteria bathroom long after it was discarded.

"While infectious HIV and [hepatitis C] "It can be recovered from inside the barrel of the syringe, the amount outside is minuscule," he said. "Even if there is one, it is likely that the virus will be quickly deactivated."

It's sad that we have to inject people in the bathrooms. It is a symptom of a bigger problem.
Dr. Alysse Wurcel, treating physician of infectious diseases at the Tufts Medical Center

Tiny or not, Dan Ciccarone, a professor of family and community medicine at the University of California, San Francisco, said he believes the risk of accidental exposure is real.

Ciccarone said he was concerned about hepatitis C and HIV at the population level, noting that "accidents happen along the way."

"The only argument against [sharps boxes] It's that HIV and hepatitis C are under control. "That's not necessarily the case.

The new cases of hepatitis C more than tripled between 2010 and 2016, with an estimated 41,000 new cases occurring only in 2016. The majority of these new infections were related to the use of injectable drugs, according to the Centers for Disease Control and Prevention. And the outbreaks of HIV linked to Injecting drug use in Massachusetts Last year and in Scott County, Indiana, a few years earlier, there are signs that HIV still has the potential to return in places where risk factors such as injecting drug use, the prevalence of fentanyl and the lack of health services are aligned.

Barocas highlighted the value of containers for sharp objects to make workers feel protected by their employers. "If an employee feels that this is a safety problem, then there is no problem," he said.

Beyond the immediate concerns about employee safety, the broader public health context of needles used in retail restrooms is that people who use drugs turn to Starbucks because they do not have a safe place to inject or dispose of them. used needles

"It's sad that we have to inject people in the bathrooms," said Wurcel. "It's a symptom of a bigger problem."

In general, if someone is accidentally punctured with a needle, you should go to the emergency department or call your doctor to assess the risk of infection. Depending on the situation, a health professional can help determine if additional treatment is needed, such as post-exposure tests or medications. For used needles located on the ground, people should call public works or the police department on proper disposal or on the administration of the facilities of any space in which they are located.

"If there is a needle, then there is probably more, so it may be necessary to clean up the local government, "said Barocas. He said.

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