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About the International Healthcare Worker Safety Center

Our mission: protecting healthcare workers

Millions of healthcare workers around the globe face a daily risk of contracting life-threatening occupational infections, such as HIV, hepatitis B, and hepatitis C, from occupational exposures to patients' blood and body fluids.

The International Healthcare Worker Safety Center at the University of Virginia is dedicated to reducing this serious risk. Under the leadership of Janine Jagger, M.P.H., Ph.D., an internationally recognized expert in the prevention of occupational blood exposures, the Center has made major contributions to needle safety in the U.S. and many other countries around the world.

Two decades of research, education and advocacy

The International Healthcare Worker Safety Center (IHWSC) has been devoted to research on the epidemiology and prevention of healthcare worker exposures to bloodborne pathogens for more than two decades. Dr. Jagger and colleagues published a landmark study in the New England Journal of Medicine in 1988 on the characteristics of medical devices causing needlestick injuries. That groundbreaking research was instrumental in the development of a new generation of safer medical devices.

Dr. Jagger created the EPINet surveillance system in 1991 to provide healthcare facilities with a standardized program for tracking needlestick injuries and blood and body fluid exposures. It is now used by over 1,500 healthcare facilities in the U.S., and by many more in other countries. The dissemination of EPINet has resulted in a massive increase in data on the causes of needlesticks and blood exposures.

In 1992, Dr. Jagger established a voluntary data-sharing network of healthcare facilities using EPINet--the "EPINet network." Participating healthcare facilities from across the U.S. annually send data to the Center that are merged into an aggregate database. With nine years of data from a cumulative total of 84 hospitals, it is the longest-standing database of healthcare workers' at-risk exposures to blood and body fluids in the U.S. EPINet data on the Center's website are regularly accessed by healthcare workers, government agencies, medical products manufacturers, and many others for benchmarking and research purposes.

The EPINet network is the foundation of the Center's research and advocacy, providing important support for new policies to improve healthcare worker safety. EPINet data have also provided valuable insight for product manufacturers as they develop new or better safety devices.

The IHWSC received official designation as a  research center from the University of Virginia School of Medicine in 1994.

Education: presentations and publications
The Center's staff frequently give presentations and conduct workshops on EPINet, sharps safety, and related topics at national and international conferences. They publish regularly in peer-reviewed medical and nursing journals (including the New England Journal of Medicine, Infection Control and Hospital Epidemiology, Nursing), and are interviewed for and quoted in specialty and trade publications.

Click here for a list of Center publications; click here for staff presentations.

For over a decade, the Center's journal Advances in Exposure Prevention (AEP) was a leading source of information on the prevention of occupational exposures to bloodborne pathogens. The Center's book, Preventing Occuptional Exposures to Bloodborne Pathogens: Articles from Advances in Exposure Prevention, 1994-2003, is the culmination of that body of work. It includes over 25 EPINet data reports, personal accounts of occupationally infected healthcare workers, and other articles of interest that were published in AEP over its ten-year span, including a section dealing with legislative and policy issues. (Click here for ordering information.)

The Center has played a leading role in promoting policies and regulations in the U.S. to better protect healthcare workers from occupational exposures, using EPINet data as a road map to guide its advocacy efforts. For example, in 1992 EPINet data revealed that one out of four needlesticks in the U.S. was caused by unnecessary needles used to access intravenous lines. To address this problem, the Center requested a national safety alert from the Food and Drug Adminstration (FDA) about the hazards created by these unnecessary needles. The FDA issued the alert, which resulted in a rapid transition to needleless technology and a clear reduction in injuries-documented in the EPINet data-in this device category.

Despite the development of innovative safety devices and regulatory action on the part of OSHA and the FDA, healthcare facilities were slow to adopt safer technology during the 1990s. Recognizing the need for a legislative mandate, Dr. Jagger and Center staff worked closely with state and federal lawmakers, using EPINet data to help fuel the drive for a national needlestick law. The Needlestick Safety and Prevention Act was signed into law by President Clinton on November 6, 2000; Dr. Jagger was present for the Oval Office ceremony and was recognized by Charles Jeffress, then-director of OSHA, for her contributions to needlestick prevention.

That landmark event--the passage of a national needle safety law--symbolizes what can be achieved globally. The Needlestick Safety Act sets a world standard, and challenges other countries to provide an equal level of protection to their healthcare workers.

International Collaborations
The Center's cooperative work with researchers from other countries is one of its strengths. From 2001 through 2005, the Center directed an innovative program in cooperation with Japanese colleagues, the Japan-U.S. Collaborative Program in Occupational Infection Control and Prevention. Funded by a group of medical products companies, the program's goal was to build a foundation for a national sharps safety movement in Japan. Selected Japanese fellows (physicians and nurses) were brought to the University of Virginia over a three-year period for intensive training in the epidemiology of occupational blood exposures, injury surveillance, and policy-oriented research. Fellows trained through the Center's program have helped conduct national surveillance, build consensus around sharps safety issues in relevant professional associations, and instituted protective measures in their facilities that are now in widespread use in Japan.

Center staff have worked closely with colleagues in Canada, the U.K., Ireland, Spain, Germany, Uruguay, and many other countries to develop customized versions of EPINet. They have also lectured on topics related to healthcare worker safety in countries all over the world.

In 2002, Dr. Jagger received one of the most prestigious awards in the U.S.: a MacArthur Foundation fellowship. The award is given to individuals who have shown "extraordinary originality" and dedication in their professional pursuits. The Advanced Medical Technology Association (AdvaMed), the largest medical technology trade association in the world, also honored Dr. Jagger by naming her "MedTech Hero" for March 2001, for her industry-wide contributions to advancing medical device safety technology. In addition, Becton Dickinson provided an endowed professorship to the Center in recognition of its contributions to improving healthcare worker safety.

How you can support the Center
The Center's financial support comes from government research grants and a diverse group of medical device manufacturers. Funding has been provided in the form of:

  • general operational support
  • support for specific activities, such as publications or development and distribution of EPINet
  • grants for focused research projects
  • fellowships for international researchers

For more information on how you can support the Center, please call (434) 924-5159.

Read about Center policies for collaborating with industry.

To contact us, click here.

Note to Visitors

As of January 2013, this website is no longer being
actively updated. It will continue to be accessible 
as a UVA site for its research and historical value.

The information and documents available on the site continue to be relevant for researchers in the area of sharps safety and protection of healthcare workers from bloodborne pathogen exposures.

EPINet Data for 2010 and 2011

Available here. 

Consensus Statement and Call to Action on Sharps Safety Released March 2012