The Cost of a Needlestick Injury
Needlestick injuries still cost the US healthcare system millions each year. But the price extends beyond just these large dollar amounts.
In 2000, the Needlestick Safety and Prevention Act (NSPA) was signed into law with the hope of putting an end to one of the most common occupational hazards in healthcare. This legislation mandated the use of safety-engineered devices (SEDs) and required healthcare employers to involve frontline workers in their selection. The results showed immediate improvements, with needlestick injuries dropping by as much as one-third in the first year of its implementation.1 While this marked a vast improvement, it failed to eliminate the risk of needlesticks.
Despite the widespread availability of safer devices and two decades of awareness campaigns, needlestick injuries remain a serious and costly danger to US healthcare workers. Today, the CDC estimates hundreds of thousands of needlestick injuries still occur annually.2 The cost of a needlestick injury is measured not only in dollars but in disrupted careers, long-term health risks, and emotional trauma. And as the healthcare industry faces escalating burnout and staffing shortages, the stakes have never been higher.
WHAT YOU NEED TO KNOW:
- The Real Cost of a Needlestick Injury
- The Human Toll of Needlesticks and Healthcare Staffing
- Needlestick Injuries Today: A Plateau with a Warning Sign
- Practical Prevention Can Reduce the Cost of Needlestick Injuries
The Real Cost of a Needlestick Injury
Healthcare organizations often try to anticipate the cost of a needlestick injury. For individual cases, the direct costs of evaluation, testing and treatment can range from $500 to $4,000, depending on the risk level of the exposure.3 But more recent analyses, adjusted for inflation, place the average direct cost of a single needlestick injury, which includes lab tests for such infections as HIV, HBV, HCV, post-exposure prophylaxis (PEP) medications, medical evaluations, along with follow-up testing and counseling, around $5,000. But such an estimate only scratches the surface of the true cost of needlestick injuries.
In more serious cases, a needlestick injury lawsuit may follow, especially if it’s found that the employer lacked proper sharps containers, failed to train staff on device usage or ignored known risks. For hospitals and health systems, the average payout for a needlestick injury can range widely depending on the circumstances, but some needlestick injury claim values can exceed $1 million when a long-term illness or permanent disability is involved.
Multiply those costs by the estimated 236,000 needlestick injuries that occur in the US annually, and the numbers quickly escalate. The annual economic burden of NSIs is estimated to fall between $118 million and $591 million, depending on underreporting and treatment severity. Some estimates even place the number far higher, closer to $1 billion when accounting for all of the additional indirect costs.
Any discussion on the cost of a needlestick injury wouldn’t be sufficient without detailing these indirect costs of such incidents, which can include:
- Lost work time for affected staff
- Temporary staffing to fill gaps
- Workers’ compensation and disability claims
- Occupational health and HR administrative hours
- Long-term medical care if a bloodborne illness is contracted
- Long-term mental health support and counseling
- Internal investigations and process changes
- Reputational risk and legal exposure
The real cost of a needlestick injury is bigger than most healthcare leaders realize and, often, far higher than what’s budgeted.
The Human Toll of Needlesticks and Healthcare Staffing
The physical risks of a needlestick injury are obvious. While the psychological aftermath is less apparent, it can deeply impact the overall operations of a healthcare organization. In interviews and incident reports, countless clinicians describe the waiting period for blood test results as one of the most emotionally distressing experiences of their careers.
A single stick can trigger days, or sometimes weeks, of fear, uncertainty and blame. Even when no illness is transmitted, the fear of contracting a life-altering disease like HIV or hepatitis hangs over every exposed worker. Some feel guilt over leaving their team short-staffed mid-surgery. Others struggle with stigma, unsure whether they’ll be judged or blamed for an “avoidable” incident. And when one clinician accidentally sticks a colleague, the emotional toll can be doubly traumatic as both individuals may carry the weight of that moment long after the test results come back.
In a 2025 survey of US nurses, 65% said they were experiencing stress and burnout, while only 60% would choose nursing as their career again.4 They cited unsafe conditions, emotional exhaustion and a lack of institutional support as reasons for these negative feelings about their work. Needlestick injuries, while often overlooked, can only contribute to creating more stress and dissatisfaction about their work environment, one which can push good clinicians closer to the exit door. In a system already stretched thin, that’s a cost healthcare organizations can’t afford to risk.
Needlestick Injuries Today: A Plateau with a Warning Sign
The most recent national snapshot from the 2023 EXPO-S.T.O.P. report showed a reported sharps injury (SI) incidence rate of 2.0 per 100 full-time equivalent (FTE) staff, based on data from 369 hospitals across 34 states.5 At first glance, that number appears promising, especially compared to 2019’s pre-COVID high of 2.3 per 100 FTE. But experts caution against seeing this as meaningful progress.
During the early pandemic years, reported SI rates dropped notably, dipping to 1.9 per 100 FTE in 2020, a statistically significant decline from 2019. However, this reduction may not reflect true safety improvements. Analysts behind the EXPO-S.T.O.P. study noted that changes in procedures, staffing, workload and reporting habits during COVID, rather than better safety practices, are likely to explain the temporary drop.
In fact, since 2021, NSI rates have remained flat at 2.0 per 100 FTE. That’s higher than the rate recorded in 2011, a stark indicator that the healthcare industry has made little to no meaningful progress in reducing sharps injuries over the past decade.
The authors warn that data gaps, underreporting and optional survey questions cloud the full picture, and may lead to a false sense of safety. Inconsistent reporting among hospitals makes it difficult to assess the true incidence or long-term trajectory of sharps injuries.
Even more concerning: some hospitals couldn’t supply basic exposure data despite having mandatory OSHA 300A forms. As the EXPO-S.T.O.P. report bluntly put it, “No data, no problem, no action.”
Why Needlestick Injuries Still Happen
More than two decades after the Needlestick Safety and Prevention Act mandated the use of safety-engineered devices, needlestick injuries are still happening, with rates not showing meaningfully improvement in over a decade. Beyond the cost of a needlestick injury or the needlestick injury claim value, the real question is: what will it take to finally prevent them?
Safer tools don’t always lead to safer environments. Despite the availability of retractable needles, shielded scalpels, and closed sharps containers, adoption is inconsistent across facilities. Some organizations are constrained by tight budgets, outdated procurement contracts or staff shortages that make training and oversight difficult to maintain.
Even when the right tools are available, they’re not always used correctly. Some safety mechanisms are unpopular with staff because they’re seen as clunky, unreliable or difficult to activate. In fast-paced environments like operating rooms or emergency departments, speed can outweigh caution, and devices may be used in ways that bypass built-in protections.
There’s also the issue of inconsistent safety culture. Hospitals may have policies on paper, but actual enforcement varies widely. Underreporting remains a major concern, particularly among nurses and surgical teams, often due to fear, stigma or the sheer time burden of documentation. The 2023 EXPO-S.T.O.P. survey showed a significant decline in hospitals able to supply even basic sharps injury data, suggesting that many incidents simply go uncounted.
In short, significant progress in preventing needlestick injuries hasn’t happened because the industry hasn’t fully prioritized eliminating such incidents. Until safety becomes more than a compliance checkbox, progress will most likely remain stalled.
Practical Prevention Can Reduce the Cost of Needlestick Injuries
Based on the many variables that cause needlestick injuries to occur, it’s clear that safety needs to be embedded seamlessly into any clinician’s workflow. That means combining the right tools, training, culture and leadership commitment to protect staff long before an exposure occurs.
Effective strategies include:
Universal use of safety-engineered devices with features that are intuitive, easy to activate and supported by staff feedback.
Hands-free passing techniques in operating rooms to reduce the risk during procedures
Regular training and drills that go beyond onboarding and reinforce best practices under real-world conditions.
A no-shame, no-blame culture that encourages quick and accurate reporting without stigma or fear of discipline.
Tracking and benchmarking systems that flag trends, identify weak points and allow teams to respond proactively.
Closed, clearly labeled sharps containers that are strategically placed and never overfilled.
Daniels’ Sharpsmart system has been on the forefront of reducing needlestick injury risk with a hands-free, overfill-resistant solution that replaces outdated containers prone to multiple touchpoints. Wall-mounted Sharpsmart units feature a gravity-sensitive safety tray proven to reduce container-related needlestick injuries across a wide range of healthcare environments.
Despite legislation and national efforts to eliminate them, needlestick injuries remain a danger to healthcare workers across most care environments. The cost of needlestick injuries can place an unnecessary financial burden on organizations already facing increasing budgetary pressure. At the same time, needlestick risks threaten the health and well-being of staff already stressed by a high pressure work environment. Nearly all needlestick injuries are preventable, yet rates have remained flat for over a decade. Every prevention step and improvement matters and when faced with the real costs of such an injury, it becomes obvious that we can’t afford to ignore the risks any longer.
1 Issues in understanding the impact of the Needlestick Safety and Prevention Act on hospital sharps injuries. Elayne Kornblatt Phillips, Mark Conaway, Ginger Parker, Jane Perry, Janine Jagger. Infection Control & Hospital Epidemiology, September 2013. https://pubmed.ncbi.nlm.nih.gov/23917907
2 Needlesticks and other sharps injuries among healthcare workers. Massachusetts Department of Public Health. https://www.mass.gov/info-details/needlesticks-and-other-sharps-injuries-among-healthcare-workers
3 How Much do Needlestick Injuries Cost? A Systematic Review of the Economic Evaluations of Needlestick and Sharps Injuries Among Healthcare Personnel. Alice Mannocci, Gabriella De Carli, Virginia Di Bari, Rosella Saulle, Brigid Unim, Nicola Nicolotti, Lorenzo Carbonari, Vincenzo Puro, Giuseppe La Torre. Infection Control & Hospital Epidemiology, June 2016. https://pubmed.ncbi.nlm.nih.gov/27022671/
4 Beyond the Bedside: The State of Nursing in 2025. Cross Country Healthcare and The Christine E. Lynn College of Nursing at Florida Atlantic University. https://www.crosscountry.com/beyondthebedside
5 Fill the Gap EXPO STOP Report. Association of Occupational Health Professionals in Healthcare. Terry Grimmond, FASM, BAgrSc, GrDpAdEd&Tr; and Julie Nicholas, BSN, RN, COHN-S, COEE. https://www.aohp.org/aohp/portals/0/Fill%20The%20Gap%20EXPO%20STOP%20Report.pdf
Laura Wakelam
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