Find Out Who is Most at Risk in the Latest AOHP Sharps Safety Exposure Report

Sharps injuries remain one of the most persistent risks facing healthcare workers today. Despite decades of regulation, safety-engineered devices and education, thousands of clinicians and support staff continue to experience occupational exposure to bloodborne pathogens each year.

The 2023 Sharps Safety Exposure Report from the Association of Occupational Health Professionals in Healthcare (AOHP) examines sharps-related exposures in US hospitals using the latest available data from the OSHA Injury Tracking Application. The findings highlight where risk concentrates and outline practical actions hospital leaders and frontline teams can take to reduce injuries.

WHAT YOU NEED TO KNOW:

Key Findings at a Glance

Based on analysis from the 2023 Sharps Safety Exposure Report by the Association of Occupational Health Professionals in Healthcare (AOHP), several clear patterns emerge across US hospitals:

A Note on OSHA Requirements for Recording Bloodborne Pathogen Exposures

Under OSHA’s Bloodborne Pathogens Standard (29 CFR 1910.1030), organizations are required to report all needlestick injuries and cuts that occur in the workplace from sharps which are either contaminated with another person’s blood or other potentially infectious material (OPIM). Each incident must be recorded on the OSHA 300 Log, regardless of whether infection occurs. OPIM includes a range of human body fluids and materials capable of transmitting bloodborne pathogens, including fluids such as cerebrospinal, pleural, peritoneal, and amniotic fluid, saliva in dental procedures, and any body fluid visibly contaminated with blood. It also includes unfixed human tissue and certain laboratory materials containing HIV or hepatitis viruses.

Although these reporting requirements are well established, the AOHP data shows that documentation is often incomplete. Many incident records lack details such as device type or exposure location. These gaps can limit the ability to identify trends and implement targeted prevention strategies.

Who Experiences the Most Sharps Injuries?

The 2023 AOHP Sharps Safety Exposure Report shows that sharps-related bloodborne pathogen exposures are concentrated among a small number of frontline roles.

Nurses account for 44.92 percent of all reported sharps exposure incidents, representing the highest-risk group by a wide margin. This elevated risk reflects the realities of nursing practice rather than workforce size alone. Frequent injections, IV insertions, blood draws and medication administration place nurses in constant contact with sharps across nearly every hospital care environment, often under time pressure and with unpredictable patient movement.

Surgical technologists and medical residents follow as the next highest-risk roles, accounting for 10.16 percent and 8.24 percent of reported exposures, respectively. Injuries in these roles most often occur in procedural settings where limited visibility, hand-to-hand instrument passing and complex workflows increase exposure risk.

Laboratory and phlebotomy staff account for 7.98 percent of exposures, followed by physicians at 6.83 percent and certified nursing assistants or technicians at 4.53 percent. These roles face sustained exposure through repetitive blood collection, specimen handling and bedside support tasks.

Environmental services and other support staff represent a smaller share of total incidents, but their injuries are frequently linked to improperly discarded or unidentified sharps encountered during cleaning and waste handling.

Why Nurses Account for Nearly Half of All Sharps Exposures

It’s not surprising that one group experiences a disproportionate number of incidents. Nurses interact with sharp devices more frequently than any other role and do so across nearly every hospital care environment.

Nursing exposure risk is driven by a combination of factors, including:

Because nursing workflows touch nearly every part of the hospital, prevention efforts focused on this group offer outsized impact. Effective strategies include safety-engineered hollowbore devices, strict point-of-use disposal, accessible bedside containers, targeted training for high-risk scenarios and staffing practices that reduce fatigue and time pressure.

Device Type Exposure Patterns: Where Prevention Has the Greatest Potential

When sharps exposure incidents are analyzed by device type, the data points to a clear opportunity for prevention. Certain devices account for a disproportionate share of injuries, many of which already have safer alternatives available.

Hollowbore needles represent the single largest category of sharps-related bloodborne pathogen exposures. In 2023, hollowbore devices accounted for 25.52 percent of all reported incidents, making them both the most common and most preventable source of injury.

Hollowbore needles carry elevated risk because they:

Many of these exposures occur despite the availability of safety-engineered alternatives.

Other notable device-related exposure patterns include:

Across all categories, the data shows that more than 30 percent of sharps exposures involve devices with existing safety-engineered alternatives, highlighting a gap between availability and consistent use.

Where Sharps Injuries Occur Most Often

Sharps exposure risk is not evenly distributed across hospital settings. The 2023 AOHP data shows injuries concentrated where procedures are frequent, workflows are intense, and sharps are used close to patients.

Inpatient units (38 percent of reported exposures)

Operating rooms and sterile processing (32 percent of exposures)

Emergency departments (approximately 14 percent of exposures)

Across all locations, the data reinforces the need to design sharps safety around real-world workflows. Container placement, accessibility, lighting and point-of-use disposal consistently influence exposure risk in each environment.

The Greatest Threats Occur When Risk Factors Converge

Across the AOHP findings, sharps injuries follow a clear pattern: risk increases when role, device and environment intersect. These combinations create predictable “perfect storm” scenarios where exposure is more likely and prevention efforts can deliver the greatest impact. The report highlights three of t

he most significant risk combinations.

#1 Nurses + hollowbore needles + bedside care

Nursing workflows involve frequent injections, IV access and blood draws, often performed under time pressure and close to patients who may be moving or distressed. When high-volume needle use meets unpredictable bedside conditions, the margin for error narrows. Reducing risk here depends on safety-engineered devices, point-of-use disposal and workflows that reduce cognitive overload.

#2 Surgical environments + sharp instruments + confined spaces

Limited visibility, rapid hand-to-hand passing and trainee involvement increase exposure risk. In these settings, technique, communication and environmental controls play an outsized role in prevention.

#3 Support staff + improper disposal

When sharps are discarded incorrectly or left unidentified, exposure risk shifts to staff with less visibility into the hazard, often outside direct clinical workflows.

Current Data Gaps Reveal a Hidden Prevention Risk

Accurate reporting is essential to reducing sharps injuries, yet the 2023 AOHP highlights how frequently key details are often missing. For example, more than one in five reported exposures lacked device identification, while inconsistent location and incident descriptions further limited the ability to identify high-risk devices and workflows.

These gaps are often due to system limitations, many of which can be easily addressed. Reporting gaps often sabotage targeted prevention where it matters most, causing preventable risks to persist. This report provides clear recommendations for better reporting methods, such as further training, updated reporting tools and regular data audits.

Actionable Recommendations: High-Impact Steps That Reduce Risk and Cost

The AOHP findings point to a small set of focused actions that can significantly reduce sharps injuries while lowering the direct and indirect costs associated with exposure management, lost productivity, and staff turnover. These priorities emphasize efficiency, not complexity.

Critical actions (implement within 90 days)

High-priority actions (implement within 6 months)

Moderate priorities (implement within 12 months)

Evidence-based forecasting in the AOHP report illustrates the financial return that targeted sharps injury prevention can deliver. Nursing-focused conversion to safety-engineered devices alone shows the largest opportunity, with modeling based on approximately 9,000 annual exposures.

A projected 70 percent reduction would prevent roughly 6,300 incidents each year. With the average cost per sharps exposure estimated at approximately $1,000, current annual costs approach $55 million. Against an estimated annual program investment of $9.5 million, the modeled net savings exceed $20 million per year, with an estimated return on investment of more than 200 percent and a payback period of less than six months. These figures underscore that effective sharps prevention is not only a safety imperative, but a financially sound operational decision.

For detailed modeling, benchmarks, and implementation guidance, refer to the full AOHP Sharps Safety Exposure Report.

The full AOHP Sharps Safety Exposure Report provides additional benchmarks and detailed recommendations for reducing sharps injuries across hospital environments. One consistent theme throughout the findings is the importance of point-of-use disposal and safety-engineered containment. Systems such as Daniels’ Sharpsmart address several of the report’s highest-risk factors by enabling hands-free disposal, preventing overfill, and reducing exposure during routine workflows. When combined with targeted device conversion and focused training, these controls support measurable reductions in injury risk while helping healthcare organizations manage both compliance and cost.