Evolution from Syringe to Addressing Needlestick Injuries
03 March 2025
The history of medical innovations is rich with groundbreaking discoveries that have revolutionised healthcare. One such innovation, the syringe, has played a crucial role in medicine for centuries.
However, while syringes have been instrumental in administering life-saving treatments, the associated risks, particularly the dangers of needlestick injuries to healthcare workers, were not initially given the necessary attention. The disposal and handling of syringes only became a significant concern much later, leading to the development of sharps safety measures and specialised containment solutions.
In this article, we explore the historical evolution of syringes, and the eventual recognition of the risks posed to healthcare workers, which prompted the development of sharps containers and safety initiatives worldwide.
The Creation of Syringes
The history of medical syringes dates back centuries, with early forms used by ancient civilizations like the Romans and Egyptians, but the first true syringe-like device wasn’t developed until the 17th century. In 1650, Blaise Pascal designed a basic syringe for scientific experiments, laying the groundwork for future medical use. A major breakthrough came in 1844 when Irish physician Francis Rynd invented the hollow needle, enabling subcutaneous injections and revolutionizing medication administration. By the late 19th century, sterilization became standard practice to reduce infection risks, but reusable needles still posed contamination dangers. The development of the first fully sterile, single-use plastic syringe in 1957, officially entering the market in 1961, significantly reduced cross-contamination risks. However, concerns over proper disposal and safety remain, emphasizing the ongoing need for advancements in medical waste management.
The Emergence of Needlestick Injury Concerns
While syringes became increasingly essential in medical treatments, the risks they posed to healthcare workers were not immediately acknowledged. Needlestick injuries mostly commonly occur when a healthcare worker accidentally punctures their skin with a used sharps, potentially exposing them to serious infections such as hepatitis B, hepatitis C, and HIV.
The risks associated with needlestick injuries became more apparent in the 1980s with the rise of bloodborne diseases. In 1987, the U.S. Centers for Disease Control and Prevention (CDC) reported six cases of healthcare workers contracting HIV through needlestick injuries. This alarming discovery underscored the need for improved safety protocols and led to a growing awareness of the dangers faced by those working in the medical field.
Source: https://www.cdc.gov/nora/councils/hcsa/stopsticks/sharpsinjuries.html
Healthcare professionals were particularly vulnerable during various stages of their workflow, including:
• Administering Injections – Accidental needle slips could occur during the injection process. For example, a paramedic responding to an emergency may get stuck while treating a patient in a moving ambulance or chaotic environment.
• Recapping Needles – A common practice that significantly increased the risk of puncture wounds.
• Disposing of Used Needles – Without proper disposal methods, needlestick injuries were more likely to occur. A home healthcare worker administering medications might suffer an injury due to improper disposal or patient movement.
• Handling Medical Waste – Housekeeping and waste disposal staff were also at risk of exposure. Waste disposal workers might be injured by needles improperly thrown in regular rubbish instead of a designated sharps container.
As the need for safety measures became evident, healthcare institutions and regulatory bodies began to advocate for better practices to protect medical workers from accidental needlestick injuries.
The Development of Sharps Containers and Safety Measures
The alarming increase in needlestick injuries necessitated the development of safer disposal methods for used needles. The introduction of sharps containers became a crucial step in reducing the risk of accidental injuries among healthcare workers.
Sharps containers are specially designed disposal units that securely contain used needles and other sharp medical instruments. These containers are made of puncture-resistant material and are equipped with safety features to prevent accidental exposure. The development of sharps containers significantly minimised the risk of needlestick injuries by ensuring that used needles were safely discarded and contained.
In the late 1970s, one of the first companies in the world to develop sharps containers was Sharpsafe. This innovation laid the groundwork for improved safety protocols in hospitals and medical facilities worldwide. They were also instrumental in the standardisation of regulations to ensure that all healthcare institutions adhered to best practices when it came to sharps disposal in the UK for the NHS.
How Australia Addressed the Needlestick Injury Concern
Following in the footsteps of the UK, Australia also introduced regulatory standards to govern the manufacturing and use of sharps containers.
In 1992, the Australian government introduced the AS4031-1992 Standards, which outlined specific requirements for sharps containers. This document provided clear guidelines on the design and construction of these containers, ensuring that they met essential safety criteria. Key aspects of the standards included:
• Design and Construction – Ensuring containers were puncture-resistant and leak-proof.
• Physical Tests – Mandating rigorous testing procedures to verify container durability.
• Colour Requirements – Standardising container colours for easy identification.
• Appropriate Markings – Requiring proper labelling to indicate the presence of biohazardous materials.
New Standards Focus on Safety for Health Workers and Sharp Container Design
As the industry developed, the need to introduce new standards for sharps containers became increasingly evident. The focus shifted towards reducing the risk of sharp injuries and establishing specific requirements for these devices.
In line with international safety standards, the Australian Government introduced AS23907:2023, which builds upon ISO 23907-2019 to enhance the design, functionality, and performance of single-use and reusable sharps containers. Some of the key updates in these new standards include:
• Updated Colours for Sharps Containers – Containers will have distinct colours based on waste type, ensuring visibility from all lateral angles at a distance of three metres.
• Mandatory Temporary and Permanent Closures – Temporary closures must be operable with one hand, while permanent closures must be tamper-resistant and manually unopenable once engaged.
• Increased Penetration Resistance – Single-use sharps containers must now withstand at least 20 Newtons of force, an improvement from the previous 12.5 Newtons requirement.
• Redefined Fill Line Capacity – New aperture designs prevent overfilling to reduce accidental exposure risks.
• Restrict Hand Access in Public Areas – These must be designed to restrict hand entry and prevent content removal in high-traffic or public areas such as emergency departments.
Conclusion
As the healthcare industry continues to evolve, it is crucial for healthcare institutions, government agencies, and regulatory bodies to recognise the importance of implementing updated standards for sharps containers. The introduction of AS23907:2023 in Australia represents a significant step towards enhancing safety protocols and minimising the risk of needlestick injuries.
By prioritising education and communication, stakeholders can foster greater awareness about the necessity of these new standards. Ensuring compliance with AS23907:2023 not only protects healthcare workers but also safeguards patients, families, and other individuals involved in the sharps management process. Through collaboration and adherence to these regulations, the healthcare sector can continue to improve safety measures and reinforce best practices in sharps disposal.