Preventing Needle Stick Injuries (NSI) Among Medical Waste Handlers: A Systematic Review Based on the Hierarchy of Hazard Controls

Abstract

Introduction: Needle Stick Injuries (NSI) is representing a significant safety hazard in hospitals, affecting frontline healthcare workers and medical waste handlers. Improper disposal of used medical needles into infectious waste bins instead of designated safety boxes became the primary cause of these incidents. Objective: This study is aiming to evaluate medical waste management interventions to prevent NSI using the Hierarchy of Hazard Controls. Method: A systematic literature review conducted following PRISMA 2020 guidelines. Articles published between 2019 and 2026 were searched in PubMed, ScienceDirect, and Google Scholar, utilizing PICO to select relevant studies. Result and Discussion: Healthcare facilities primarily rely on administrative controls, such as Standard Operating Procedures (SOPs), and Personal Protective Equipment (PPE). However, these approaches frequently fail due to human errors and non-compliance worker. Current engineering interventions, including Internet of Thing (IoT) smart bins and RFID sorting, tend to be too complex and lack direct physical barriers to prevent Improper needle disposal. Conclusion: Current reliance on PPE and administrative protocols is not enough to protect waste handlers from NSI risk. Hospitals need to prioritizing practical engineering controls, such as direct physical barriers integrated with waste bins, to prevent NSI at the source.