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Hi Grant, The British HIV Association PEPSE (post-exposure ;prophylaxis for sexual exposures) guidelines contain advice about discarded needles in the community describing how HIV virus may or may not be viable http://www.bhiva.org/documents/Guidelines/PEPSE/PEPSE2011.pdf . This document is worth reading as it explains the underlying principle around the threshold for pep - "Where the estimated transmission risk is between 1 in 1000 and 1 in 10,000 PEP may be considered". The 2008 UK HIV PEP guidelines explicitly state that PEP should be given where there is a significant exposure from a known HIV positive source or a source strongly suspected of being HIV positive (my emphasis). A discarded needle or other sharps in a waste sack is unlikely to meet these criteria. Paul Paul D'Arcy Nurse Consultant Imperial Health a+ Work Imperial College Healthcare NHS Trust 4 West Charing Cross Hospital Fulham Palace Road London W6 8RF P: 020 3313 7010 E: [log in to unmask]<mailto:[log in to unmask]> W: www.imperial.nhs.uk<blocked::BLOCKED::BLOCKED::http://www.imperial.nhs.uk/> [cid:image004.jpg@01CF80A0.EE40CAA0] [Description: cid:image001.jpg@01CC6D3F.5AB8A7C0]Imperial Health at Work has been accredited as a Safe, Effective, Quality Occupational Health Service www.seqohs.org<http://www.seqohs.org> From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Ciccone GRANT Sent: 05 June 2014 01:50 To: [log in to unmask] Subject: [MAYBE SPAM] [OCC-HEALTH] Needlestick Injuries & PEP Good morning all from Singapore, I would just like to get some opinions from you all. Is it usual practice for a staff member who has sustained a needlestick injury from an unknown source (eg: hospital rubbish bag) to be started on PEP for 28 days even though the level of transmittable risk is minimal. Here in Singapore - we do not have a universal healthcare system similar to the NHS back home and the cost of a course of PEP is in the region of S$1,300 (£700) which is met out of my budget. Is there any evidence to suggest that PEP is not required? If so, could you please share it with me. Many thanks and best regards Grant Ciccone RN GradCert (OH) FRSPH FRSM LCGI Occupational Health Nurse Manager National University Hospital 13b Medicine Clinic NUH Medical Centre, Level 13, F15, Singapore 119074 T: +65 6772 2779 (Ward 54) +65 9785 6297 (Occupational Health) E: [log in to unmask]<mailto:[log in to unmask]> www.nuh.com.sg<http://www.nuh.com.sg/> ******************************** Please remove this footer before replying. OCC-HEALTH ARCHIVES: http://www.jiscmail.ac.uk/lists/occ-health.html CONFERENCES AND STUDY DAYS: http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH Imperial College Healthcare NHS Trust notice: The contents of this e-mail are confidential to the ordinary user of the e-mail address to which it is addressed and may also be privileged. If you are not the addressee of this e-mail you may not copy, forward, disclose or otherwise use it in any form whatsoever. If you have received this e-mail in error please telephone the Imperial College Healthcare NHS Trust on +44 (0)20 3311 3311 and ask for the person who sent you the email. Please also delete the message from your computer. [end] ******************************** Please remove this footer before replying. OCC-HEALTH ARCHIVES: http://www.jiscmail.ac.uk/lists/occ-health.html CONFERENCES AND STUDY DAYS: http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH