Authors: Fayo Haji , Mohammad Ali Maksoud , Ahmed Mustafa El-Shiekh Idrees

Abstract

Background: Needlestick injuries (NSIs) and sharps injuries are a major occupational hazard for surgeons, exposing them to bloodborne pathogens and significant psychological and economic burdens. Despite extensive literature on healthcare workers, comprehensive global estimates specific to surgeons are scarce.
Methods: We conducted a systematic review and meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Scopus, and Web of Science were searched through September 2025 for studies reporting NSI prevalence in surgeons. Data extraction and risk of bias assessment were performed independently by two reviewers. Pooled prevalence estimates were calculated using random-effects models. Predictors of NSIs and reporting behaviors were also considered.
Results: Twelve cross-sectional studies comprising 9,997 surgeons and trainees were included. The pooled prevalence of NSIs was 46% [95% confidence interval (CI): 31-62], with substantial heterogeneity (I2= 99.2%). Reporting rate to occupational authorities was 62% (95% CI: 50-73). Consistent predictors of injury included senior training level, extended working hours, and inadequate specialty-specific preparation. Post-exposure management was suboptimal, with low uptake of prophylaxis. Publication bias assessment employing Doi
plots and Luis Furuya-Kanamori indices suggested asymmetry.
Conclusions: Nearly half of surgeons sustain NSIs during their careers, yet many incidents remain unreported and inadequately managed. High prevalence and variability underscore the need for standardized definitions, improved preventive training, and robust reporting systems. Adoption of safety-engineered devices, specialty-specific education, and streamlined post-exposure protocols are critical to reduce occupational risk. Global strategies tailored to surgical settings are essential to enhance compliance with international
safety guidelines.

Keywords: Needlestick injuries, sharps injuries, occupational injury, surgeons, meta-analysis.