Occupational Health: Analysis of the Psychological Impact of Exposure to Needlestick and Sharps Injuries Among Primary Health Care Professionals

Occupational exposure to biological material, particularly needlestick and sharps injuries, is a relevant public health concern in Primary Health Care (PHC), as it combines infectious risk with psychological sequelae that are often underestimated. This study aimed to analyze the occurrence of needlestick and sharps injuries and their psychological impact among PHC professionals, considering biosafety knowledge, vaccination status, postexposure conduct, and perceived availability of psychological support. This was a descriptive, exploratory, mixed-methods study conducted in a medium-sized municipality in the interior of São Paulo state, Brazil. A nonprobabilistic convenience sample of 53 PHC workers was included, comprising nursing technicians, nurses, oral health assistants, and dentists. Data were collected using a sociodemographic questionnaire, a biosafety and postexposure management instrument, the Impact of Event Scale–Revised (IES-R) among injured participants, and open-ended questions analyzed using the Collective Subject Discourse technique. Among the 53 participants with valid responses for injury occurrence, 16 reported having experienced a needlestick or sharps injury, corresponding to 31.4% of the valid sample. Dentists presented the highest proportion of reported injuries, followed by nursing technicians, oral health assistants, and nurses. Self-reported hepatitis B vaccination coverage was high, with 94.3% reporting completion of the three-dose schedule; however, insufficient anti-HBs testing and limited guidance regarding postvaccination serological monitoring indicated weaknesses in occupational health surveillance. Exploratory bivariable and multivariable analyses suggested higher odds of injury among dentists and among professionals who reported feeling vulnerable to acquiring diseases although these associations did not reach statistical significance and presented wide confidence intervals. Qualitative findings indicated that needlestick and sharps injuries were frequently associated with fear, anxiety, insecurity, sleep disturbance, increased vigilance, and changes in safety practices. Although participants recognized the importance of psychological support after occupational exposure, formal psychological follow-up was rarely reported. Among injured professionals, the IES-R total score indicated relevant psychological distress. Using the ≥ 33 cutoff, 37.5% presented clinically significant post-traumatic stress symptoms, while 43.8% reached the ≥ 24 threshold for elevated psychological distress. No statistically significant predictors of IES-R scores were identified; however, these findings should be interpreted cautiously due to the small number of injured participants and limited statistical power. In conclusion, needlestick and sharps injuries in PHC should be understood not only as biological exposure events but also as potentially traumatic occupational experiences. As a local exploratory study with a nonprobabilistic sample, the findings should not be generalized without caution. Nevertheless, they highlight the need for structured institutional actions, including periodic biosafety training, clear definition of occupational exposure, systematic reporting, immediate referral to reference services, anti-HBs monitoring, postexposure serological follow-up, nonpunitive reporting systems, and incorporation of psychological screening or referral into postexposure care pathways.