Acupuncture-Related Needlestick Injuries Among Healthcare Workers in China: A Multicenter Cross-Sectional Study

Abstract

Background Needlestick injuries (NSIs) are a major occupational hazard for healthcare workers, but evidence on acupuncture-related NSIs remains limited. Methods A multicenter cross-sectional survey was conducted among acupuncture physicians, students, and nurses across 10 provinces in China from February to July 2025. Past-year and lifetime NSI prevalence, severe NSI prevalence, and blood-exposure NSI prevalence were estimated. Incidence density was calculated as the number of injuries per 1000 person-years. Multivariable logistic regression was used to identify factors associated with past-year NSI occurrence and non-reporting. Results A total of 2147 participants were included. Past-year and lifetime NSI prevalence were 40.71% and 55.43%. Physicians had the highest past-year prevalence (49.22%), followed by students (43.19%) and nurses (17.42%). The overall incidence density was 998.14 per 1000 person-years. Acupuncture needles were the most frequently implicated device (85.38%), and needle removal was the most common injury scenario (71.34%). Only 24.12% of participants always reported NSIs, while 34.96% never reported any NSI. Training was associated with reduced NSI risk and reduced non-reporting behavior. Hepatitis B vaccination coverage remained suboptimal, particularly among students. Conclusion Acupuncture-related NSIs are frequent and substantially underreported in China. Occupation-specific training, strengthened controls for high-risk workflows, higher vaccination coverage, and improved reporting systems are needed.