Sharps injuries among healthcare waste workers: Implications for biosafety and occupational vaccination – A systematic review with meta-analysis

This systematic review and meta -analysis estimated the prevalence of sharps injuries among healthcare waste workers (HWW) and evaluated hepatitis B virus (HBV) vaccination coverage and HBV and hepatitis C virus (HCV) infections. PubMed, Scopus, Embase, LILACS, SciELO, the Virtual Health Library, the CAPES Periodicals Portal, and Google Scholar were searched through 19 May 2026. Twenty-two studies involving approximately 9,000 HWW and 1,722 sharps injuries were included. Random-effects meta -analyses used logit transformation and restricted maximum likelihood estimation. The pooled prevalence of sharps injuries was 34.1% (95% CI, 22.8–47.5%), with substantial heterogeneity (I 2 = 98.9%). HBV vaccination coverage was 31.1% (95% CI, 8.2–68.3%) and was not associated with sharps injury prevalence (β = 0.338; p = 0.544). Pooled HBV and HCV prevalence estimates were 2.3% (95% CI, 0.3–15.4%) and 3.36% (95% CI, 1.17–9.23%), respectively. No HCV seroconversion was reported in follow-up studies. Approximately one-third of HWW experienced sharps injuries, highlighting the need to strengthen waste segregation, personal protective equipment use, biosafety training, HBV vaccination, and occupational surveillance to improve worker safety and reduce preventable blood-borne infections.