What is a lancing device?

Lancing devices are small pen-like tools that hold a spring-loaded lancet, which is the small needle used to puncture the skin to obtain small samples of blood for certain tests.

• There are a variety of brands and types of lancing devices. All lancing devices are made so that the needle component is disposable. The differences in the types of lancing devices are whether or not the entire device is disposable, and the nature of the plastic housing inside which the needle sits.

• Some are made for single-use only and are completely disposable.

• Other types of lancing devices have a disposable end piece that contains the needle, and the entire plastic end-piece with the needle inside, is disposed of after use.

• A third type of lancing device has 2 removable parts: the, needle (lancet) and the plastic end-cap which is the protective cover for the needle and governs the depth of penetration of the needle. A disposable needle is inserted into the plastic pen, and the needle is housed in a plastic end cap. The plastic end cap is not disposable. These devices are intended for personal use only and not for use with multiple people.

What are lancing devices used for and where?

Lancing devices are also used to obtain a small blood sample from the finger, forearm, earlobe, or heel for certain blood tests. Lancing devices are commonly used by people with diabetes to check their blood sugar. Other common uses of lancing devices are to test levels of hemoglobin, cholesterol, or PKU (phenylketonuria). Lancing devices are currently used in a variety of clinical and community settings.

What is the concern about the use of personal lancing devices in a group or multiple person setting?

There is a potential for incorrect use of a lancing device for blood sampling.

• Some lancing devices may carry a very small risk of blood contamination from one person to another if both the needle AND endcap are not changed between user. These products are designed for personal use by one individual only.

• Current standards state that when using these devices for multiple individuals, the needle component AND the guard (end-cap) must be changed between uses.

• The concern with the re-use of these devices is that there is a potential to change only the lancet (needle) between user. If only the needle is changed between users, there is a potential that blood from one patient may contact the guard (end-cap) that covers and guards the needle (lancet). That blood, if infected, could transmit an infection to the next patient, should it come into contact with open skin (created by the needle) or get on the needle prior to penetration.

• Infections that can be transmitted in this way include: Hepatitis B, Hepatitis C, HIV (Human Immunodeficiency Virus) and other infections. In most cases, the risk of contracting a serious infection from such usage is considered to be very low.

If I received a blood test with a personal lancing device in a group or multiple person setting, how concerned should I be?

During testing, both the lancet and the end cap are exposed to blood. Users of these devices should be aware that hepatitis B or other blood-borne infections could be transmitted through reuse of the lancets / needles or the endcaps. In most cases, the risk of contracting a serious infection in these situations is considered to be very low. To date, there have been no reported cases of disease transmission of blood-borne infections from the use of lancing devices in a community setting in Manitoba or Canada.

How can I prevent myself from getting an infection when using a lancing device or having my blood tested by my care provider?

If you have a personal lancet device that you use only on yourself, you do not need to be concerned.

If you have a personal lancing device at home, it is important that you do not share the needles (lancets) or endcaps with family or friends. This practice is necessary to avoid the transmission of hepatitis B or other blood-borne infections.

Read the manufacturer’s instructions on your lancing device to ensure you are using it properly.

If you are in a situation where you are having you blood tested by one of these devices, ask your health care provider if both the lancet and the endcap are disposable. If they are not, decline testing.

Should I be tested for infections?

Manitoba Health is not advising the public that as a matter of routine that they need to be tested for any infections as a result of having a blood test done using a lancing device.

If you have further questions or concerns about your health or about lancing devices, please consult your physician. In some circumstances, it may be appropriate to offer and/or undergo testing for hepatitis or HIV, either to identify the presence of infection or to rule out the presence of infection for purposes of reassurance.

If you have concerns that a lancing device may have been misused in a situation where clients may be at greater risk for blood borne infections, contact your local public health office.

What is Manitoba Health doing about lancet devices?

• Manitoba Health has released a media bulletin reminding the public that finger stick lancing devices used to obtain finger prick blood samples for blood sugar and other testing should be used for one individual person only unless standards for correct part replacement between tests can be assured.

• In addition to releasing this bulletin, Manitoba Health is also continuing its investigation of the use of these devices within Manitoba's health system and is preparing further information for health care providers, allied health professionals and non-government health organizations as to the proper use of these devices and how to assist people with concerns about exposures to such risks.