you should always wear gloves when you handle the rockwork. if you really need dexterity like during fragging, then just be really careful to not touch the worms. they'll retract into their holes when out of water anyways though.
yeah they hurt a bit if you get stung (which isnt terribly hard to do) but you learn how to avoid em. i dont see fish going after them either... i mean the vast majority of tanks have tons of these bristleworms and ive only heard two cases where a fish (a clown and a wrasse respectively) actually got hurt by a worm. i believe both survived with no ill effects. so if you're worried about the fish, dont imo.
imo it's just a lot more trouble to take the thing out than it's worth. chances are that that one individual worm isnt the only one in your tank... not by a long shot.
edit: oh first aid. as above, scotch tape. some also pour vinegar over the wound and apparently that helps a lot. Id imagine hot water would also help to denature the poison.
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