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Washington Watch | Issues Update | Health & Safety

Health & Safety

American Journal of Nursing - February, 2003 - Volume 103, Issue 1

The Needlestick Law
When your employer won’t comply.

By Susan Wilburn, MPH, RN

Does the safer needle device law cover private freestanding dialysis clinics? My employer says it doesn’t apply to us so we don’t have to have any safety devices.

Dialysis clinics are covered by the Needlestick Safety and Prevention Act, which became law in 2000 and has been enforced by the Occupational Safety and Health Administration (OSHA) since April 2001. The law, which addressed the implementation of safer needle devices, made changes to the OSHA Bloodborne Pathogens Standard (BPS), which applies to all employees with reasonably anticipated occupational exposure to blood or other potentially infectious materials in private-sector workplaces (not-for profit and for-profit companies). In the 26 OSHA-approved state programs it also covers state, county, and municipal employees.

The revised BPS includes new requirements for: using safer needle devices; involving frontline health care worker in evaluating, selecting, and implementing safer needle products purchased by the institution; maintaining a log of all contaminated needlestick injuries along with the type and brand of device in use; and reviewing and updating the exposure control plan at least annually to document employee involvement and reflect changes in technology that will eliminate or reduce exposure.

In 2002 OSHA clarified the application of the BPS in relation to reusing blood tube holders that are used for phlebotomy and needle destruction devices. In a June 12, 2002, letter of interpretation, OSHA stated, “In order to prevent potential worker exposure to the contaminated hollow bore needle at both the front and back ends, blood tube holders, with needles attached, must be immediately discarded into an accessible sharps container after the safety feature has been activated.” On September 12, 2002, OSHA clarified that NDDs are categorized as engineering controls for the disposal of contaminated needles and their use alone will not be sufficient to meet the standard’s requirements for a safer needle device.

You should explain the law to your employer (a guide addressing frequently asked questions can be found on the OSHA Web site at www.osha.gov/needlesticks/needlefaq.html) and volunteer to represent your colleagues on the committee to evaluate and select the safer devices to use on your unit. Ask for a copy of the exposure control plan, required by the BPS, to assess the written documentation of compliance with the new law. Submit written concerns to your employer to document your attempts to become OSHA compliant.

If your employer refuses to purchase safety devices, consider filing an OSHA complaint (see www.osha.gov/as/opa/worker/complain.html and include, if possible, the specific violation of either the Occupational Safety and Health Act or the BPS. OSHA also recommends including

• the number of employees at the site and how many are at risk.
• details on the status of compliance, such as types of sharps used in all areas of the workplace and whether safety devices are in place for all procedures that require sharps.
• the units on which the use of safety devices has not been implemented.
• the number of needlestick injuries recorded in available needlestick logs.
• data regarding the decision to use the particular product.
• examples of near-misses (sharps left in a bed or overfilled sharps containers).

Wafer Medical Device Implementation in Health Care Facilities: Sharing Lessons Learned. Developed by The National Institute for Occupational Safety and Health (NIOSH) to assist in meeting the needlestick law’s requirement. Go to www.cdc.gov/niosh/topics/bbp/safer

Susan Wilburn is an occupational safety and health specialist at the ANA.

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