Through the diligent work of the American Nurses Association, a tremendous victory was achieved when the federal "Needlestick Safety and Prevention Act" was signed into law on 11/6/00. The passage of federal needlestick legislation was part of ANA's Safe Needles Save Lives campaign, a three pronged approach utilized by ANA to push for an amendment to the federal Occupational Health and Safety Administration (OSHA) Occupational Exposure to Bloodborne Pathogens Standard (Standard) that would require employers to use the most effective devices to decrease needlestick injuries. The other two approaches included amending the OSHA Standard through the federal regulatory process as well as the passage of state needlestick legislation.

This issue continues to be addressed on the state level with legislation to strengthen needlestick protections for nurses and other health care providers. Some states without state OSHA plans have introduced legislation to cover state and municipal employees who are not covered by the "Needlestick Safety and Prevention Act." States with state OSHA plans have are pushing for protections that go beyond the federal needlestick law.

This year, legislation was considered in 16 states. The trend in 2002 was to adopt presumptive eligibility under workers compensation or other employer benefit programs for communicable diseases and bloodborne pathogens similar to the NV legislation passed in 2001 and require safe needle devices to be used in public health care facilities. Legislation in NY was enacted to add civilian employees of the Dept. of Corrections to the list of public safety workers who can receive coverage for the care, treatment, diagnosis, and recommended medicines if exposed to communicable diseases or bodily fluids. PA enacted amendments to the Bloodborne Pathogen Standard Act to include exposure to bodily fluids. It also requires education of employees on use of safe needlestick devices before they are introduced into a clinical setting. Compliance monitoring now becomes the responsibility of each employer. TN has a new law requiring disclosure of inmates test results for bloodborne pathogens to be disclosed to exposed correctional employees within 24 hours of results. In VA new law covers EMTs, paramedics, firefighters and police who test positive for exposure, are granted presumption of occupational exposure and may make claim under workers' comp. Samples of legislation that did not succeed this year include: HI legislation would have required sharp injury log data beyond the federal requirement including the procedure the exposed employee was performing at the time of the incident and any suggestion by the injured employee as to whether or how protective mechanisms or work practice controls could be used to prevent such injuries. FL, IL, MA, MI, and MS legislation attempted to require safe needle devices to be used in facilities employing public employees.

Five states enacted legislation in 2001. Landmark legislation was enacted in NV that requires presumptive eligibility coverage under workers compensation for diseases contracted through employment. Because there is such a long interval between exposure to and diagnosis of HIV and Hepatitis C, many health care workers are denied workers compensation benefits for their illness resulting from a needlestick injury. This legislation would presume the infection stemmed from a needlestick injury related to employment allowing workers to receive workers compensation benefits.

Legislation enacted, prior to 2001, in AR requires hospitals to purchase safe needle devices. Legislation enacted in CA makes clarifying changes to a bloodborne pathogens provision in state law and requires the Department of Health Services to maintain a Sharps Injury Control program that shall, among other things maintain a continuously updated list of existing needleless systems and needles with engineered sharps injury prevention. PA legislation requires the Department of Health to establish bloodborne pathogen standards for public employees. RI legislation requires the division of occupational safety and the department of labor to adopt additional regulations governing occupational exposure to bloodborne pathogens including the establishment of needleless systems and an evaluation committee.