Federal Legislation
The Needlestick Safety and Prevention Act (H.R. 5178), signed on November 6, 2000, authorized federal Occupational Safety and Health Administration (OSHA) to revise the 1991 Bloodborne Pathogens Standard (29 CFR 1930.1030) to require the use of safety-engineered sharp devices. The Revised Standard was published in the Federal Register on January 18, 2001.

Implementation:
Effective April 18, 2001, the revised Bloodborne Pathogens Standard applies to any facility under federal OSHA (27 states) where employees may be exposed to blood or other potentially infectious material. The revised standard does not cover public (state and municipal) facilities in federal OSHA states. (Note, however, that of the 27 states that are under federal OSHA, six - Georgia, Maine, New Hampshire, Ohio, Texas and West Virginia - have passed needle safety laws covering public health care settings.)

States with state OSHA plans (there are 23) must by October 18, 2001 implement regulations that are "at least as effective" (that is, at least as protective) as those of federal OSHA. In the interim, state plans will continue to enforce their current requirements. Some states with state OSHA plans, such as California, have already revised their bloodborne pathogens standards to require the use of safer devices.

Provisions of the revised standard include:
Health care employers are required to provide safety-engineered sharp devices and needleless systems to employees to reduce the risk of occupational exposure to HIV, hepatitis C and other bloodborne diseases.

Expanded definition of "engineering controls" to include devices with engineered sharps injury protection.

Requirement that exposure control plans document consideration and implementation of safer medical devices designed to eliminate or minimize occupational exposure. Plans must be reviewed and updated at least annually.

Enforcement - the most commonly cited standard in OSHA inspections is the Bloodborne Pathogen Standard.

OSHA has already started conducting more inspections of health care facilities. During inspections, compliance with all occupational safety and health requirements is reviewed, including the Bloodborne Pathogens Standard. The increase in inspections is part of a recent initiative that included a letter sent to 2,600 health care facilities that had the highest average illness and injury rates, announcing that OSHA would be conducting targeted inspections. The major source for OSHA inspections of health care facilities, however, will still be employee complaints.

Potential benefits to compliance include decreases in:

• Workers' needlestick injuries§ Lost time incidents
• Incidence of HIV, HBV and HCV in workers and in the general population
• Medical costs associated with needlestick evaluation, medical consultation, prophylaxis and long term treatment
• Mortality due to HIV, HBV, and HCV§ Risk of exposure to other diseases

Medisystems offers a full line of safety products to assist in compliance with the legislation.

For the full text of the Needlestick Safety and Prevention Act, visit the Occupational Safety and Health Administration site.

State Legislation
The following states have passed needlestick prevention legislation (alphabetical order):

* These state plans cover public sector (state and local government) employment only.

For detailed descriptions of individual state laws or legislation activity in your state, please visit the International Healthcare Worker Safety Center web site.