2000CRE1511 INTRODUCTION OF THE ``NEEDLESTICK SAFETY AND PREVENTION ACT''
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[Congressional Record: September 18, 2000 (Extensions)]
[Page E1511-E1512]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]
[DOCID:cr18se00-43]
INTRODUCTION OF THE ``NEEDLESTICK SAFETY AND PREVENTION ACT''
______
HON. MAJOR R. OWENS
of new york
in the house of representatives
Monday, September 18, 2000
Mr. OWENS. Mr. Speaker, I am proud to join with my colleague, the
Chairman of the Subcommittee on Workforce Protections of the Committee
on Education and the Workforce, the Honorable Cass Ballenger, to
introduce the Needlestick Safety and Prevention Act. This legislation
modifies the Bloodborne Pathogens Standard (29 C.F.R. 1910.1030) issued
in 1991 by the Occupational Safety and Health Administration of the
U.S. Department of Labor to improve the protection afforded to health
care workers from the spread of bloodborne pathogens such as the HIV
virus, hepatitis B, and hepatitis C, as a result of accidental
needlesticks and other percutaneous injuries.
Though controversial at the time it was issued, today all agree that
the Bloodborne Pathogen Standard has helped to significantly reduce the
spread of bloodborne pathogens among health care workers. There is,
however, more that can be done.
In March, the Center for Disease Control and Prevention estimated
that more than 380,000 needlestick injuries occur in hospitals every
year. At an average hospital, there will be an estimated 30 reported
needlestick injuries for every 100 beds. It is estimated that there are
between 600,000 and 800,000 needlestick injuries every year in all
health care settings. Nurses, doctors, laboratory staff, emergency
medical technicians, and housekeepers have all been victimized by
needlesticks. Needlestick injuries may account for as much as 80% of
occupational exposures to blood.
Needlestick injuries, unfortunately, are not uncommon among health
care workers. However, they are by no means trivial. Needlestick
injuries impose unnecessary and unacceptable costs on our health care
system. Costs to employers associated with followup medical
examinations to determine whether needlestick victims have been
infected by a bloodbone pathogen are by no means insignificant and can
run into the thousands of dollars. Where workers are found to have been
infected as a result of a needlestick injury, costs of treatment and
compensation can easily run into the hundreds of thousands of dollars.
For those who are infected as a result of a needlestick injury, the
costs cannot be measured in dollars, they are life-threatening.
At a hearing held on this subject in June, the Subcommittee on
Workforce Protections heard from Karen Daley who testified on behalf of
the American Nurses Association. In July 1998, Ms. Daley reached into a
needle box with a gloved hand to dispose of a needle with which she had
drawn blood and was stuck by a needle. Five months later, she was
diagnosed with both HIV and hepatitis C. Ms. Daley has had to give up
direct nursing care, work that she loves and had performed for twenty
years. Ms. Daley has suffered weight loss, nausea, loss of appetite,
hair loss, headaches, skin rashes, severe fatigue, and bone marrow
depression as a consequence of treatments for her injury. Her life now
revolves around treatment for her diseases. Even more seriously,
current research indicates that co-infection of HIV and hepatitis C can
accelerate progression to liver failure and may lead to cirrhosis,
cancer, or failure in five to ten years.
What is most tragic about Ms. Daley's story and that of many like her
is that her injury was not simply accidental, it was unnecessary and
therefore inexcusable. In Ms. Daley's own words:
[T]his injury did not occur because I wasn't observing
universal precautions. I did everything within my power--
taking all the necessary precautions including wearing gloves
and following proper procedures--to reduce my own risk of
exposure to bloodborne pathogens. This injury did not occur
because I was careless or distracted or not paying attention
to what I was doing. This injury and the life-altering
consequences I am now suffering should not have happened.
And, worst of all, this injury did not have to happen and
would not have happened if a safer needle and disposal system
had been in place in my own work setting.
It is estimated that 80% of all needlestick injuries could be
prevented if greater use is made of available sharps with engineered
sharps injury protections, such as retractable needles, and needleless
systems. Since the publication of the bloodborne pathogen standard,
there has been a substantial increase in the number and assortment of
effective engineering controls that are commercially available. There
is a large body of research concerning the effectiveness of engineering
controls, including safer medical devices. Further, there is general
consensus among health care employers as well as health care workers
that
[[Page E1512]]
the overall cost of using sharps with engineered sharps injury
protections and needleless systems is substantially cheaper than the
costs of contending with unnecessary needlestick injuries associated
with the use of less safe devices.
The under-utilization of safer medical devices is a national issue.
As of August 31st, sixteen States had already enacted legislation
requiring the use of safer medical devices and a seventeenth was in the
process of doing so. The State laws, however, only partially address
the concern. They may not be applicable to private health care sector
workers and impose differing requirements that may create burdens for
both employers and medical equipment manufacturers. Legislation
introduced earlier in this Congress by the Hon. Fortney Pete Stark and
the Hon. Marge Roukema to address this same issue, the Health Care
Worker Needlestick Prevention Act, H.R. 1899, currently has 187
cosponsors.
To its credit, the Occupational Safety and Health Administration
(OSHA) has already acted to ensure that there is greater use of sharps
with engineered safety protections and needless systems. In November
1999, OSHA issued a revised Compliance Directive on Enforcement
Procedures for Occupational Exposure to Bloodborne Pathogens and has
sought to highly publicize the new compliance directive. One of the
principal purposes for issuing the new directive was to emphasize the
requirement that employers identify, evaluate, and make use of
effective safer medical devices in order to minimize the risk of
occupational exposure to bloodborne pathogens.
The legislation that Mr. Ballenger and I are introducing today builds
on OSHA's efforts. By making modest changes in the bloodborne pathogen
standard, this legislation, if adopted, will help to achieve
substantial improvement in the safety and health of American health
care workers. This legislation will help to ensure that health care
workers use the safest available medical devices, that they are trained
to ensure proper usage, and that employers and workers review and learn
from experience to ensure continued improvement.
Specifically, the legislation amends the standard to provide for
definitions of ``engineering controls,'' ``sharps with engineered
sharps injury protections,'' and ``needleless systems'' in order to
provide greater clarity of the requirements of the standard. The
legislation ensures that employers regularly monitor and assess the
development of ``appropriate commercially available and effective safer
medical devises'' and implement use of the such devises appropriately.
It further ensures that those who must use the equipment will have a
voice in its selection and will be properly trained in its use.
Finally, the legislation promotes greater awareness and more active
vigilance by ensuring that needlestick injuries are monitored and
tracked.
In developing this legislation, Mr. Ballenger and I have sought the
greatest possible consensus. For example, I have reluctantly agreed to
leave aside for now the issue of extending the protections of the
bloodborne pathogen standard to health care workers employed by state
and local governments. We have sought to address the concerns of both
health care employers and health care workers. While reinforcing the
requirement that safer medical devices be used where they are
commercially available, this legislation does not mandate the use of
engineered controls where such controls are not commercially available.
Neither this legislation, nor the underlying standard it amends,
requires anyone to use any engineering control, including a safer
medical device, where such use may jeopardize a patient's safety, an
employee's safety, or where it may be medically contraindicated. This
legislation leaves intact all of the affirmative defenses available to
employers related to the use of engineered controls under the
Bloodborne Pathogens Standard. Finally, we have worked closely with
OSHA to ensure that this legislation appropriately builds upon and
compliments the existing standard.
In conclusion, I want to thank the many people who have worked with
Mr. Ballenger and I to develop this legislation. For my part, I want to
especially thank Madeleine Golde and Lorraine Theibaud of the Service
Employees International Union; Barbara Coufel of the American
Federation of State, County, and Municipal Employees; Bill Cunningham
of the American Federation of Teachers; and Stephanie Reed and Karen
Daley of the American Nurses Association. Finally, I would like to pay
special tribute to Peggy Ferro. At a 1992 hearing by another committee
entitled ``Healthcare Worker Safety and Needlestick Injuries,'' Ms.
Ferro testified about how she contracted HIV from a conventional
needle. Ms. Ferro died in 1998. I sincerely commend Chairman Ballenger
for his efforts to ensure that we are more responsive to Ms. Daley than
we were to Ms. Ferro.
____________________