Sharps Safety & Occupational Exposure: 20th Anniversary of the Needlestick Safety and Prevention Act Reminds Us Progress Still Necessary
By Kelly M. Pyrek
Twenty years ago, the federal Needlestick Safety & Prevention Act (NSPA) of 2000 was signed into law with the hope that it could bring new awareness to the dangers of occupational exposures and percutaneous injuries in the healthcare environment.
“Since the NSPA of 2000 was signed into law the issue has received greater focus from occupational health and infection prevention staff,” says Angela Laramie, an epidemiologist with the Massachusetts Department of Public Health. “Hospitals are continuing to convert to using devices with sharps injury prevention features across the hospital, including devices in pre-packaged kits. In Massachusetts, after seeing an initial decrease in sharps injury rates in MDPH licensed hospitals from 2002 to 2010 that was statistically significant, sharps injury rates between 2010 and 2015 have plateaued.”
To review, the NSPA revised the Occupational Safety and Health Administration (OSHA)’s standard regulating occupational exposure to bloodborne pathogens and sought to further reduce healthcare workers' exposure by imposing additional requirements upon employers regarding their sharps-related procedures. OSHA's regulations modified the definition of "engineering controls" and added definitions for the terms "sharps with engineered sharps injury protection" and "needleless systems;” required employers to consider and implement new technologies when they update their exposure control plan; required employers to solicit employee input with respect to appropriate engineering controls; and required employers to maintain a sharps injury log.
“It is important to note that the NSPA in and of itself is not enforceable in healthcare facilities,” emphasizes Amber Hogan Mitchell, DrPH, MPH, CPH, president and executive director of the International Safety Center. “Rather, it required OSHA to incorporate additional requirements in its Bloodborne Pathogens Standard, including more specific requirements for the use of device with sharps injury prevention (SIP) features, annual frontline employee evaluation and selection of those devices, and maintaining a sharps injury log. After 2000, we saw reductions in injuries overall, but in the last several years, injuries have started to increase, especially among physicians using suture needles and nurses using disposable syringes. These are two areas where we must remain diligent about capturing injury data, evaluating safer devices and work practices, and reducing the numbers of injuries.”
For one commonwealth, at least, there has been an increase in the percentage of injuries reported involving devices with engineered sharps injury prevention features over time. “In 2002 in Massachusetts, 26 percent of all injuries occurred with devices with sharps injury prevention features. Excluding suture needles, the percentage is 32 percent,” Laramie says. “In 2015, 45 percent of injuries occurred with devices with sharps injury prevention features. If we exclude suture needles that figure increases to 57 percent. This may be seen as a proxy for use of such devices, in which case it is appropriate that we are seeing an increase in the proportion of injuries with these devices. The goal is to eliminate use of devices without sharps injury prevention features, in which case all injuries would occur with devices with sharps injury prevention features.”
Read further from the March 2020 issue HERE