[Congressional Record Volume 146, Number 110 (Monday, September 18, 2000)]
[Extensions of Remarks]
[Pages E1511-E1512]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     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.

                          ____________________