[Congressional Record Volume 146, Number 111 (Tuesday, September 19, 2000)]
[Senate]
[Pages S8761-S8762]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. JEFFORDS (for himself, Mr. Enzi, Mr. Kennedy, and Mr. 
        Reid):
  S. 3067. A bill to require changes in the bloodborne pathogens 
standard in effect under the Occupational Safety and Health Act of 
1970; to the Committee on Health, Education, Labor and Pensions.


               THE NEEDLESTICK SAFETY and PREVENTION ACT

  Mr. JEFFORDS. Mr. President, I am pleased to be able to introduce 
today, along with Senators Enzi, Kennedy, and Reid, the Needlestick 
Safety and Prevention Act. This legislation will ensure that our 
nation's health care workers, who tend to our citizens when care is 
urgently needed, will no longer be risking their own health, and, 
perhaps, their own lives, when providing this life giving work.
  Statistics paint a stark picture of the risks from accidental sharps 
injuries that health care workers face daily on the job, injuries that 
can be prevented, and, when Congress passes this legislation, will be 
prevented. The Centers for Disease Control and Prevention has estimated 
that as many as 800,000 injuries from contaminated sharps occur 
annually among health care workers. Due to these injuries, numerous 
health care workers have contracted fatal or other serious viruses and 
diseases, including the human immunodeficiency virus (HIV), hepatitis 
B, and hepatitis C.
  ``Needlesticks'' refer to the broad category of injuries suffered by 
workers in health care settings who are exposed to sharps, including 
items such as disposable syringes with needles, IV catheters, lancets, 
and glass capillary tubes/pipettes. The true shame in these alarming 
statistics is that accidental needlestick injuries can be prevented. 
Technological advancements have led to the development of safer medical 
devices, such as syringes with needle guards or sheaths.
  The heart of the ``Needlestick Safety and Prevention Act'' is its 
requirement that employers identify, evaluate, and make use of 
effective safer medical devices. And the legislation emphasizes 
training, education, and the participation of those workers exposed to 
sharps injuries in the evaluation and selection of safer devices. The 
Act also creates new record keeping requirements, a ``sharps injury 
log,'' to aid employers in identifying high risk areas, and in 
determining the types of engineering controls and devices most 
effective in reducing or eliminating the risk of exposure. Importantly, 
the legislation we introduce today will not impede, but will encourage 
technological development, as it does not favor the use of a specific 
device, but requires an employer to evaluate the effectiveness of 
available devices.
  I urge all my colleagues to join us in supporting the ``Needlestick 
Safety and Prevention Act.''
  I ask unanimous consent that a copy of this bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 3067

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Needlestick Safety and 
     Prevention Act''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) Numerous workers who are occupationally exposed to 
     bloodborne pathogens have contracted fatal and other serious 
     viruses and diseases, including the human immunodeficiency 
     virus (HIV), hepatitis B, and hepatitis C from exposure to 
     blood and other potentially infectious materials in their 
     workplace.
       (2) In 1991 the Occupational Safety and Health 
     Administration issued a standard regulating occupational 
     exposure to bloodborne pathogens, including the human 
     immunodeficiency virus, (HIV), the hepatitis B virus (HBV), 
     and the hepatitis C virus (HCV).
       (3) Compliance with the bloodborne pathogens standard has 
     significantly reduced the risk that workers will contract a 
     bloodborne disease in the course of their work.
       (4) Nevertheless, occupational exposure to bloodborne 
     pathogens from accidental sharps injuries in health care 
     settings continues to be a serious problem. In March 2000, 
     the Centers for Disease Control and Prevention estimated that 
     more than 380,000 percutaneous injuries from contaminated 
     sharps occur annually among health care workers in United 
     States hospital settings. Estimates for all health care 
     settings are that 600,000 to 800,000 needlestick and other 
     percutaneous injuries occur among health care workers 
     annually. Such injuries can involve needles or other sharps 
     contaminated with bloodborne pathogens, such as HIV, HBV, or 
     HCV.
       (5) Since publication of the bloodborne pathogens standard 
     in 1991 there has been a substantial increase in the number 
     and assortment of effective engineering controls available to 
     employers. There is now a large body of research and data 
     concerning the effectiveness of newer engineering controls, 
     including safer medical devices.
       (6) 396 interested parties responded to a Request for 
     Information (in this section referred to as the ``RFI'') 
     conducted by the Occupational Health and Safety 
     Administration in 1998 on engineering and work practice 
     controls used to eliminate or minimize the risk of 
     occupational exposure to bloodborne pathogens due to 
     percutaneous injuries from contaminated sharps. Comments were 
     provided by health care facilities, groups representing 
     health care workers, researchers, educational institutions, 
     professional and industry associations, and manufacturers of 
     medical devices.
       (7) Numerous studies have demonstrated that the use of 
     safer medical devices, such as needleless systems and sharps 
     with engineered sharps injury protections, when they are part 
     of an overall bloodborne pathogens risk-reduction program, 
     can be extremely effective in reducing accidental sharps 
     injuries.
       (8) In March 2000, the Centers for Disease Control and 
     Prevention estimated that, depending on the type of device 
     used and the procedure involved, 62 to 88 percent of sharps 
     injuries can potentially be prevented by the use of safer 
     medical devices.
       (9) The OSHA 200 Log, as it is currently maintained, does 
     not sufficiently reflect injuries that may involve exposure 
     to bloodborne pathogens in health care facilities. More than 
     98 percent of health care facilities responding to the RFI 
     have adopted surveillance systems in addition to the OSHA 200 
     Log. Information gathered through these surveillance systems 
     is commonly used for hazard identification and evaluation of 
     program and device effectiveness.
       (10) Training and education in the use of safer medical 
     devices and safer work practices are significant elements in 
     the prevention of percutaneous exposure incidents. Staff 
     involvement in the device selection and evaluation process is 
     also an important element to achieving a reduction in sharps 
     injuries, particularly as new safer devices are introduced 
     into the work setting.
       (11) Modification of the bloodborne pathogens standard is 
     appropriate to set forth in greater detail its requirement 
     that employers identify, evaluate, and make use of effective 
     safer medical devices.

     SEC. 3. BLOODBORNE PATHOGENS STANDARD.

       The bloodborne pathogens standard published at 29 C.F.R. 
     1910.1030 shall be revised as follows:
       (1) The definition of ``Engineering Controls'' (at 29 
     C.F.R. 1930.1030(b)) shall include as additional examples of 
     controls the following: ``safer medical devices, such as 
     sharps with engineered sharps injury protections and 
     needleless systems''.
       (2) The term ``Sharps with Engineered Sharps Injury 
     Protections'' shall be added to the definitions (at 29 C.F.R. 
     1910.1030(b)) and defined as ``a nonneedle sharp or a needle 
     device used for withdrawing body fluids, accessing a vein or 
     artery, or administering medications or other fluids, with a 
     built-in safety feature or mechanism that effectively reduces 
     the risk of an exposure incident''.
       (3) The term ``Needleless Systems'' shall be added to the 
     definitions (at 29 C.F.R. 1910.1030(b)) and defined as ``a 
     device that does not use needles for (A) the collection of 
     bodily fluids or withdrawal of body fluids after initial 
     venous or arterial access is established, (B) the 
     administration of medication or fluids, or (C) any other 
     procedure involving the potential for occupational exposure 
     to bloodborne pathogens due to percutaneous injuries from 
     contaminated sharps''.
       (4) In addition to the existing requirements concerning 
     exposure control plans (29 C.F.R. 1910.1030(c)(1)(iv)), the 
     review and update of such plans shall be required to also--
       (A) ``reflect changes in technology that eliminate or 
     reduce exposure to bloodborne pathogens''; and
       (B) ``document consideration and implementation of 
     appropriate commercially available and effective safer 
     medical devices designed to eliminate or minimize 
     occupational exposure''.
       (5) The following additional recordkeeping requirement 
     shall be added to the bloodborne pathogens standard at 29 
     C.F.R. 1910.1030(h): ``The employer shall establish and 
     maintain a sharps injury log for the recording of 
     percutaneous injuries from contaminated sharps. The 
     information in the sharps injury log shall be recorded and 
     maintained in such manner as to protect the confidentiality 
     of the injured employee. The sharps injury log shall contain, 
     at a minimum--

[[Page S8762]]

       ``(A) the type and brand of device involved in the 
     incident,
       ``(B) the department or work area where the exposure 
     incident occurred, and
       ``(C) an explanation of how the incident occurred.''.

     The requirement for such sharps injury log shall not apply to 
     any employer who is not required to maintain a log of 
     occupational injuries and illnesses under 29 C.F.R. 1904 and 
     the sharps injury log shall be maintained for the period 
     required by 29 C.F.R. 1904.6.
       (6) The following new section shall be added to the 
     bloodborne pathogens standard: ``An employer, who is required 
     to establish an Exposure Control Plan shall solicit input 
     from non-managerial employees responsible for direct patient 
     care who are potentially exposed to injuries from 
     contaminated sharps in the identification, evaluation, and 
     selection of effective engineering and work practice controls 
     and shall document the solicitation in the Exposure Control 
     Plan.''.

     SEC. 4. EFFECT OF MODIFICATIONS.

       The modifications under section 3 shall be in force until 
     superseded in whole or in part by regulations promulgated by 
     the Secretary of Labor under section 6(b) of the Occupational 
     Safety and Health Act of 1970 (29 U.S.C. 655(b)) and shall be 
     enforced in the same manner and to the same extent as any 
     rule or regulation promulgated under section 6(b).

     SEC. 5. PROCEDURE AND EFFECTIVE DATE.

       (a) Procedure.--The modifications of the bloodborne 
     pathogens standard prescribed by section 3 shall take effect 
     without regard to the procedural requirements applicable to 
     regulations promulgated under section 6(b) of the 
     Occupational Safety and Health Act of 1970 (29 U.S.C. 655(b)) 
     or the procedural requirements of chapter 5 of title 5, 
     United States Code.
       (b) Effective Date.--The modifications to the bloodborne 
     pathogens standard required by section 3 shall--
       (1) within 6 months of the date of enactment of this Act, 
     be made and published in the Federal Register by the 
     Secretary of Labor acting through the Occupational Safety and 
     Health Administration; and
       (2) take effect on the date that is 90 days after the date 
     of such publication.

  Mr. ENZI. Mr. President, I am pleased to be part of the introduction 
today of S. 3067, a bipartisan bill to provide protection for our 
nations health care workers against accidental needlesticks and sharps 
injuries. I want to acknowledge and commend my colleagues Senators 
Jeffords, Kennedy and Reed in the Senate and the Honorable Mr. 
Ballenger and Honorable Major Owens in the House for their work on this 
important safety issue.
  Since the mid-1980's, injuries to health care workers from needles or 
other ``sharps,'' such as IV catheters or lancets, have presented an 
increasingly troubling issue. As the spread of bloodborne pathogens 
such as HIV and Hepatitis B and C has escalated over the last 15 years, 
so has the danger to health care workers of contracting one of these 
diseases through sharps contaminated with bloodborne pathogens, such as 
HIV and Hepatitis B and C. Even where the injured worker does not 
ultimately contract a bloodborne disease, the uncertainty and fear of 
infection created by such injuries can be excruciating and destructive 
to the lives of the injured health care workers.
  In response to this problem, in 1991 the Occupational Safety and 
Health Administration, or ``OSHA,'' issued a standard requiring 
workplace safety measures to be used to protect against occupational 
exposure to bloodborne pathogens. This was a laudable step in the fight 
against worker infection, and its implementation brought a reduction in 
the risk of contracting a bloodborne disease in the workplace. The 
success of this measure, however, was limited by the effectiveness of 
the safety technology available at the time, and occupational exposure 
to bloodborne pathogens from accidental sharps injuries has continued 
to be a problem. In March 2000, the Centers for Disease Control 
estimated that between 600,000 and 800,000 needlesticks still occur 
among health care workers annually.
  Fortunately, since the publication of the bloodborne pathogens 
standard there has been a substantial increase in the number and 
assortment of new medical devices, such as needless systems and 
retractable needles, that protect against needlesticks. Numerous 
studies have shown that the use of these safer devices, as part of an 
overall bloodborne pathogen risk reduction program, can be extremely 
effective in reducing accidental sharps injuries.
  The legislation we introduce today will ensure that these safer 
devices are used, and lives will be saved as a result. The bill 
provides narrowly tailored instruction to OSHA to amend its bloodborne 
pathogen standard to make certain that employers understand they must 
identify, evaluate, and, where appropriate, make use of these safer 
medical devices to eliminate or reduce occupational exposure to 
bloodborne pathogens. OSHA issued similar instructions in a compliance 
directive published December 1998. Because OSHA's directive is merely 
agency guidance and does not have the force of law, however, I felt it 
was important that both employers and employees be given formal 
regulatory instruction on this vitally important safety issue. This 
legislation provides this security and improves protection for 
employees while still allowing employers the necessary flexibility to 
determine the best technology to use in the particular circumstances 
presented. This legislation even goes a step further to ensure that 
employers will have valuable input from the front line employees when 
it makes these determinations.
  This bill is an important step for safety in the workplace, and I 
hope it will bring some peace of mind to the more than 8 million 
workers who perform the vitally important service of providing health 
care in this country. I am extremely proud to be a part of legislation 
which will save lives and help stop the spread of bloodborne diseases.
  Mr. KENNEDY. Mr. President, it is a privilege to join my colleagues 
in introducing the Needle Stick Safety and Prevention Act. I commend 
Senators Jeffords, Enzi and Reid for their effective work on this bill 
that is vitally important to health care professionals and all 
Americans who come in contact with them.
  The need for needle stick protection is compelling. Last year alone, 
there were almost 800,000 needle stick injuries to health care 
professionals. Over 1,000 health care workers were infected with 
serious diseases, including HIV, Hepatitis B and Hepatitis C. Sadly, 
all of these injuries were preventable. The good news is that through 
the provisions of this bill, many future needle stick injuries will be 
prevented. In fact, the Center for Disease Prevention estimates that 
needle stick injuries will be reduced by as much as 88 percent.
  But as is so often the case, numbers alone cannot convey the full 
story of human tragedy resulting from these injuries. One of my 
constituents, Karen Daley of Boston, is the President of the 
Massachusetts Nurses Association and was a registered nurse, a job she 
loved and found very fulfilling. In January 1999, while working in an 
emergency room in Boston, Karen was accidentally stuck by a 
contaminated needle. Six months later, she tested positive for HIV and 
Hepatitis C. Fortunately, Karen is in relative good health, although 
she will never again be able to practice her chosen profession of 
nursing.
  The Needle Stick Safety and Prevention Act is intended to prevent 
tragic accidents like this. This bill requires employers to implement 
the use of safety-designed needles and sharps to reduce the potential 
transmission of disease to health care workers and patients. This bill 
also provides that employers establish an injury log to record the kind 
of devices, and the location, of all needle stick accidents.
  Equally important, this bill allows non-managerial employees--those 
on the front lines of service delivery--to be involved in determining 
the appropriate devices used in health care settings.
  This bill has bipartisan support in the Senate and the House. It also 
is supported by the American Hospital Association, the American Nurses 
Association, the Service Employees International Union and the American 
Federation of Federal, State County and Municipal Employees.
  I urge all of my colleagues, on both sides of the aisle, to join us 
in supporting this important bill, and I am hopeful that it can be 
enacted into law before this session of Congress ends.
                                 ______