[Congressional Record (Bound Edition), Volume 146 (2000), Part 14]
[House]
[Pages 20584-20591]
[From the U.S. Government Publishing Office, www.gpo.gov]



                 NEEDLESTICK SAFETY AND PREVENTION ACT

  Mr. BALLENGER. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 5178) to require changes in the bloodborne pathogens 
standard in effect under the Occupational Safety and Health Act of 
1970, as amended.
  The Clerk read as follows:

                               H.R. 5178

       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.

       The Congress finds the following:
       (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 Safety and Health 
     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 
     healthcare 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 healthcare facilities. More than 
     98 percent of healthcare 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. 1910.1030(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 annually 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--
       ``(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

[[Page 20585]]

     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) at the end of 90 days after such publication, take 
     effect.

  The SPEAKER pro tempore (Mr. Rogan). Pursuant to the rule, the 
gentleman from North Carolina (Mr. Ballenger) and the gentleman from 
New York (Mr. Owens) each will control 20 minutes.
  The Chair recognizes the gentleman from North Carolina (Mr. 
Ballenger).


                             General Leave

  Mr. BALLENGER. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days within which to revise and extend their 
remarks on H.R. 5178.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from North Carolina?
  There was no objection.
  Mr. BALLENGER. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I am pleased to have the opportunity today to talk about 
H.R. 5178, the Needlestick Safety and Prevention Act, a bill that I 
introduced last week.
  A tremendous amount of bipartisan discussion and effort has gone into 
this bill. Since its introduction last month, many Members, from both 
sides of the aisle, have joined as cosponsors, including many members 
of our full committee. I am especially pleased to have worked with my 
colleague from the Subcommittee on Workforce Protection, the gentleman 
from New York (Mr. Owens), on this bill, and thank him for his support 
and sponsorship.
  This bill represents the consensus agreement of many groups, from 
hospitals to nurses to health care workers to industry. I know there 
are compromises that have gone into this effort. I want to commend all 
those who have been involved in this work and who helped bring us here 
today.
  I want to thank the gentleman from Pennsylvania (Chairman Goodling) 
for his support of this bill, and also take another opportunity to 
acknowledge his distinguished service as chairman of our committee and 
for his leadership on so many workforce issues.
  I also want to acknowledge my colleagues from the other body, 
Senators Jeffords, Enzi, Kennedy and Reid, for their work on this 
important workplace safety issue. On matters related to the 
Occupational Safety and Health Administration, it is not often that I 
find myself in such company. However, as we have all learned of the 
important basic public health issue at the heart of this bill, it was 
apparent the opportunity to work together and advance this legislation 
was at hand.
  This legislation is the product of a hearing held this past June by 
the Subcommittee on Workforce Protection on the public health concern 
about accidental needlestick injuries to health care workers. Even more 
than that, this legislation will help to ensure that our Nation's 
nearly 8 million health care workers will not have to risk their own 
health, and perhaps their own lives, when providing care for all of us.
  Our knowledge about needlestick and other ``sharps'' injuries and 
what can be done about them has greatly increased over the past decade. 
One estimate is that more than 600,000 needlestick and other sharps 
injuries occur in health care settings in the United States each year. 
The very consequences of such injuries to health care workers can mean 
exposure to serious viruses and diseases, including the HIV virus, 
hepatitis B and hepatitis C.
  At the same time as our knowledge about the risks and consequences of 
needlestick injuries has increased, the technology of devices used in 
health care settings which can protect against these injuries has also 
advanced. Today, our knowledge about the effectiveness of such ``safer 
medical devices'' such as needleless systems, is also better known. 
H.R. 5178 will assure that safer medical devices will be used, and the 
lives of health care workers will be made better for it.
  H.R. 5178 builds on the work of an OSHA guidance document, a 
compliance directive, issued last fall. Quite simply, H.R. 5178 amends 
the OSHA Bloodborne Pathogens Standard. It makes clear in the standard 
itself the direction already provided by OSHA in its compliance 
directive, that is, that employers who have employees with occupational 
exposure to bloodborne pathogens must consider, and where appropriate, 
use effective engineering controls, including safer medical devices, in 
order to reduce the risk of injury from needlesticks and from other 
sharp medical instruments. This legislation requires employers to use 
safer medical devices only where the devices are appropriate, 
commercially available, and effective at reducing or eliminating sharps 
injuries.
  Under no circumstances, either through this legislation or through 
the underlying Bloodborne Pathogen Standard, are employers required to 
use a safer medical device or engineering control where such a device 
jeopardizes a patient's safety and an employee's safety, or where such 
a device is medically contraindicated. All affirmative defenses are 
available to an employer and are kept intact in this legislation.
  H.R. 5178 amends the OSHA standard in two additional ways. First, in 
considering and selecting safer medical devices, employers would be 
required to solicit input from the frontline health care workers who 
would actually use the devices. Testimony at our hearing in June 
indicated the importance of this requirement. Because there are so many 
new devices on the market and because each health care setting is 
different, careful evaluation of devices by the professionals who will 
use them is necessary to know what works and what does not in 
particular settings.
  Second, this legislation requires employers to maintain a sharps 
injury log. Now, I am certainly not one to favor increased paperwork 
for employers. In this situation, however, I understand the importance 
of such a law as a tool to track high-risk areas for injury and also as 
a means to evaluate the effectiveness of particular devices. This 
legislation ensures that such a log will protect the confidentiality of 
the insured employee.
  While it does all that, this legislation also provides employers with 
the needed flexibility to determine the best technology to use in 
particular circumstances. It is careful not to favor the use of a 
specific device. In fact, this legislation is crafted not to impede, 
but to encourage, technological development by encouraging the use of 
new technologies. It is left to the employer to evaluate the 
effectiveness of these available devices, and I would like to emphasize 
this to any Senator who may be listening to this: it is careful not to 
favor the use of a specific device. In fact, this legislation is 
crafted not to impede, but to encourage technological development, by 
encouraging the use of new technologies; and it is left to the employer 
to evaluate the effectiveness of the available devices.
  H.R. 5178 will help resolve an important public health worker safety 
issue.

[[Page 20586]]

  Mr. Speaker, this legislation has broad-based support from both 
employer and employee communities. The American Hospital Association; 
the American Nurses Association; Premier, the leading group health 
purchasing organization; the Service Employees International Union; 
AFSCME; the American Federation of Teachers; the Firefighters; and many 
manufacturers, are all supporters. And it certainly has the support of 
one nurse from Massachusetts, Karen Daley, who told us at our hearing 
in June of her personal experience with a needlestick injury and who so 
generously asked that we take this action; not to help her, for it was 
too late, but to make a difference in working lives of the Nation's 
nearly 8 million health care workers.
  Mr. Speaker, at this time I am offering a substitute to the version 
of H.R. 5178 that passed the Subcommittee on Workforce Protection. This 
substitute makes a technical correction to clarify that the 
documentation of the consideration and implementation of safer medical 
devices is to be done annually.
  Along with my distinguished colleague, the gentleman from New York 
(Mr. Owens), I am offering a joint statement of legislative intent.
  I would like to go out of my way now to thank Vickie Lipnic and Greg 
Maurer for the time and effort in resolving the many problems that 
arose in this effort. I want to thank all of my colleagues who have 
joined together in bringing this issue forward, and I urge its support 
in the full House.
  Mr. Speaker, I include for the Record the joint statement of 
legislative intent on H.R. 5178.

 H.R. 5178--Needlestick Safety and Prevention Act: Joint Statement of 
   Legislative Intent on Substitute by Hon. Cass Ballenger of North 
       Carolina and Hon. Major Owens of New York in the House of 
               Representatives, Tuesday, October 3, 2000

       Mr. Speaker, I am joined today by the ranking member of the 
     Subcommittee on Workforce Protections of the Committee on 
     Education and the Workforce, the Honorable Major Owens, in 
     discussing the Needlestick Safety and Prevention Act. I am 
     pleased to offer this bipartisan legislation which addresses 
     an important public health issue confronting our nation's 
     health care workers.
       At this time, pending is a substitute to the version of 
     H.R. 5178 which passed the Workforce Protections 
     Subcommittee. I am pleased to be joined by Mr. Owens in 
     offering the substitute. What follows is both the text of the 
     substitute to H.R. 5178 and a statement of legislative intent 
     which I offer on behalf of myself and Mr. Owens.


    joint statement of legislative intent on substitute to h.r. 5178

       This legislation follows a hearing held by the Workforce 
     Protections Subcommittee in late June of this year. The 
     legislation derives from the convergence of two critical 
     circumstances which have a profound effect on the safety of 
     health care workers in the United States.
       The first circumstance is the increased concern over 
     accidental needlestick injuries suffered by health care 
     workers each year in health care settings. ``Needlesticks'' 
     is a term used broadly, as health care workers can suffer 
     injuries from a broad array of ``sharps'' used in health care 
     settings, from needles to IV catheters to lancets. The second 
     circumstance is the technological advancements made over the 
     past decade in the many types of ``safer medical devices'' 
     that can be used in health care settings to help protect 
     health care workers against sharps injuries. Because of the 
     convergence of these two circumstances--and because of 
     increasing concern over the public health issue related to 
     the spread of hepatitis C, it is appropriate to take this 
     action at this time.
       Section 1 of the Bill provides the title the ``Needlestick 
     Safety and Prevention Act.'' Section 2 of the bill provides 
     the Congressional findings.
       Section 3 of the bill directly modifies the Bloodborne 
     Pathogens Standard, 29 C.F.R. 1910.1030, one of the health 
     and safety standards promulgated by the Department of Labor's 
     Occupational Safety and Health Administration (OSHA). The 
     legislation builds on the most recent action taken by OSHA 
     related to the Bloodborne Pathogens Standard--the revision in 
     November 1999 to OSHA's Compliance Directive on Enforcement 
     Procedures for the Occupational Exposure to Bloodborne 
     Pathogens (``Compliance Directive'').
       In modifying the Bloodborne Pathogens Standard (``BBP 
     standard'') this bill makes narrowly-tailored changes to the 
     BBP standard. It makes clear in the BBP standard the 
     direction already provided by OSHA in its Compliance 
     Directive: namely, that employers who have employees with 
     occupational exposure to bloodborne pathogens must consider 
     and, where appropriate, use effective engineering controls, 
     including safer medical devices, in order to reduce the risk 
     of injury from needlesticks and from other sharp medical 
     instruments (``sharps'').
       The bill accomplishes this in several ways. First, the BBP 
     standard is modified so that the definition of ``engineering 
     controls'' at 29 C.F.R. 1910.1030(b) includes as additional 
     examples of such controls, ``safer medical devices, such as 
     sharps with engineering sharps injury protections and 
     needleless systems.'' Following that step, the BBP standard 
     is amended so that both ``sharps with engineered sharps 
     injury protections'' and ``needleless systems'' are added to 
     the definitions of the standard.
       While sharps with engineered sharps injury protections and 
     needleless systems are examples of safer medical devices, it 
     is not the intent of this legislation to limit engineering 
     controls or, for that matter, safer medical devices, to the 
     examples cited in this legislation. Nor should the citing of 
     these examples be considered an endorsement or preference of 
     a specific product or assurance of a specific product's 
     effectiveness.
       Rather, it is the intent of this legislation to reflect 
     innovation and evolving technology in the marketplace. It is 
     also the intent of this legislation that any devices that 
     have been considered or determined to be engineering controls 
     by OSHA shall continue to be considered as such. This 
     legislation anticipates that hospitals and other employers, 
     in crafting their Exposure Control Plans, will adopt 
     procedures and use devices that have been proven to reduce 
     the risk of needlestick injuries.
       Employers use their Exposure Control Plans to evaluate 
     appropriate practices and devices for reducing occupational 
     exposure. To focus attention on the need for employees to 
     look at changes in technology, this legislation further 
     modifies the BBP standard by adding to the existing 
     requirements concerning Exposure Control Plans at 29 C.F.R. 
     1910.1030(c)(1)(iv). Through these modifications, employers 
     will be required to demonstrate in the review and update of 
     their Exposure Control Plans that their Exposure Control 
     Plans reflect changes in technology and also that they 
     document annually the consideration and implementation of 
     appropriate, commercially available and effective safer 
     medical devices. The clarification that documentation of such 
     devices is to be done ``annually'' is the only difference 
     between the substitute bill described here and the bill as 
     reported by the Subcommittee on Workforce Protections.
       It is through an employers' Exposure Control Plan that 
     engineering controls and safer devices are considered and 
     deployed in the workplace. To the extent that specific types 
     of devices, such as catheter securement devices or needle 
     destruction devices can reduce the risk of needlestick 
     injuries, such devices could be appropriate components of an 
     employer's comprehensive exposure control plan. Nevertheless, 
     it is impossible for this legislation to recommend any one 
     type of engineering control. Perhaps better stated it is not 
     the intent of this legislation to disturb the underlying 
     flexible, performance-oriented nature of the Bloodborne 
     Pathogens Standard, whereby the employer must evaluate the 
     circumstances of the workplace and assess what is effective 
     and what is not in that particular work setting.
       It is important to note also that the requirement in this 
     legislation for the consideration and implementation of safer 
     medical devices is hinged upon the ``appropriateness'' and 
     the ``commercial availability'' of such devices. Finally, 
     while this may be stating the obvious, it is not the intent 
     of this legislation, nor for that matter of the current 
     Bloodborne Pathogens Standard, for employers to implement use 
     of any engineering control, including a safer medical device, 
     in any situation where it may jeopardize a patient's safety, 
     an employee's safety or where it may be medically 
     contraindicated. We do not expect an OSHA inspector to 
     substitute his judgment for that of the professional clinical 
     and medical judgment of health care professionals responsible 
     for patient safety. Moreover, all of the affirmative defenses 
     available to an employer under the current Bloodborne 
     Pathogens Standard remain intact with this legislation.
       Section 3 of the bill amends the BBP standard in two 
     additional ways. First, it adds a requirement that in 
     addition to the recordkeeping requirements already found in 
     the BBP standard, employers must record percutaneous injuries 
     from contaminated sharps in a sharps injury log. The 
     legislation sets out the minimum information to be included 
     in such a log, namely the type of device used, an explanation 
     of the incident, and where the injury occurred. Employers are 
     free to include other information should they find it 
     helpful. However, this legislation does require that in 
     recording the information and maintaining the log, the 
     confidentiality of the injured employee is to be protected.
       The requirement for a sharps injury log is consistent with 
     current OSHA recordkeeping in two specific ways. First, the 
     sharps injury log requirement does not apply to any employer 
     who is not already required to maintain a log of occupational 
     injuries and illnesses under 29 C.F.R. 1904. Second, 
     employers are not required to maintain the logs for

[[Page 20587]]

     a period of time beyond that currently required for the OSHA 
     200 logs.
       It is the sole intent of the sharps injury log requirement 
     that it be used as a tool only for employers so that they may 
     determine their high risk areas for sharps injuries and use 
     it as a means to evaluate particular devices that may or may 
     not be effective in reducing sharps injuries. At a 
     Subcommittee on Workforce Protection hearings in June, 
     representatives of the American Hospital Association 
     testified that many health care settings, particularly 
     hospitals, already have in place some type of ``surveillance 
     system'' for tracking needlestick and other sharps injuries. 
     The AHA witness noted that hospitals have found this to be an 
     effective tool to provide necessary information to help 
     reduce such injuries.
       The second way in which Section 3 amends the BBP standard 
     is by specifying that employers must 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. Employers are also to 
     document this in the Exposure Control Plans. The intent of 
     this section is simple--to involve those workers who will 
     actually be using the new devices in their selection. It is 
     not the intent of this legislation to force a particular 
     technology on employers or employees without some careful 
     consideration and evaluation of the technology's 
     effectiveness.
       Section 4 of the legislation explains that the 
     modifications as delineated by Section 3 of the bill can be 
     changed by a future rulemaking by OSHA on the Bloodborne 
     Pathogens Standards.
       Finally, Section 5 of the bill directs that the 
     modifications to the BBP standards are to be made without 
     regard to the standard OSHA rulemaking requirements or the 
     requirements of the Administrative Procedures Act. 
     Admittedly, preemption of the OSHA rulemaking procedures is 
     not an action to be undertaken lightly. Indeed, the 
     requirements of this bill are driven by the unique 
     circumstances surrounding this narrow and particular public 
     health issue. Although there is no such thing as binding 
     precedent for Congress, it is not the intent of this 
     legislation, through the process used here, to diminish the 
     carefully constructed requirements and procedures for OSHA 
     rulemaking.
       The legislation does prescribe, however, that the changes 
     to the BBP standard are to be made by the Secretary of Labor 
     and published in the Federal Register within six months of 
     enactment and that the changes will take effect 90 days after 
     such publication.

  Mr. OWENS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, it is not exaggerating to say this is legislation that 
will save lives. I rise in support of H.R. 5178. This legislation will 
significantly improve the health and safety of health care workers by 
reducing accidental needlesticks and other sharps injuries.
  It is estimated that there are between 600,000 and 800,000 incidences 
of accidental needlestick injuries among health care workers every 
year. As a direct result, more than 1,000 of these workers will 
contract a serious potentially life-threatening disease such as HIV or 
hepatitis C. Studies have shown that as many as 80 percent of these 
accidental needlesticks can be avoided through the use of available 
safer medical devices.
  The Occupational Safety and Health Administration, OSHA, has already 
taken action to reduce accidental needlestick injuries. In November 
1999, OSHA issued a revised compliance directive on enforcement 
procedures for occupational exposure to bloodborne pathogens. The 
principal purpose of the new directive is to emphasize the requirement 
that health care employers identify, evaluate, and make use of 
effective, safer medical devices. H.R. 5178 builds upon OSHA's efforts.
  Specifically, H.R. 5178 amends OSHA's 1991 Bloodborne Pathogen 
Standard to clarify and reiterate the requirement to use ``appropriate 
commercially available and effective safer medical devices designed to 
eliminate or minimize occupational exposure to bloodborne pathogens.'' 
H.R. 5178 provides 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 devices. It ensures that health care workers 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 through the use of a sharps injury log.
  The primary intent of H.R. 5178 is to protect the safety and health 
of health care workers. One of the principal ways the legislation 
accomplishes this is by encouraging the development of safer medical 
devices. Under the bill, it is the responsibility of health care 
employers, in consultation with their workers and subject to oversight 
by OSHA, to determine for themselves what are the safest devices on the 
market that meet their individual needs.
  As newer safer devices come to the market, employers are required to 
consider and implement appropriate and effective safer medical devices. 
Since the bill anticipates and encourages technological development, 
the bill intentionally does not define any specific medical device as a 
safer medical device per se. To do so would be self-defeating.
  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 Pathogen Standard.
  Mr. Speaker, this is good legislation. This is life-saving 
legislation. It is supported by health care employers, including the 
American Hospital Association and Kaiser Permanente. It is supported by 
medical equipment manufacturers, including Becton-Dickinson and 
Retractable Technologies, Inc.; and it is supported by the unions that 
represent health care workers, including the American Nurses 
Association, the Service Employees, AFSCME, AFT, AFGE, and the 
Firefighters.
  I commend the gentleman from North Carolina (Chairman Ballenger) for 
his leadership on this issue, and I urge my colleagues to support H.R. 
5178.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BALLENGER. Mr. Speaker, I yield 3 minutes to the gentleman from 
Pennsylvania (Mr. Goodling).
  Mr. GOODLING. Mr. Speaker, I want to encourage everyone to vote for 
that legislation, but particularly I want to thank our subcommittee 
Chair, the gentleman from North Carolina (Mr. Ballenger), because if I 
were a betting person several months ago and they said this legislation 
was going to come to the floor of the House, I would have said I doubt 
that.

                              {time}  1615

  I did not think you could get the employees and the employers 
together on the issue, but the gentleman from North Carolina (Chairman 
Ballenger) and his cunning ways overwhelmed them and brought that 
about, and what that means is an awful lot of people will not risk the 
danger of some horrible disease, and not only that, the expense of 
trying to prevent that disease from happening after the needlestick.
  Again, I compliment the gentleman from North Carolina (Mr. 
Ballenger), our subcommittee chair, the gentleman has done an 
outstanding job.
  Mr. Speaker, I rise in support of H.R. 5178, the Needlestick Safety 
and Prevention Act. I want to congratulate Congressman Ballenger for 
his leadership in forging a consensus between the employer and the 
employee communities on this once contentious issue. Congressman 
Ballenger's work on this issue is indicative of his excellent service 
as Chairman of the Subcommittee on Workforce Protections for the past 
six years.
  More than 600,000 times a year, healthcare workers are accidentally 
stuck by needles and other devices in the course of their work. With 
every accidental needlestick, health care workers risk contracting 
fatal diseases such as AIDs and Hepatitis C. H.R. 5178 will help 
prevent many of these accidental needlesticks.

[[Page 20588]]

  Even in the fortunate majority of these cases when no diseases are 
transmitted, employers incur thousands of dollars in expenses for blood 
tests and preventative medications.
  Fortunately, rapidly improving technology offers workers and 
employers safer medical devices that reduce the risk of needlestick 
injuries. H.R. 5178 requires employers to consider using safer medical 
devices. When such devices are appropriate, commercially available and 
effective, employers must implement safer devices in the workplace.
  H.R. 5178's flexible approach to safer medical devices puts the 
decision-making in the hands of employers rather than distant 
Washington bureaucrats.
  Employers, with input from frontline health care employees, have the 
flexibility and the responsibility to choose practices and devices that 
will help protect their workers in their workplaces.
  By embracing a flexible, decentralized solution, H.R. 5178 enables 
employer and employee representatives to unite behind legislation that 
will help make work safer for health care workers. As a result, both 
the American Hospital Association and the American Nurses Association 
have enthusiastically endorsed H.R. 5178. I encourage my colleagues to 
vote for H.R. 5178.
  Mr. OWENS. Mr. Speaker, I yield such time as she may consume to the 
gentlewoman from New York (Mrs. McCarthy).
  Mrs. McCARTHY of New York. Mr. Speaker, before I make my remarks on 
this legislation, I also would like to compliment the gentleman from 
North Carolina (Chairman Ballenger) for the work and how swiftly we 
have gotten this through the committee, and I appreciate that. I thank 
my colleague from New York (Mr. Owens) again for his work to protect 
our health care workers, that is what it comes down to.
  Mr. Speaker, I have spent over 30 years of nursing before I came 
here; and I certainly can tell my colleagues how many times I have 
gotten stuck with a needle. And I was probably very lucky, because many 
years ago, we did not face the diseases that we are facing today. 
Today, we are facing TB, Hepatitis B, Hepatitis C, HIV, AIDS, and these 
are the things we have to be concerned about. What people have to 
realize, it is not that nurses or health care workers are not being 
careful; but when we are dealing with life-threatening situations of 
taking care of a patient, we are concerned about giving the patient 
certainly the medications they need fast, starting IVs and everything 
else goes out of their minds.
  This legislation is going to protect health care workers across this 
Nation. We heard that 600,000 to 800,000 healthcare workers are stuck 
every single year. We know that when a health care worker is stuck, 
they have to go down for a test. They have to be followed through. It 
can cost, for each person that is stuck, $3,000. We are not even 
talking about those that, unfortunately, do get fatal diseases from 
these injuries.
  Mr. Speaker, I commend certainly the committee and the hard work that 
has been done on this and how fast it has gone, because now we know we 
have legislation that is out there that is going to protect our health 
care workers, and more than that, this is legislation that can save 
lives.
  I am very proud to be here to encourage all of my colleagues, all of 
my colleagues to support this overwhelmingly. This is good legislation, 
and it should pass unanimously. I thank all my colleagues for their 
work.
  Mr. BALLENGER. Mr. Speaker, I yield 2\1/2\ minutes to the gentlewoman 
from New Jersey (Mrs. Roukema).
  Mrs. ROUKEMA. Mr. Speaker, I certainly thank the gentleman from North 
Carolina (Mr. Ballenger), our subcommittee chairman, but I think we are 
here today to say in a very real and definite and substantial way that 
Congress, when it sets public policy, it should put health and safety 
first. And as such, the safety of our health care workers and their 
patients are of paramount concern in this legislation.
  I will tell my colleagues, we have safer medical devices that are 
being added to OSHA, as we amend OSHA in this legislation today, but in 
addition, employers are required to consider and implement the use of 
such safe medical devices in their facilities. It is certainly because 
of the leadership of the gentleman from North Carolina (Mr. Ballenger), 
the gentleman from New York (Mr. Owens), and the gentleman from 
Pennsylvania (Chairman Goodling) on this subject. It was mentioned 
earlier nobody thought we could get this kind of a compromise in this 
kind of a leadership in such a short period of time.
  Mr. Speaker, I will not go into all the statistics that have already 
been noted here today, but they are alarming statistics about the 
health and the safety, not only of the workers, but also the spread of 
terrible diseases, because of the breakdown of these safety devices, to 
the patients in our hospitals.
  These numbers are alarming as they have already been stated, but 
especially alarming since we already know that the technology exists 
that could prevent these injuries and this spread of infection.
  The least we can do is see that the medical professionals have the 
latest in safety precautions available to them. We cannot prevent all 
the hospitals and doctor office accidents, but certainly we can with 
today's safety needles provide the lifesaving support for those that 
need it.
  I would like to point out, too, that while the statistics are 
alarming, I must also say that we should put health and safety first, 
not only health and safety first, but the bottom line, we are saving 
money.
  Mr. Speaker, I do want to finally commend again the gentleman from 
North Carolina (Mr. Ballenger) and the gentleman from New York (Mr. 
Owens) for their leadership, but also we must remember the forward 
thinking companies like Becton-Dickinson in Bergen County, New Jersey 
for their contribution to the development of these safe technologies.
  Mr. Speaker I rise in strong support of H.R. 5178, the Needlestick 
Safety and Prevention Act. When we in Congress set public policy, we 
must always put health and safety first. As such, the safety of health 
care workers and their patients are of a paramount concern.
  H.R. 5178, the Needlestick Safety and Prevention Act, takes an 
important step in helping to reduce the risks of occupational exposure 
to bloodborne pathogens. The bill requires the Occupational Safety and 
Health Administrative (OSHA) to amend the Bloodborne Pathogens Standard 
to include the definition of ``safer medical devices.'' In addition, 
employers are required to consider and implement the use of such safer 
medical devices in their facilities. I would like to thank Mr. 
Ballenger and Mr. Owens and Committee Chairman Goodling for leading the 
charge to bring this bipartisan legislation to the floor.
  It is currently estimated that there are between 800,000 and 1 
million needlesticks and other sharps injuries to healthcare workers in 
the United states each year. An average hospital incurs approximately 
30 worker needlestick injuries per 100 beds per year. These numbers are 
alarming, especially since the technology exists to prevent these 
injuries.
  Many of these accidents are instant tragedies, infecting dedicated 
medical workers with blood-borne diseases, sometimes even the incurable 
AIDS virus. And ALL of these needlesticks leave the victim frightened 
of the consequences until a blood test can be done to determine whether 
they have been infected.
  The least we can do is see that medical professionals have the latest 
in safety precautions available to them. We cannot prevent all hospital 
and doctor's office accidents, but we should prevent those we can. 
Today's safety needles are lifesavers for those trying to save lives. 
We need to encourage the use of safe needles and devices to improve 
healthcare worker safety in the workplace.
  Numerous studies have demonstrated that the use of safe-needle 
devices, when they are part of an ``overall'' bloodborne pathogens 
risk-reduction program, are extremely effective in reducing accidental 
needlesticks. In fact, the Centers for Disease Control and Prevention 
estimates that 76 percent of needlestick injuries could be eliminated 
immediately if health care institutions switched to safe needles and 
similar devices. We should be doing everything possible to encourage 
the use of safe technology.

[[Page 20589]]

  Not only does the use of safe technology save lives--it also saves 
money. For example, it is estimated that for a 300 bed hospital to 
convert to safe technology, it would cost $70,000 a year. When you 
compare that amount to the estimated $500,000 in testing and drug 
regimens for just one needlestick injury, it becomes clear--needlestick 
prevention makes practical and fiscal sense. And this does not begin to 
include the emotional toll of the injured worker or the countless 
lawsuits filed.
  The use of safe technology should be viewed as an insurance policy: 
an insurance policy for workers and patients and an insurance policy 
for hospitals.
  Mr. Speaker, I commend Mr. Ballenger and Mr. Owens for their 
leadership on this important issue. I also would like to commend 
forward-thinking companies like Becton-Dickinson of Bergen County, New 
Jersey, for their contribution to the development of this safe 
technology.
  I strongly urge my colleagues to vote in favor of this important 
legislation.
  Mr. OWENS. Mr. Speaker, I yield such time as he may consume to the 
gentleman from New Jersey (Mr. Andrews).
  Mr. ANDREWS. Mr. Speaker, I thank my friend, the gentleman from New 
York (Mr. Owens), for yielding me the time.
  Mr. Speaker, I rise in support of this legislation. I want to 
congratulate the gentleman from North Carolina (Mr. Ballenger) and the 
gentleman from New York (Mr. Owens), my friend, for their intelligence 
in bringing this to the floor.
  There are a lot of competing interests in this legislation, union and 
management, health care providers and product providers, and it was a 
substantial task to bring all of those parties together. The gentleman 
from North Carolina (Mr. Ballenger) and the gentleman from New York 
(Mr. Owens) took the lead in doing that, and I thank them and commend 
them for it.
  The gentleman from New York (Mr. Owens) said in his remarks that it 
is not an overstatement to say that this legislation will save peoples' 
lives; he is right. There are instances where people are injured and 
sometimes fatally injured as a result of injuries on the job that will 
be prevented as a result of passing this legislation.
  This is what we are here to do, to bring the two parties together and 
both sides of the bargaining table to make this happen. I know the 
gentleman from New York (Mr. Owens) in particular has been tenacious in 
pursuing this legislation for many numbers of years, and on behalf of 
my constituents, I thank him for it.
  I also thank the gentleman from Pennsylvania (Mr. Goodling) and the 
gentleman from Missouri (Mr. Clay) for their leadership of the full 
committee in bringing us here.
  I first heard about this legislation when members of the health care 
team, nurses, mainly, at the Camden County Health Services Center in my 
district visited me in my office here, they are members of the AFSCME 
union, and they had called it to the attention of their employer to 
voluntarily adopt a standard like this, which the employer, to its 
credit, did. That was then followed up here at the national level by 
any number of groups and interests to make sure that we could codify 
this effort by OSHA to balance the concerns of union and management, to 
balance all concerns and to write a good bill. I believe that we have 
done that.
  I also appreciate the way that this bill incorporates technological 
changes and does not wed itself to any particular technology. I applaud 
that, because I believe that it will permit the development and 
evolution of even greater technologies as time goes by.
  Mr. Speaker, I also applaud the fact that the bill reflects my own 
understanding that a device that does not use needles for the 
securement of devices for administration of medication or fluids and 
thereby diminishes or eliminates exposure to bloodborne pathogens 
clearly falls within the definition of a device that does not use 
needles for any other procedure involving the potential for 
occupational exposure to bloodborne pathogens due to the injuries from 
contaminated sharps.
  I think I followed that, not being a medical professional. In other 
words, that OSHA can find the very best technology available in any 
given time in the future to protect workers, that is what we are here 
to do.
  Mr. Speaker, I again thank the gentleman from North Carolina (Mr. 
Ballenger) and the gentleman from New York (Mr. Owens). I rise in 
enthusiastic support of the legislation and urge its unanimous 
approval.
  Mr. BALLENGER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Nebraska (Mr. Barrett).
  Mr. BARRETT of Nebraska. Mr. Speaker, I thank the gentleman from 
North Carolina (Mr. Ballenger) for yielding me this time, and I 
compliment him as well, the job that he did in bringing this bill to 
the floor.
  And I certainly am pleased to join with my colleagues in total 
support of H.R. 5178, the Needlestick Safety and Prevention Act. I 
think this is one of the major public health issues facing the health 
care community today, and I think it certainly deserves the attention 
of the Congress.
  According to the Department of Labor, as has already been mentioned, 
there are an estimated 800,000 needlestick injuries which occur in the 
United States each year, and this puts thousands of health care workers 
including nurses and doctors and CNAs and even custodians at the risk 
of accidental exposure to more than 20 pathogens, including HIV and 
Hepatitis B and C. In addition to protecting health care workers, 
Congress should be concerned about protecting every patient admitted to 
a hospital or treated at a clinic, because patients are also at risk of 
an accidental needlestick injury.
  A very crucial component of the comprehensive prevention program is 
the use of the so-called safe needles. These are needles designed to 
retract into the body of the syringe once it is used so it can then be 
disposed of with a much lower chance of an accidental needlestick. A 
company in my district, Becton-Dickinson is a leading manufacturer of 
these devices, and I am pleased that a company with Nebraska ties can 
play a role in addressing this very important public health concern.
  For the safety of health care workers and patients, this very 
important public health issue should not be overlooked. And I certainly 
extend my full support to the bill and urge its passage.
  Mr. OWENS. Mr. Speaker, I yield such time as he may consume to the 
gentleman from California (Mr. Thompson).
  Mr. THOMPSON of California. Mr. Speaker, I rise in strong support of 
this measure. I would like to thank the gentleman from North Carolina 
(Mr. Ballenger) and the gentleman from New York (Mr. Owens) for 
bringing this important bill to the floor today for this vote.
  H.R. 5178 is an important bill that I believe will truly make a 
difference in the lives of health care workers, patients and the 
families of both throughout this Nation. As was pointed out earlier, 
there is an estimated 800,000 needlesticks per year across this 
country. The potential for needlesticks put health care workers and 
patients at risk of contracting diseases, like Hepatitis C and B and 
HIV.
  In California, the results of legislation that I authored when in the 
State Senate found that most needlesticks could be prevented by using 
better designed safer needles and following stricter disposal 
protocols.
  This bill and these findings helped to lead to a 1998 mandate for 
safer needles in California. In addition to saving lives, it is 
estimated that in California, we will save over $100 million per year 
as a result of these safer needles. The savings are calculated by using 
the costs of disability payments, testing and treatment, lost wages, 
and liability costs.
  H.R. 5178 will require the use of safer needles, require more 
consistent documentation of needlestick injuries, and it establishes 
the stronger Federal uniform standard for the disposal and the usage of 
needles. It will save lives. It will save money, and it deserves the 
support of every Member of Congress.
  Mr. BALLENGER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Ohio (Mr. LaTourette).

[[Page 20590]]


  Mr. LaTOURETTE. Mr. Speaker, I want to commend the gentleman from 
North Carolina (Mr. Ballenger) for this bill, H.R. 5178, and commend 
him for his hard work in bringing it to the floor today.
  I also want to thank the gentleman from New York (Mr. Owens). I share 
their commitment to reducing the risk of exposure from men and women 
whose occupation places them in close proximity to bloodborne pathogens 
in the workplace.

                              {time}  1630

  H.R. 5178 amends the OSHA standards on blood-borne pathogens to 
include the definition of safer medical devices. I especially want to 
thank both gentlemen today for including that in their manager's 
statement of legislative intent, clarifying that it is not the intent 
of the legislation to limit in any way any engineering controls or 
safer medical devices to the few examples that are cited in the 
legislation.
  The statement offered today clearly expresses the intent of the 
bill's crafters to provide for innovative and evolving technology in 
our efforts to minimize risk.
  As the gentleman from North Carolina knows, I am particularly 
concerned about a device that is manufactured not surprisingly in my 
district by a fellow named Joe Adkins through his company, Safeguard 
Medical Devices. The product they have developed is roughly the size of 
a pocket pager, and is intended to be carried by all personnel who may 
encounter unsafe used syringes. It is designed to blunt and seal the 
end of the needle with a ``BB'' type ball that seals the syringe hub, 
further reducing the risk of downstream infection.
  The language thankfully included in the manager's statement leaves no 
doubt that products that minimize the risks of exposures to blood-borne 
pathogens, like the one developed by Safeguard Medical Devices, are 
intended to be covered by the broad language of section 3 in the bill 
referring to safer medical devices, and that the examples cited in the 
bill were intended to be illustrative, rather than exhaustive.
  For that, I thank the chairman and thank the gentleman from New York 
(Mr. Owens).
  Mr. OWENS. Madam Speaker, I yield myself such time as I may consume.
  Madam Speaker, I will enter into the Record a letter by Mr. Charles 
Loveless, director of legislation for the Association of Federal, 
State, County and Municipal Employees, the AFL-CIO.

                                              AFSCME, AFL-CIO,

                                  Washington, DC, October 2, 2000.
       Dear Representative: On behalf of the 1.3 million members 
     of the American Federation of State, County and Municipal 
     Employees (AFSCME), I urge you to support the Needlestick 
     Safety and Prevention Act (H.R. 5178), introduced by 
     Representatives Cass Ballenger and Major Owens.
       H.R. 5178 would amend the Occupational Safety and Health 
     Administration's (OSHA) Bloodborne Pathogens Standard to 
     require that employers use safety-designed needles and sharps 
     in order to reduce needlestick injuries and the transmission 
     of serious diseases from patients to nurses and other 
     workers. This important legislation codifies and refines a 
     compliance directive issued by OSHA late last year, after 
     seeking public input on the use of safer devices.
       Needlestick injuries are a serious, but preventable, public 
     health problem. Despite the availability of safer devices, 
     the vast majority of needles and sharps in use today are old-
     style devices that lack integrated safety features. As a 
     consequence, 600,000 to 800,000 needlestick injuries occur 
     each year in the health care workplace. Among those who 
     sustain such an injury, an estimated 1,000 contract a serious 
     disease, including Hepatitis C and HIV.
       H.R. 5178 is an important measure that will save lives. We 
     endorse this bipartisan bill and urge you to approve it.
           Sincerely,
                                              Charles M. Loveless,
                                          Director of Legislation.

  Madam Speaker, I have no additional speakers, and I yield back the 
balance of my time.
  Mr. BALLENGER. Madam Speaker, I yield 2 minutes to the gentlewoman 
from Maryland (Mrs. Morella).
  Mrs. MORELLA. Madam Speaker, I rise in strong support of H.R. 5178, 
the Needle Stick Safety and Prevention Act.
  I do want to thank the gentleman from North Carolina (Mr. Ballenger) 
for bringing this bill to the floor. I want to thank the ranking 
member, the gentleman from New York (Mr. Owens), for his role and 
leadership in bringing this bill before us. I am proud to be a 
cosponsor.
  This bipartisan legislation is designed to protect health care 
workers from needle stick injuries by updating the Occupational, 
Safety, and Health Administration's standards in order to address 
advances in safer medical devices such as needleless systems and 
needles that are specifically engineered for injury protection.
  Passage of H.R. 5178 would reduce the risk of HIV, hepatitis B, 
hepatitis C, that are caused by accidental needle sticks. This year, 
the Centers for Disease Control and Prevention estimated that more than 
380,000 needle stick injuries from contaminated needles occur annually 
among health care workers in our U.S. hospitals.
  The total number of needle stick and other skin-puncturing injuries 
in all health care settings is, as Members have heard before, 600,000 
to 800,000 annually.
  The CDC has also estimated that, depending on the type of device used 
and the procedure involved, that 62 to 82 percent of needle stick 
injuries can potentially be prevented by the use of safer medical 
devices.
  One particular needleless system has been developed by Calypte 
Biomedical Corporation of Rockville, Maryland. Long concerned about the 
risk of HIV transmission through accidental needle stick injuries, 
Calypte Biomedical manufactures FDA-approved, urine-based HIV 
diagnostic tests which would dramatically reduce needle stick 
accidents.
  This legislation is supported by the American Hospital Association, 
the American Nurses Association, a number of other agencies and 
organizations. It ensures that hospitals and other medical employers 
will have the flexibility to best protect their workers. I urge my 
colleagues to support it.
  Mr. BALLENGER. Madam Speaker, I yield 2 minutes to the gentleman from 
Georgia, (Mr. Isakson).
  Mr. ISAKSON. Madam Speaker, I thank the gentleman for yielding time 
to me, and commend him on this important issue, as well as the 
gentleman from New York (Mr. Owens) and his support.
  Madam Speaker, the transfer of blood-borne pathogens in this country 
is a problem in our hospitals and facilities, and it does threaten our 
health care leaders.
  Our chairman and author of this bill, the gentleman from North 
Carolina (Mr. Ballenger), has done a great job in holding hearings to 
bring about that information.
  I associate myself with the remarks of the gentleman from Ohio (Mr. 
LaTourette), the gentlewoman from Maryland (Mrs. Morella), and others 
who have understood the leadership that has been shown in this by not 
issuing a franchise to one single producer of a product that destroys 
needles, but rather, to acknowledge that every hospital and health care 
facility should select those products that are best for them, to have a 
clear and direct policy to minimize and we hope eliminate needle stick 
injuries and the transfer of possible dangerous germs and disease in 
their facility.
  The leadership the gentleman from North Carolina (Mr. Ballenger) has 
shown Americans and assured health care workers that the hospitals and 
medical workplaces of America will be safer. It has also ensured that 
incentive remains for the private sector to produce new and modern 
products that are safer and more efficient than those in the past, so 
hospitals can develop the very best possible policy to meet OSHA's, 
what I would add, very thoughtful rule in terms of developing these 
plans for every hospital in America.
  Mr. GILMAN. Madam Speaker, I rise today in support of H.R. 5178, the 
Needlestick Safety and Prevention Act. I applaud my colleague from 
North Carolina, Mr. Ballenger for his leadership on this issue and as a 
cosponsor of this legislation, I urge my colleagues to support this 
much needed bill.
  H.R. 5178 directs employers to consider, and where appropriate, use 
such safer medical devices to reduce the risk of needlesticks

[[Page 20591]]

and other injuries from sharps. Employers with employees who may be 
exposed to bloodborne pathogens are required to use safer medical 
devices only where such devices are appropriate, effective and 
commercially available. I have met with various nurses' groups over the 
years who have been pushing for the use of safer needles in hospitals 
and doctors' officers throughout the country. Although these safe 
needles tend to cost more than the average needle that is currently 
used, the safe needles protect health care professionals by featuring 
one of a number of new innovations such as a retractable needle.
  Moreover, H.R. 5178 calls for employers to maintain a sharps injury 
log to record sharps injuries and to call upon frontline health care 
workers who would actually use the devices in the selection of the 
devices. This will ensure that the people actually using the new 
needles will be comfortable with all aspects of the safe device.
  Accordingly, I urge my colleagues to protect our Nation's health care 
professionals and support this legislation.
  Mr. STARK. Madam Speaker, I am pleased to speak in support of H.R. 
5178, The Needlestick Safety and Prevention Act and urge all of my 
colleagues to join me in voting to protect nurses, doctors, and other 
health care workers from accidental needlestick injuries in the 
workplace.
  This legislation is long overdue. Health care workers across our 
country are put in danger each and every day because safe needle 
technologies that exist and are proven to reduce the risk of workplace 
needlestick injuries are still not widely used in our nation's health 
facilities.
  Through accidental needlesticks, health care workers are exposed to 
the spread of deadly bloodborne diseases such as AIDS and Hepatitis B 
and C. Estimates are that some 600,000 to one million needlesticks 
occur each year. While the vast majority of those injuries do not 
result in the spread of a bloodborne pathogen, those that do can prove 
debilitating and even fatal. Health care workers simply should not be 
forced to risk their lives while trying to save ours.
  Enactment of H.R. 5178 will dramatically lower the occurrence of 
accidental needlestick injuries by requiring the use of safer needle 
technology in our nation's health care system. This bill, like the 
legislation I co-authored with Representative Roukema (H.R. 1899), will 
dramatically improve needlestick protections for health care workers 
by: clarifying the bloodborne pathogens requirements regarding the use 
of safer needle devices, improving existing reporting requirements, and 
ensuring that health care workers are involved in the selection of 
appropriate safety devices.
  I have been working on this issue for many years. My first bill to 
protect health care workers from preventable needlestick injuries was 
introduced in 1993. In the last Congress, similar legislation gained 
the support of more than 100 of my colleagues. H.R. 1899, which 
Representative Roukema and I introduced together in this Congress, now 
has the bipartisan support of more than 185 of our colleagues.
  States have also begun focussing attention on this important issue. 
My home state of California was the first state to pass comprehensive 
legislation requiring the use of safe needle devices in 1998. Since 
then, more than a dozen states have followed course and passed 
legislation protecting health care workers their own borders.
  But, this is a national problem that deserves a national solution. 
That is why I am so pleased to join Representative Ballenger and 
Representative Owens in support of H.R. 5178 on the House floor today. 
I would also like to congratulate both of them for stepping into 
leadership roles on this vitally important safety issue for health care 
workers across the country.
  While I fully support the bill before us today, our work to protect 
health care workers from these injuries will not be complete even with 
passage of this important legislation. We need to go further. OSHA 
applies mainly to the private sector and therefore H.R. 5178 leaves 
health care workers in public hospitals in approximately 27 states 
without the same protections. We need to extend equivalent protections 
to these workers and I pledge to work with my colleagues to achieve 
this goal as well.
  Passage of H.R. 5178 will take us a long way toward minimizing the 
danger of needlestick injuries and potential infection by deadly 
diseases for the millions of health care workers across our country. 
Put simply, a yes vote for H.R. 5178 will save lives. I urge all of my 
colleagues to join me in voting yes.
  Mr. KUCINICH. Madam Speaker, I rise in strong support for H.R. 5178, 
the Needlestick Safety and Prevention Act. There are an estimated 
600,000 to 800,000 needlestick injuries each year. Over 80 percent of 
these injuries could have easily been prevented with the use of safer 
needle devices. Hospital nurses are the most frequently injured, 
followed by physicians, nursing assistants and housekeepers.
  A resident of Cleveland, Ohio, Mr. Stanley McKee, testified before 
the Ohio Senate regarding his needlestick injury. Mr. McKee works at a 
hospital in the environmental services department. He was disposing of 
the trash from the intensive care unit when he felt an object stick him 
in the leg. When he checked the bag he saw the used needle protruding 
out. For months, Mr. McKee was forced to undergo a series of shots 
until it could be determined whether he had indeed contracted an 
illness. The costly medical care he required and the severe mental 
anguish he experienced while awaiting news of his test results could 
have easily been prevented with safety devices as required in The 
Health Care Worker Needlestick Prevention Act, H.R. 5178. The average 
cost to test and treat a worker following an accidental stick where an 
infection does not occur is about $500. The costs to treat an employee 
who is infected from an accidental stick can total up to one million 
dollars over a person's life. However, these injuries can be prevented 
with safer needles that cost less than a postage stamp.
  This bill will save lives by drastically reducing the threat of 
contracting infectious diseases including hepatitis and the HIV virus 
through accidental needlesticks. Healthcare professionals dedicate 
their lives to caring for others. Let us show our appreciation and 
respect by working to pass this important legislation to ensure the 
safety of members of the healthcare community.
  I would like to thank Chairman Ballenger for leading the Subcommittee 
on Workplace Protections of the Committee on Education and the 
Workforce to report H.R. 5178 to the whole House of Representatives. I 
would also like to praise Rep. Fortney Pete Stark, whose many yeas of 
advocacy for needlestick safety laid the groundwork for today's bill. I 
urge a YES vote.
  Mr. BALLENGER. Madam Speaker, I have no further requests for time, 
and I yield back the balance of my time.
  The SPEAKER pro tempore (Mrs. Morella). The question is on the motion 
offered by the gentleman from North Carolina (Mr. Ballenger) that the 
House suspend the rules and pass the bill, H.R. 5178, as amended.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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