I

106TH CONGRESS

2D SESSION H. R. 5178

To require changes in the bloodborne pathogens standard in effect under

the Occupational Safety and Health Act of 1970

IN THE HOUSE OF REPRESENTATIVES

SEPTEMBER 14, 2000

Mr. BALLENGER (for himself and Mr. OWENS) introduced the following bill;

which was referred to the Committee on Education and the Workforce

A BILL

To require changes in the bloodborne pathogens standard

in effect under the Occupational Safety and Health Act

of 1970

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Needlestick Safety and

5 Prevention Act.’’

6 SEC. 2. FINDINGS.

7 The Congress finds the following:

8 (1) Numerous workers who are occupationally

9 exposed to bloodborne pathogens have contracted

10 fatal and other serious viruses and diseases, includ-
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1 ing the human immunodeficiency virus (HIV), hepa2 titis B, and hepatitis C from exposure to blood and

3 other potentially infectious materials in their work4 place.

5 (2) In 1991 the Occupational Safety and

6 Health Administration issued a standard regulating

7 occupational exposure to bloodborne pathogens, in8 cluding the human immunodeficiency virus, (HIV),

9 the hepatitis B virus (HBV), and the hepatitis C

10 virus (HCV).

11 (3) Compliance with the bloodborne pathogens

12 standard has significantly reduced the risk that

13 workers will contract a bloodborne disease in the

14 course of their work.

15 (4) Nevertheless, occupational exposure to

16 bloodborne pathogens from accidental sharps inju17 ries in health care settings continues to be a serious

18 problem. In March 2000, the Centers for Disease

19 Control and Prevention estimated that more than

20 380,000 percutaneous injuries from contaminated

21 sharps occur annually among health care workers in

22 United States hospital settings. Estimates for all

23 health care settings are that 600,000 to 800,000

24 needlestick and other percutaneous injuries occur

25 among health care workers annually. Such injuries
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1 can involve needles or other sharps contaminated

2 with bloodborne pathogens, such as HIV, HBV, or

3 HCV.

4 (5) Since publication of the bloodborne patho5 gens standard in 1991 there has been a substantial

6 increase in the number and assortment of effective

7 engineering controls available to employers. There is

8 now a large body of research and data concerning

9 the effectiveness of newer engineering controls, in10 cluding safer medical devices.

11 (6) 396 interested parties responded to a Re12 quest for Information (in this section referred to as

13 the ‘‘RFI’’) conducted by the Occupational Health

14 and Safety Administration in 1998 on engineering

15 and work practice controls used to eliminate or mini16 mize the risk of occupational exposure to bloodborne

17 pathogens due to percutaneous injuries from con18 taminated sharps. Comments were provided by

19 health care facilities, groups representing healthcare

20 workers, researchers, educational institutions, pro21 fessional and industry associations, and manufactur22 ers of medical devices.

23 (7) Numerous studies have demonstrated that

24 the use of safer medical devices, such as needleless

25 systems and sharps with engineered sharps injury
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1 protections, when they are part of an overall

2 bloodborne pathogens risk-reduction program, can be

3 extremely effective in reducing accidental sharps in4 juries.

5 (8) In March 2000, the Centers for Disease

6 Control and Prevention estimated that, depending

7 on the type of device used and the procedure in8 volved, 62 to 88 percent of sharps injuries can po9 tentially be prevented by the use of safer medical de10 vices.

11 (9) The OSHA 200 Log, as it is currently

12 maintained, does not sufficiently reflect injuries that

13 may involve exposure to bloodborne pathogens in

14 healthcare facilities. More than 98 percent of

15 healthcare facilities responding to the RFI have

16 adopted surveillance systems in addition to the

17 OSHA 200 Log. Information gathered through these

18 surveillance systems is commonly used for hazard

19 identification and evaluation of program and device

20 effectiveness.

21 (10) Training and education in the use of safer

22 medical devices and safer work practices are signifi23 cant elements in the prevention of percutaneous ex24 posure incidents. Staff involvement in the device se25 lection and evaluation process is also an important
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1 element to achieving a reduction in sharps injuries,

2 particularly as new safer devices are introduced into

3 the work setting.

4 (11) Modification of the bloodborne pathogens

5 standard is appropriate to set forth in greater detail

6 its requirement that employers identify, evaluate,

7 and make use of effective safer medical devices.

8 SEC. 3. BLOODBORNE PATHOGENS STANDARD.

9 The bloodborne pathogens standard published at 29

10 CFR 1910.1030 shall be revised as follows:

11 (1) The definition of ‘‘Engineering Controls’’

12 (at 29 CFR 1930.1030(b)) shall include as addi13 tional examples of controls the following: ‘‘safer

14 medical devices, such as sharps with engineered

15 sharps injury protections and needleless systems’’.

16 (2) The term ‘‘Sharps with Engineered Sharps

17 Injury Protections’’ shall be added to the definitions

18 (at 29 CFR 1910.1030(b)) and defined as ‘‘a non19 needle sharp or a needle device used for withdrawing

20 body fluids, accessing a vein or artery, or admin21 istering medications or other fluids, with a built-in

22 safety feature or mechanism that effectively reduces

23 the risk of an exposure incident’’.

24 (3) The term ‘‘Needleless Systems’’ shall be

25 added to the definitions (at 29 CFR 1910.1030(b))
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1 and defined as ‘‘a device that does not use needles

2 for (A) the collection of bodily fluids or withdrawal

3 of body fluids after initial venous or arterial access

4 is established, (B) the administration of medication

5 or fluids, or (C) any other procedure involving the

6 potential for occupational exposure to bloodborne

7 pathogens due to percutaneous injuries from con8 taminated sharps’’.

9 (4) In addition to the existing requirements

10 concerning exposure control plans (29 CFR

11 1910.1030(c)(1)(iv)), the review and update of such

12 plans shall be required to also—

13 (A) ‘‘reflect changes in technology that

14 eliminate or reduce exposure to bloodborne

15 pathogens’’; and

16 (B) ‘‘document consideration and imple17 mentation of appropriate commercially available

18 and effective safer medical devices designed to

19 eliminate or minimize occupational exposure’’.

20 (5) The following additional recordkeeping re21 quirement shall be added to the bloodborne patho22 gens standard at 29 CFR 1910.1030(h): ‘‘The em23 ployer shall establish and maintain a sharps injury

24 log for the recording of percutaneous injuries from

25 contaminated sharps. The information in the sharps
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1 injury log shall be recorded and maintained in such

2 manner as to protect the confidentiality of the in3 jured employee. The sharps injury log shall contain,

4 at a minimum—

5 ‘‘(A) the type and brand of device involved

6 in the incident,

7 ‘‘(B) the department or work area where

8 the exposure incident occurred, and

9 ‘‘(C) an explanation of how the incident oc10 curred.’’.

11 The requirement for such sharps injury log shall not

12 apply to any employer who is not required to main13 tain a log of occupational injuries and illnesses

14 under 29 CFR 1904 and the sharps injury log shall

15 be maintained for the period required by 29 CFR

16 1904.6.

17 (6) The following new section shall be added to

18 the bloodborne pathogens standard: ‘‘An employer,

19 who is required to establish an Exposure Control

20 Plan shall solicit input from non-managerial employ21 ees responsible for direct patient care who are poten22 tially exposed to injuries from contaminated sharps

23 in the identification, evaluation, and selection of ef24 fective engineering and work practice controls and
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1 shall document the solicitation in the Exposure Con2 trol Plan.’’.

3 SEC. 4. EFFECT OF MODIFICATIONS.

4 The modifications under section 3 shall be in force

5 until superseded in whole or in part by regulations promul6 gated by the Secretary of Labor under section 6(b) of the

7 Occupational Safety and Health Act of 1970 (29 U.S.C.

8 655(b)) and shall be enforced in the same manner and

9 to the same extent as any rule or regulation promulgated

10 under section 6(b).

11 SEC. 5. PROCEDURE AND EFFECTIVE DATE.

12 (a) PROCEDURE.—The modifications of the

13 bloodborne pathogens standard prescribed by section 3

14 shall take effect without regard to the procedural require15 ments applicable to regulations promulgated under section

16 6(b) of the Occupational Safety and Health Act of 1970

17 (29 U.S.C. 655(b)) or the procedural requirements of

18 chapter 5 of title 5, United States Code.

19 (b) EFFECTIVE DATE.—The modifications to the

20 bloodborne pathogens standard required by section 3

21 shall—

22 (1) within 6 months of the date of enactment

23 of this Act, be made and published in the Federal

24 Register by the Secretary of Labor acting through
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1 the Occupational Safety and Health Administration;

2 and

3 (2) at the end of 90 days after such publication,

4 take effect.

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