II

106TH CONGRESS

2D SESSION H. R. 5178

IN THE SENATE OF THE UNITED STATES

OCTOBER 4 (legislative day, SEPTEMBER 22), 2000

Received

AN ACT

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,
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1 SECTION 1. SHORT TITLE.

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

3 Prevention Act.’’

4 SEC. 2. FINDINGS.

5 The Congress finds the following:

6 (1) Numerous workers who are occupationally

7 exposed to bloodborne pathogens have contracted

8 fatal and other serious viruses and diseases, includ9 ing the human immunodeficiency virus (HIV), hepa10 titis B, and hepatitis C from exposure to blood and

11 other potentially infectious materials in their work12 place.

13 (2) In 1991 the Occupational Safety and

14 Health Administration issued a standard regulating

15 occupational exposure to bloodborne pathogens, in16 cluding the human immunodeficiency virus, (HIV),

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

18 virus (HCV).

19 (3) Compliance with the bloodborne pathogens

20 standard has significantly reduced the risk that

21 workers will contract a bloodborne disease in the

22 course of their work.

23 (4) Nevertheless, occupational exposure to

24 bloodborne pathogens from accidental sharps inju25 ries in health care settings continues to be a serious

26 problem. In March 2000, the Centers for Disease
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1 Control and Prevention estimated that more than

2 380,000 percutaneous injuries from contaminated

3 sharps occur annually among health care workers in

4 United States hospital settings. Estimates for all

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

6 needlestick and other percutaneous injuries occur

7 among health care workers annually. Such injuries

8 can involve needles or other sharps contaminated

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

10 HCV.

11 (5) Since publication of the bloodborne patho12 gens standard in 1991 there has been a substantial

13 increase in the number and assortment of effective

14 engineering controls available to employers. There is

15 now a large body of research and data concerning

16 the effectiveness of newer engineering controls, in17 cluding safer medical devices.

18 (6) 396 interested parties responded to a Re19 quest for Information (in this section referred to as

20 the ‘‘RFI’’) conducted by the Occupational Safety

21 and Health Administration in 1998 on engineering

22 and work practice controls used to eliminate or mini23 mize the risk of occupational exposure to bloodborne

24 pathogens due to percutaneous injuries from con25 taminated sharps. Comments were provided by
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1 health care facilities, groups representing healthcare

2 workers, researchers, educational institutions, pro3 fessional and industry associations, and manufactur4 ers of medical devices.

5 (7) Numerous studies have demonstrated that

6 the use of safer medical devices, such as needleless

7 systems and sharps with engineered sharps injury

8 protections, when they are part of an overall

9 bloodborne pathogens risk-reduction program, can be

10 extremely effective in reducing accidental sharps in11 juries.

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

13 Control and Prevention estimated that, depending

14 on the type of device used and the procedure in15 volved, 62 to 88 percent of sharps injuries can po16 tentially be prevented by the use of safer medical de17 vices.

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

19 maintained, does not sufficiently reflect injuries that

20 may involve exposure to bloodborne pathogens in

21 healthcare facilities. More than 98 percent of

22 healthcare facilities responding to the RFI have

23 adopted surveillance systems in addition to the

24 OSHA 200 Log. Information gathered through these

25 surveillance systems is commonly used for hazard
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1 identification and evaluation of program and device

2 effectiveness.

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

4 medical devices and safer work practices are signifi5 cant elements in the prevention of percutaneous ex6 posure incidents. Staff involvement in the device se7 lection and evaluation process is also an important

8 element to achieving a reduction in sharps injuries,

9 particularly as new safer devices are introduced into

10 the work setting.

11 (11) Modification of the bloodborne pathogens

12 standard is appropriate to set forth in greater detail

13 its requirement that employers identify, evaluate,

14 and make use of effective safer medical devices.

15 SEC. 3. BLOODBORNE PATHOGENS STANDARD.

16 The bloodborne pathogens standard published at 29

17 CFR 1910.1030 shall be revised as follows:

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

19 (at 29 CFR 1910.1030(b)) shall include as addi20 tional examples of controls the following: ‘‘safer

21 medical devices, such as sharps with engineered

22 sharps injury protections and needleless systems’’.

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

24 Injury Protections’’ shall be added to the definitions

25 (at 29 CFR 1910.1030(b)) and defined as ‘‘a non-
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1 needle sharp or a needle device used for withdrawing

2 body fluids, accessing a vein or artery, or admin3 istering medications or other fluids, with a built-in

4 safety feature or mechanism that effectively reduces

5 the risk of an exposure incident’’.

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

7 added to the definitions (at 29 CFR 1910.1030(b))

8 and defined as ‘‘a device that does not use needles

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

10 of body fluids after initial venous or arterial access

11 is established, (B) the administration of medication

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

13 potential for occupational exposure to bloodborne

14 pathogens due to percutaneous injuries from con15 taminated sharps’’.

16 (4) In addition to the existing requirements

17 concerning exposure control plans (29 CFR

18 1910.1030(c)(1)(iv)), the review and update of such

19 plans shall be required to also—

20 (A) ‘‘reflect changes in technology that

21 eliminate or reduce exposure to bloodborne

22 pathogens’’; and

23 (B) ‘‘document annually consideration and

24 implementation of appropriate commercially

25 available and effective safer medical devices de-
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1 signed to eliminate or minimize occupational ex2 posure’’.

3 (5) The following additional recordkeeping re4 quirement shall be added to the bloodborne patho5 gens standard at 29 CFR 1910.1030(h): ‘‘The em6 ployer shall establish and maintain a sharps injury

7 log for the recording of percutaneous injuries from

8 contaminated sharps. The information in the sharps

9 injury log shall be recorded and maintained in such

10 manner as to protect the confidentiality of the in11 jured employee. The sharps injury log shall contain,

12 at a minimum—

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

14 in the incident,

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

16 the exposure incident occurred, and

17 ‘‘(C) an explanation of how the incident oc18 curred.’’.

19 The requirement for such sharps injury log shall not

20 apply to any employer who is not required to main21 tain a log of occupational injuries and illnesses

22 under 29 CFR 1904 and the sharps injury log shall

23 be maintained for the period required by 29 CFR

24 1904.6.
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1 (6) The following new section shall be added to

2 the bloodborne pathogens standard: ‘‘An employer,

3 who is required to establish an Exposure Control

4 Plan shall solicit input from non-managerial employ5 ees responsible for direct patient care who are poten6 tially exposed to injuries from contaminated sharps

7 in the identification, evaluation, and selection of ef8 fective engineering and work practice controls and

9 shall document the solicitation in the Exposure Con10 trol Plan.’’.

11 SEC. 4. EFFECT OF MODIFICATIONS.

12 The modifications under section 3 shall be in force

13 until superseded in whole or in part by regulations promul14 gated by the Secretary of Labor under section 6(b) of the

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

16 655(b)) and shall be enforced in the same manner and

17 to the same extent as any rule or regulation promulgated

18 under section 6(b).

19 SEC. 5. PROCEDURE AND EFFECTIVE DATE.

20 (a) PROCEDURE.—The modifications of the

21 bloodborne pathogens standard prescribed by section 3

22 shall take effect without regard to the procedural require23 ments applicable to regulations promulgated under section

24 6(b) of the Occupational Safety and Health Act of 1970
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1 (29 U.S.C. 655(b)) or the procedural requirements of

2 chapter 5 of title 5, United States Code.

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

4 bloodborne pathogens standard required by section 3

5 shall—

6 (1) within 6 months of the date of the enact7 ment of this Act, be made and published in the Fed8 eral Register by the Secretary of Labor acting

9 through the Occupational Safety and Health Admin10 istration; and

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

12 take effect.

Passed the House of Representatives October 3,

2000.

Attest: JEFF TRANDAHL,

Clerk.