II

106TH CONGRESS

2D SESSION S. 3067

To require changes in the bloodborne pathogens standard in effect under

the Occupational Safety and Health Act of 1970

IN THE SENATE OF THE UNITED STATES

SEPTEMBER 19, 2000

Mr. JEFFORDS (for himself, Mr. ENZI, Mr. KENNEDY, and Mr. REID) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

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 Congress makes the following findings:

8 (1) Numerous workers who are occupationally

9 exposed to bloodborne pathogens have contracted
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1 fatal and other serious viruses and diseases, includ2 ing the human immunodeficiency virus (HIV), hepa3 titis B, and hepatitis C from exposure to blood and

4 other potentially infectious materials in their work5 place.

6 (2) In 1991 the Occupational Safety and

7 Health Administration issued a standard regulating

8 occupational exposure to bloodborne pathogens, in9 cluding the human immunodeficiency virus, (HIV),

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

11 virus (HCV).

12 (3) Compliance with the bloodborne pathogens

13 standard has significantly reduced the risk that

14 workers will contract a bloodborne disease in the

15 course of their work.

16 (4) Nevertheless, occupational exposure to

17 bloodborne pathogens from accidental sharps inju18 ries in health care settings continues to be a serious

19 problem. In March 2000, the Centers for Disease

20 Control and Prevention estimated that more than

21 380,000 percutaneous injuries from contaminated

22 sharps occur annually among health care workers in

23 United States hospital settings. Estimates for all

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

25 needlestick and other percutaneous injuries occur
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1 among health care workers annually. Such injuries

2 can involve needles or other sharps contaminated

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

4 HCV.

5 (5) Since publication of the bloodborne patho6 gens standard in 1991 there has been a substantial

7 increase in the number and assortment of effective

8 engineering controls available to employers. There is

9 now a large body of research and data concerning

10 the effectiveness of newer engineering controls, in11 cluding safer medical devices.

12 (6) 396 interested parties responded to a Re13 quest for Information (in this section referred to as

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

15 and Safety Administration in 1998 on engineering

16 and work practice controls used to eliminate or mini17 mize the risk of occupational exposure to bloodborne

18 pathogens due to percutaneous injuries from con19 taminated sharps. Comments were provided by

20 health care facilities, groups representing health care

21 workers, researchers, educational institutions, pro22 fessional and industry associations, and manufactur23 ers of medical devices.

24 (7) Numerous studies have demonstrated that

25 the use of safer medical devices, such as needleless
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1 systems and sharps with engineered sharps injury

2 protections, when they are part of an overall

3 bloodborne pathogens risk-reduction program, can be

4 extremely effective in reducing accidental sharps in5 juries.

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

7 Control and Prevention estimated that, depending

8 on the type of device used and the procedure in9 volved, 62 to 88 percent of sharps injuries can po10 tentially be prevented by the use of safer medical de11 vices.

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

13 maintained, does not sufficiently reflect injuries that

14 may involve exposure to bloodborne pathogens in

15 health care facilities. More than 98 percent of health

16 care facilities responding to the RFI have adopted

17 surveillance systems in addition to the OSHA 200

18 Log. Information gathered through these surveil19 lance systems is commonly used for hazard identi20 fication and evaluation of program and device effec21 tiveness.

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

23 medical devices and safer work practices are signifi24 cant elements in the prevention of percutaneous ex25 posure incidents. Staff involvement in the device se-
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1 lection and evaluation process is also an important

2 element to achieving a reduction in sharps injuries,

3 particularly as new safer devices are introduced into

4 the work setting.

5 (11) Modification of the bloodborne pathogens

6 standard is appropriate to set forth in greater detail

7 its requirement that employers identify, evaluate,

8 and make use of effective safer medical devices.

9 SEC. 3. BLOODBORNE PATHOGENS STANDARD.

10 The bloodborne pathogens standard published at 29

11 CFR 1910.1030 shall be revised as follows:

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

13 (at 29 CFR 1930.1030(b)) shall include as addi14 tional examples of controls the following: ‘‘safer

15 medical devices, such as sharps with engineered

16 sharps injury protections and needleless systems’’.

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

18 Injury Protections’’ shall be added to the definitions

19 (at 29 CFR 1910.1030(b)) and defined as ‘‘a non20 needle sharp or a needle device used for withdrawing

21 body fluids, accessing a vein or artery, or admin22 istering medications or other fluids, with a built-in

23 safety feature or mechanism that effectively reduces

24 the risk of an exposure incident’’.
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1 (3) The term ‘‘Needleless Systems’’ shall be

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

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

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

5 of body fluids after initial venous or arterial access

6 is established, (B) the administration of medication

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

8 potential for occupational exposure to bloodborne

9 pathogens due to percutaneous injuries from con10 taminated sharps’’.

11 (4) In addition to the existing requirements

12 concerning exposure control plans (29 CFR

13 1910.1030(c)(1)(iv)), the review and update of such

14 plans shall be required to also—

15 (A) ‘‘reflect changes in technology that

16 eliminate or reduce exposure to bloodborne

17 pathogens’’; and

18 (B) ‘‘document consideration and imple19 mentation of appropriate commercially available

20 and effective safer medical devices designed to

21 eliminate or minimize occupational exposure’’.

22 (5) The following additional recordkeeping re23 quirement shall be added to the bloodborne patho24 gens standard at 29 CFR 1910.1030(h): ‘‘The em25 ployer shall establish and maintain a sharps injury
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1 log for the recording of percutaneous injuries from

2 contaminated sharps. The information in the sharps

3 injury log shall be recorded and maintained in such

4 manner as to protect the confidentiality of the in5 jured employee. The sharps injury log shall contain,

6 at a minimum—

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

8 in the incident,

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

10 the exposure incident occurred, and

11 ‘‘(C) an explanation of how the incident oc12 curred.’’.

13 The requirement for such sharps injury log shall not

14 apply to any employer who is not required to main15 tain a log of occupational injuries and illnesses

16 under 29 CFR 1904 and the sharps injury log shall

17 be maintained for the period required by 29 CFR

18 1904.6.

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

20 the bloodborne pathogens standard: ‘‘An employer,

21 who is required to establish an Exposure Control

22 Plan shall solicit input from non-managerial employ23 ees responsible for direct patient care who are poten24 tially exposed to injuries from contaminated sharps

25 in the identification, evaluation, and selection of ef-
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1 fective engineering and work practice controls and

2 shall document the solicitation in the Exposure Con3 trol Plan.’’.

4 SEC. 4. EFFECT OF MODIFICATIONS.

5 The modifications under section 3 shall be in force

6 until superseded in whole or in part by regulations promul7 gated by the Secretary of Labor under section 6(b) of the

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

9 655(b)) and shall be enforced in the same manner and

10 to the same extent as any rule or regulation promulgated

11 under section 6(b).

12 SEC. 5. PROCEDURE AND EFFECTIVE DATE.

13 (a) PROCEDURE.—The modifications of the

14 bloodborne pathogens standard prescribed by section 3

15 shall take effect without regard to the procedural require16 ments applicable to regulations promulgated under section

17 6(b) of the Occupational Safety and Health Act of 1970

18 (29 U.S.C. 655(b)) or the procedural requirements of

19 chapter 5 of title 5, United States Code.

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

21 bloodborne pathogens standard required by section 3

22 shall—

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

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

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

2 and

3 (2) take effect on the date that is 90 days after

4 the date of such publication.

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