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106TH CONGRESS

1ST SESSION H. R. 1899

To require the Secretary of Labor to issue regulations to eliminate or

minimize the significant risk of needlestick injury to health care workers.

IN THE HOUSE OF REPRESENTATIVES

MAY 20, 1999

Mr. STARK (for himself, Mrs. ROUKEMA, Mr. GEORGE MILLER of California,

and Mr. ANDREWS) introduced the following bill; which was referred to

the Committee on Education and the Workforce, and in addition to the

Committees on Commerce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of

such provisions as fall within the jurisdiction of the committee concerned

A BILL

To require the Secretary of Labor to issue regulations to

eliminate or minimize the significant risk of needlestick

injury to health care workers.

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 ‘‘Health Care Worker

5 Needlestick Prevention Act’’.

6 SEC. 2. REQUIREMENTS.

7 (a) BLOODBORNE PATHOGENS STANDARD.—
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1 (1) IN GENERAL.—Except as provided in para2 graph (2), the Secretary of Labor, acting through

3 the Occupational Safety and Health Administration,

4 shall amend the bloodborne pathogens standard to

5 require that—

6 (A) employers utilize needleless systems

7 and sharps with engineered sharps injury pro8 tections in their work sites to prevent the

9 spread of bloodborne pathogens; and

10 (B) to assist employers in meeting the re11 quirement of subparagraph (A), non-managerial

12 direct care health care workers of employers

13 participate in the identification and evaluation

14 of needleless systems and sharps with engi15 neered sharps injury protections.

16 (2) EXCEPTION.—The bloodborne pathogens

17 standard requirements of paragraph (1) shall apply

18 to any employer, except where the employer dem19 onstrates, to the Secretary’s satisfaction, that—

20 (A) there are circumstances in the employ21 er’s work facility in which the needleless sys22 tems and sharps with engineered sharps injury

23 protections do not promote employee safety,

24 interfere with patient safety, or interfere with

25 the success of a medical procedure; or
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1 (B) the needleless systems and sharps with

2 engineered sharps injury protections required

3 are not commercially available to the employer.

4 (b) STANDARD CONTENT.—For carrying out the re5 quirement of subsection (a)(1) for needleless systems and

6 sharps with engineered sharps injury protections, the

7 amendment required by subsection (a) shall include the

8 following:

9 (1) EXPOSURE CONTROL PLAN.—The employer

10 shall include in their exposure control plan an effec11 tive procedure for identifying and selecting existing

12 needleless systems and sharps with engineered

13 sharps injury protections and other methods of pre14 venting bloodborne pathogens exposure.

15 (2) SHARPS INJURY LOG.—In addition to the

16 recording of all injuries from contaminated sharps

17 on the OSHA Occupational Injuries and Illnesses

18 200 log or its equivalent, the employer shall main19 tain a separate contaminated sharps injury log con20 taining the following information (to the extent such

21 information is known to the employer) with regard

22 to each exposure incident:

23 (A) Date and time of the exposure inci24 dent.
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1 (B) Type and brand of sharp involved in

2 the exposure incident.

3 (C) Description of the exposure incident

4 which shall include—

5 (i) job classification of the exposed

6 employee;

7 (ii) department or work area where

8 the exposure incident occurred;

9 (iii) the procedure that the exposed

10 employee was performing at the time of

11 the incident;

12 (iv) how the incident occurred;

13 (v) the body part involved in the expo14 sure incident;

15 (vi) if the sharp had engineered

16 sharps injury protections—

17 (I) whether the protective mecha18 nism was activated, and whether the

19 injury occurred before the protective

20 mechanism was activated, during acti21 vation of the mechanism, or after acti22 vation of the mechanism, if applicable;

23 and

24 (II) whether the employee re25 ceived training on how to use the de-
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1 vice before use, and a brief description

2 of the training;

3 (vii) if the sharp had no engineered

4 sharps injury protections, the injured em5 ployee’s opinion as to whether and how

6 such a mechanism could have prevented

7 the injury, as well as the basis for the

8 opinion; and

9 (viii) the employee’s opinion about

10 whether any other engineering, administra11 tive, or work practice control could have

12 prevented the injury as well as the basis

13 for the opinion.

14 (3) TRAINING.—A requirement that all direct

15 care health care workers shall be provided adequate

16 training on the use of all needleless systems and

17 sharps with engineered sharps injury protections

18 which they may be required to use.

19 SEC. 3. NATIONAL CLEARINGHOUSE ON SAFER NEEDLE

20 TECHNOLOGY.

21 (a) IN GENERAL.—The Director of the National In22 stitute for Occupational Safety and Health shall establish

23 and maintain a national database on existing needleless

24 systems and sharps with engineered sharps injury protec25 tions.
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1 (b) EVALUATION CRITERIA.—The Director shall de2 velop a set of evaluation criteria for use by employers, em3 ployees, and other persons when they are evaluating and

4 selecting needleless systems and sharps with engineered

5 sharps injury protections.

6 (c) TRAINING.—The Director shall develop a model

7 training curriculum to train employers, employees, and

8 other persons on the process of evaluating needleless sys9 tems and sharps with engineered sharps injury protections

10 and shall (to the extent feasible) provide technical assist11 ance to persons who request such assistance.

12 (d) MONITORING.—The Director shall establish a na13 tional system to collect comprehensive data on needlestick

14 injuries to healthcare workers, including data on mecha15 nisms to analyze and evaluate prevention interventions in

16 relation to needlestick injury occurrence. In carrying out

17 its duties under this subsection, the National Institute for

18 Occupational Safety and Health shall have access to infor19 mation recorded by employers on the sharps injury log as

20 required by section 2(b)(2).

21 (e) AUTHORIZATION.—There is authorized to be ap22 propriated $15,000,000 to the National Institute of Occu23 pational Safety and Health to carry out the requirements

24 of this section.
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1 SEC. 4. DEFINITIONS.

2 For purposes of this Act:

3 (1) BLOODBORNE PATHOGENS.—The term

4 ‘‘bloodborne pathogens’’ means pathogenic micro5 organisms that are present in human blood and can

6 cause disease in humans. These pathogens include

7 hepatitis B virus, hepatitis C virus, and human im8 munodeficiency virus.

9 (2) CONTAMINATED.—The term ‘‘contami10 nated’’ means the presence or the reasonably antici11 pated presence of blood or other potentially infec12 tious materials on an item or surface.

13 (3) DIRECT CARE HEALTH CARE WORKER.—

14 The term ‘‘direct care health care worker’’ means an

15 employee responsible for direct patient care with po16 tential occupational exposure to sharps related inju17 ries.

18 (4) EMPLOYER.—The term ‘‘employer’’ means

19 each employer having an employee with occupational

20 exposure to human blood or other material poten21 tially containing bloodborne pathogens.

22 (5) ENGINEERED SHARPS INJURY PROTEC23 TIONS.—The term ‘‘engineered sharps injury protec24 tions’’ means—

25 (A) a physical attribute built into a needle

26 device used for withdrawing body fluids, access-
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1 ing a vein or artery, or administering medica2 tions or other fluids, that effectively reduces the

3 risk of an exposure incident by a mechanism

4 such as barrier creation, blunting, encapsula5 tion, withdrawal, retraction, destruction, or

6 other effective mechanisms; or

7 (B) a physical attribute built into any

8 other type of needle device, or into a nonneedle

9 sharp, which effectively reduces the risk of an

10 exposure incident.

11 (6) NEEDLELESS SYSTEM.—The term

12 ‘‘needleless system’’ means a device that does not

13 use needles for—

14 (A) the withdrawal of body fluids after ini15 tial venous or arterial access is established;

16 (B) the administration of medication or

17 fluids; and

18 (C) any other procedure involving the po19 tential for an exposure incident.

20 (7) SHARP.—The term ‘‘sharp’’ means any ob21 ject used or encountered in a health care setting

22 that can be reasonably anticipated to penetrate the

23 skin or any other part of the body, and to result in

24 an exposure incident, including, but not limited to,

25 needle devices, scalpels, lancets, broken glass, broken
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1 capillary tubes, exposed ends of dental wires and

2 dental knives, drills, and burs.

3 (8) SHARPS INJURY.—The term ‘‘sharps in4 jury’’ means any injury caused by a sharp, including

5 cuts, abrasions, or needlesticks.

6 (9) SHARPS INJURY LOG.—The term ‘‘sharps

7 injury log’’ means a written or electronic record sat8 isfying the requirements of section 2(b)(2).

9 SEC. 5. APPLICATION TO MEDICARE HOSPITALS.

10 The Secretary of Health and Human Services shall

11 provide by regulation that, as a condition of participation

12 under the medicare program under title XVIII of the So13 cial Security Act of a hospital that is not otherwise subject

14 to the bloodborne pathogens standard amended under sec15 tion 2(a) because it is exempt from regulation by the Oc16 cupational Safety and Health Administration, the hospital

17 shall comply with the bloodborne pathogen standard

18 amended under section 2(a) with respect to any employees

19 of the hospital, effective at the same time as such amended

20 standard would have applied to the hospital if it had not

21 been so exempt.

22 SEC. 6. EFFECTIVE DATE.

23 This Act shall become effective upon the date of its

24 enactment, except that the Secretary of Labor shall take
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1 the action required by section 2 within one year of such

2 date.

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