HR 1899 IH
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.
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 `Health Care Worker Needlestick Prevention
Act'.
SEC. 2. REQUIREMENTS.
(a) BLOODBORNE PATHOGENS STANDARD-
(1) IN GENERAL- Except as provided in paragraph (2), the Secretary of
Labor, acting through the Occupational Safety and Health Administration,
shall amend the bloodborne pathogens standard to require that--
(A) employers utilize needleless systems and sharps with engineered
sharps injury protections in their work sites to prevent the spread of
bloodborne pathogens; and
(B) to assist employers in meeting the requirement of subparagraph
(A), non-managerial direct care health care workers of employers
participate in the identification and evaluation of needleless systems and
sharps with engineered sharps injury protections.
(2) EXCEPTION- The bloodborne pathogens standard requirements of
paragraph (1) shall apply to any employer, except where the employer
demonstrates, to the Secretary's satisfaction, that--
(A) there are circumstances in the employer's work facility in which
the needleless systems and sharps with engineered sharps injury
protections do not promote employee safety, interfere with patient safety,
or interfere with the success of a medical procedure; or
(B) the needleless systems and sharps with engineered sharps injury
protections required are not commercially available to the
employer.
(b) STANDARD CONTENT- For carrying out the requirement of subsection
(a)(1) for needleless systems and sharps with engineered sharps injury
protections, the amendment required by subsection (a) shall include the
following:
(1) EXPOSURE CONTROL PLAN- The employer shall include in their exposure
control plan an effective procedure for identifying and selecting existing
needleless systems and sharps with engineered sharps injury protections and
other methods of preventing bloodborne pathogens exposure.
(2) SHARPS INJURY LOG- In addition to the recording of all injuries from
contaminated sharps on the OSHA Occupational Injuries and Illnesses 200 log
or its equivalent, the employer shall maintain a separate contaminated
sharps injury log containing the following information (to the extent such
information is known to the employer) with regard to each exposure
incident:
(A) Date and time of the exposure incident.
(B) Type and brand of sharp involved in the exposure
incident.
(C) Description of the exposure incident which shall
include--
(i) job classification of the exposed employee;
(ii) department or work area where the exposure incident
occurred;
(iii) the procedure that the exposed employee was performing at the
time of the incident;
(iv) how the incident occurred;
(v) the body part involved in the exposure incident;
(vi) if the sharp had engineered sharps injury
protections--
(I) whether the protective mechanism was activated, and whether
the injury occurred before the protective mechanism was activated,
during activation of the mechanism, or after activation of the
mechanism, if applicable; and
(II) whether the employee received training on how to use the
device before use, and a brief description of the
training;
(vii) if the sharp had no engineered sharps injury protections, the
injured employee's opinion as to whether and how such a mechanism could
have prevented the injury, as well as the basis for the opinion;
and
(viii) the employee's opinion about whether any other engineering,
administrative, or work practice control could have prevented the injury
as well as the basis for the opinion.
(3) TRAINING- A requirement that all direct care health care workers
shall be provided adequate training on the use of all needleless systems and
sharps with engineered sharps injury protections which they may be required
to use.
SEC. 3. NATIONAL CLEARINGHOUSE ON SAFER NEEDLE TECHNOLOGY.
(a) IN GENERAL- The Director of the National Institute for Occupational
Safety and Health shall establish and maintain a national database on existing
needleless
systems and sharps with engineered sharps injury protections.
(b) EVALUATION CRITERIA- The Director shall develop a set of evaluation
criteria for use by employers, employees, and other persons when they are
evaluating and selecting needleless systems and sharps with engineered sharps
injury protections.
(c) TRAINING- The Director shall develop a model training curriculum to
train employers, employees, and other persons on the process of evaluating
needleless systems and sharps with engineered sharps injury protections and
shall (to the extent feasible) provide technical assistance to persons who
request such assistance.
(d) MONITORING- The Director shall establish a national system to collect
comprehensive data on needlestick injuries to healthcare workers, including
data on mechanisms to analyze and evaluate prevention interventions in
relation to needlestick injury occurrence. In carrying out its duties under
this subsection, the National Institute for Occupational Safety and Health
shall have access to information recorded by employers on the sharps injury
log as required by section 2(b)(2).
(e) AUTHORIZATION- There is authorized to be appropriated $15,000,000 to
the National Institute of Occupational Safety and Health to carry out the
requirements of this section.
SEC. 4. DEFINITIONS.
For purposes of this Act:
(1) BLOODBORNE PATHOGENS- The term `bloodborne pathogens' means
pathogenic microorganisms that are present in human blood and can cause
disease in humans. These pathogens include hepatitis B virus, hepatitis C
virus, and human immunodeficiency virus.
(2) CONTAMINATED- The term `contaminated' means the presence or the
reasonably anticipated presence of blood or other potentially infectious
materials on an item or surface.
(3) DIRECT CARE HEALTH CARE WORKER- The term `direct care health care
worker' means an employee responsible for direct patient care with potential
occupational exposure to sharps related injuries.
(4) EMPLOYER- The term `employer' means each employer having an employee
with occupational exposure to human blood or other material potentially
containing bloodborne pathogens.
(5) ENGINEERED SHARPS INJURY PROTECTIONS- The term `engineered sharps
injury protections' means--
(A) a physical attribute built into a needle device used for
withdrawing body fluids, accessing a vein or artery, or administering
medications or other fluids, that effectively reduces the risk of an
exposure incident by a mechanism such as barrier creation, blunting,
encapsulation, withdrawal, retraction, destruction, or other effective
mechanisms; or
(B) a physical attribute built into any other type of needle device,
or into a nonneedle sharp, which effectively reduces the risk of an
exposure incident.
(6) NEEDLELESS SYSTEM- The term `needleless system' means a device that
does not use needles for--
(A) the withdrawal of body fluids after initial venous or arterial
access is established;
(B) the administration of medication or fluids; and
(C) any other procedure involving the potential for an exposure
incident.
(7) SHARP- The term `sharp' means any object used or encountered in a
health care setting that can be reasonably anticipated to penetrate the skin
or any other part of the body, and to result in an exposure incident,
including, but not limited to, needle devices, scalpels, lancets, broken
glass, broken capillary tubes, exposed ends of dental wires and dental
knives, drills, and burs.
(8) SHARPS INJURY- The term `sharps injury' means any injury caused by a
sharp, including cuts, abrasions, or needlesticks.
(9) SHARPS INJURY LOG- The term `sharps injury log' means a written or
electronic record satisfying the requirements of section 2(b)(2).
SEC. 5. APPLICATION TO MEDICARE HOSPITALS.
The Secretary of Health and Human Services shall provide by regulation
that, as a condition of participation under the medicare program under title
XVIII of the Social Security Act of a hospital that is not otherwise subject
to the bloodborne pathogens standard amended under section 2(a) because it is
exempt from regulation by the Occupational Safety and Health Administration,
the hospital shall comply with the bloodborne pathogen standard amended under
section 2(a) with respect to any employees of the hospital, effective at the
same time as such amended standard would have applied to the hospital if it
had not been so exempt.
SEC. 6. EFFECTIVE DATE.
This Act shall become effective upon the date of its enactment, except
that the Secretary of Labor shall take the action required by section 2 within
one year of such date.
END