S 1140 IS1S

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To require the Secretary of Labor to issue regulations to eliminate or minimize the significant risk of needlestick injury to health care workers.

May 26, 1999

Mrs. BOXER (for herself and Mr. REID) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

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 health care 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 1 year of such date.

END