Copyright 1999 The Chronicle Publishing Co.
The San
Francisco Chronicle
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MARCH 17, 1999, WEDNESDAY, FINAL EDITION
SECTION: NEWS; Pg. A1
LENGTH: 1106 words
HEADLINE:
Hospitals, Clinics Tell Of Needle Sticks;
In reports,
many ask that OSHA require the use of safety devices
BYLINE: William Carlsen, Chronicle Staff Writer
DATELINE: Washington, D.C.
BODY:
Hundreds of the nation's medical facilities
have documented high rates of needle sticks among their workers
and report that safe needle devices dramatically reduce the number of
potentially deadly injuries.
More than 600 reports from hospitals,
clinics and other medical facilities are under review by the U.S. Occupational
Safety and Health Administration. The reports, filed last fall, overwhelmingly
support calls for medical facilities to provide safety needles to their workers
-- and increase pressure on the workplace safety agency to direct those
facilities to do so.
"It's criminal that OSHA has not acted (on these
responses), while health care workers continue to die," said Andy Stern,
president of the Service Employees International Union. "Safe technology is on
the market and it is now being used successfully, as these OSHA responses show.
There's no excuse now for the government to delay." Last summer, OSHA put out a
request to medical centers across the country for feedback on the extent of
needle stick injuries and specifically asked whether safety devices were
working.
Over the next several months, reports from medical facilities
of every size and from nearly every state poured into the agency's Washington
headquarters.
The responses reveal that needle-stick injuries are a
serious and pervasive problem, and that the use of safety needles has led to
significant declines in needles injuries.
"Implementing safety devices
has been most effec-
tive at the medical center," was a typical response
from Karen Miller, an infection control specialist at the 400-bed Borgess
Medical Center in Kalamazoo, Mich. "There was an 86 percent drop in sharps
injuries (in blood collection) in one year."
The response was similar at
Logan Hospital and Medical Center, a 50-bed facility in Guthrie, Okla. "Needle
sticks decreased from 59.5 to 15.4 per 100 occupied beds after retractable IV
catheter (needles) were introduced," said associate chief nursing officer Jan
Ruhl.
Beth Israel Deaconess, a large teaching hospital in Boston,
reported similar success with safety needles, reporting 'a 60 percent reduction
of reported needle stick injuries institution-wide."
The Health Care
Association of New York State, representing more than 450 hospitals, nursing
homes, home health care agencies and other medical centers, told OSHA that
"safer medical devices should be part of an overall health and safety program."
The agency's request for reports followed a series of Chronicle articles
last April reporting that U.S. medical workers suffer up to 1 million accidental
needle sticks each year and thousands of nurses, doctors, lab technicians and
public safety workers have been infected with HIV, hepatitis and other lethal
diseases.
Last September, California enacted legislation that will make
it mandatory for health care facilities in the state to switch to safe needle
devices by August 1. Ten other states this year have introduced safe needle
legislation modeled on California's law, with nine other states and the District
of Columbia drafting similar laws.
Safe needles advocates are concerned
that different state laws could cause confusion, especially among needle
manufacturers, and they want OSHA to enforce uniform regulations nationwide.
In a meeting last week with five unions, however, OSHA officials said
the agency was not prepared to act now, noting that it was still analyzing the
more than 600 reponses it received.
One proposal under consideration,
according to the union officials present at the meeting, is a directive by OSHA
to its field inspectors to require hospitals to evaluate safe needle devices.
OSHA officials have declined several requests for comments and
interviews. The agency is preparing a report on the responses it received, which
will be made public within a few weeks along with recommendations, according to
one staff person.
The American Hospital Association recently issued a
12-step guide for its members to help them evaluate and replace conventional
needles with safety needles, but the powerful lobbying group is opposed to
mandatory federal regulation.
"The problem is that anyone can come up
with a device and say it is a safety needle," said Rick Wade, the association's
senior vice president for communication.
He said the health care
industry is being "squeezed" for financial resources, and before OSHA mandates
the use of safety needles, the government and manufacturers should develop a
nationwide standard.
"There are a wide range of different devices," he
said. "We need to get everyone to agree on what constitutes an effective safer
needle."
But Wade said his organization has not proposed to OSHA or any
other government agency what process would be needed to set such a standard and
who would make the determination.
In a 21-page response to OSHA's
request for information, the nation's largest needle manufacturer, Becton
Dickinson, urged OSHA to issue new enforcement rules making it clear to
employers that they have to provide their workers with safe needle devices.
But the company argued against any single safety needle standard, saying
that it would kill off innovation and competition.
Noting that it
manufactures a wide range of safety needles, Becton Dickinson said it "found
that many employers do not make these new products available to their employees.
Without (enforcement action), the adoption of safety devices' will take much
longer to achieve."
Included among the OSHA responses was a study by the
Departmentof Veterans Affairs that tested safety needles and recommended that a
number of them be adopted. And ECRI, a health care research institute, submitted
a report on safety needles it completed last year that recommended a number of
the devices after thorough testing.
Meanwhile, health care worker unions
are furious that OSHA has not acted more than three months after the deadline
for the responses.
"OSHA is the first agency that should act," said
SEIU's Stern. "Instead the states have acted, the congress is acting, but OSHA
is delaying doing anything."
Susan Wilburn, occupational health
specialist for the American Nurses Association, underscored the urgency for
action.
She said she was notified last week that two nurse members
learned recently that they had tested positive for HIV and hepatitis C, as a
result of accidental needle sticks. In both cases, the injuries would have been
prevented by safety needles, she said.
"I believe OSHA will come out
with (an enforcement policy) later this year," she said. "Is it soon enough?
Absolutely not."
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March 17, 1999 
