OSHA chief pledges focus on needlesticks
OSHA chief pledges focus on needlesticks
Revised bloodborne pathogens standard may result
In spite of progress made in preventing some bloodborne pathogen exposures to health care workers, the U.S. Occupational Safety and Health Administration needs to focus on preventing needlesticks that could lead to life-threatening illnesses or even death, says Charles N. Jeffress, assistant secretary of labor for occupational safety and health.
The OSHA official, speaking recently at the Frontline Health Care Workers Safety Conference in Washington, DC, pointed out that in 1987, there were 8,700 cases of occupationally acquired hepatitis B among HCWs. Four years after publication of the agency's bloodborne pathogens standard, only 400 new cases of hepatitis B related to occupational exposure among HCWs were reported.
"This is a dramatic decline," Jeffress says. "We're all pleased with the progress made in preventing hepatitis B infections, but we're here today because we know we could do more."
OSHA estimates that the nation's 5.6 million HCWs suffer about 800,000 needlesticks per year, or approximately one needlestick for every seven workers. Needlesticks account for up to 80% of blood exposures, he says. However, he also acknowledges that those estimates are extrapolated from "small pools of data," and notes the health care community agrees that needlesticks are underreported.
While the agency says a "comprehensive strategy" works best for preventing needlesticks, OSHA plans to systematically address the problem by publishing a formal request for information (RFI) on needlestick prevention in the Federal Register. The notice will be a call for public comments and research results, and will include about a dozen questions on reducing needlesticks among HCWs.
The purpose is to get a consensus from industry experts, hospital occupational health and infection control practitioners, and others on what needs to be done. "Underlying all those specific queries is one basic question: What works? This is a chance for you to tell us," Jeffress states.
Responses to the RFI will determine whether OSHA might revise the bloodborne pathogens standard to include requirements for using newer, safer needle technology in hospitals.
Jeffress says OSHA has received a number of suggestions less formally. Those include implementing an emergency temporary standard mandating safer devices, reopening the bloodborne pathogens standard, rewriting instructions to inspectors, emphasizing engineering controls for reducing needlesticks, and taking a closer look at exposure control plans.
"We are examining each of those alternatives," he says. "I am committed to finding ways to reduce needlesticks among health care workers."
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