Needlestick legislation makes an impact on hospital injury rates

Background: Occupational injury and infection from contaminated sharp devices are the most deadly risk for healthcare workers. OSHA standards, dating back to 1991, required hospitals in the U.S. to institute engineering and work practice controls to minimize risk of bloodborne pathogen transmission. With passage of the 2000 Needlestick Safety and Prevention Act, the standards were strengthened and made more specific regarding the requirement for employers to identify, evaluate and implement safety-engineered medical devices. This study systematically examines the impact of the law on hospital worker sharp injuries.

Methods: Using EPINet hospital surveillance data, which tracks sharps injuries among hospital workers in 85 hospitals throughout the U.S., we were able to observe changes in injuries from 1995-2004. AHA data were used to generate hospital-specific denominators (FTE, ADC, Beds) and track annual injury rates across the period prior to and following the legislative implementation.

Results: Comparing the slope of injury rates before the legislation and after, there was a significant (P<.001) decrease in slope beginning in the year 2000. The decrease varies between 45-50%, depending on the denominator. Not only was there a significant discontinuity in the pre- and post-slopes, but the rates continued to decrease in the post-legislation period.

Conclusions: These findings strongly support the conclusion that, even in the presence of OSHA regulations that pre-date the legislation, and even with a market of safety engineered devices available prior to the legislation, the legislation had an independent and powerful impact on the sharps injury experience of hospital workers in the U.S.