Needlestick safety legislation's impact on healthcare worker injury

Occupational infection from contaminated sharp devices is the deadliest risk for healthcare workers. 1991 OSHA standards required hospitals to minimize bloodborne pathogen transmission. With the 2000 Needlestick Safety and Prevention Act, standards were strengthened regarding requirement for employers to identify, evaluate and implement safety-engineered medical devices. This study examines the impact of the law on hospital worker sharps injuries.

Using EPINet surveillance data, which tracks sharps injuries among workers in 85 hospitals, we observed changes in injury rates from 1995-2004, during the period prior to and following the legislation. There was a significant (P<.0001) decrease in slope beginning in the year 2000, and the rates continued to decrease in the post-legislation period. Historically, the most common location for injuries was patient rooms, which showed over 50% decrease; OR is now the site of most injuries. While nurses still represent the largest portion of injuries, since 2000 their rates are coming down, while doctors' are increasing. Injury rates from non-safety sharp devices decreased significantly after 2000 (P<.001), while rates of injury from safety-engineered devices decreased initially but then increased slightly (NS); the highest rates from safety devices have not reached the lowest rates of non-safety devices. 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.