Taking Action to Prevent Needlesticks

A labor/management health and safety committee can be an effective vehicle to ensure that workers have safe equipment and work practices. However, workers and their unions must be prepared to take action when attempts to work cooperatively with management fail to control hazards.

Negotiate needlestick protections

Workers can gain important protections by negotiating needlestick prevention language into collective bargaining agreements. Negotiating needlestick protections is particularly important for public-sector workers in states where they are not covered by health and safety laws. Workers covered by OSHA also need language in their contracts since OSHA does not have enough staff or resources to make sure that all employers comply with health and safety laws. The following are examples of contract language on needlestick prevention.

Compliance with OSHA’s bloodborne pathogens standard

The employer agrees to comply with all requirements of the OSHA Bloodborne Pathogens Standard. A Sharps Injuries Prevention Committee consisting of an equal number of representatives selected by the employer and the union will meet on a regular basis. The Committee is authorized to review the sharps injuries log and all other records relating to the prevention of needlesticks. The Committee is further charged to identify, evaluate and select effective engineering controls.

Needle devices

Needles with engineered sharps injury protection shall be used for:

• Withdrawal of body fluids, 
  
  
• Accessing a vein or artery, 
  
  
• Administration of medication or fluids, and 
  
  
• Any other procedure that potentially exposes the health care worker to bloodborne pathogens for which an engineered sharp safety device is available. 

Nonneedle sharps

Sharps other than needle devices (such as scalpels, sutures) shall have engineered sharps injury protections.

Using the OSHA bloodborne pathogen standard

Federal OSHA applies to private-sector workers but does NOT cover state and local government workers. OSHA allows states to operate their own state OSHA programs instead of being covered by the federal government. State programs approved by federal OSHA cover both the private sector, and state and local government workers. Twenty-one states and Puerto Rico have federally approved OSHA programs that cover public employees (Arizona, Arkansas, California, Hawaii, Indiana, Iowa, Kentucky, Maryland, Michigan, Minnesota, Nevada, New Mexico, North Carolina, Oregon, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, Wyoming). Three states (Connecticut, New Jersey, New York) have federally approved state programs that apply only to state and local government workers, and private-sector workers are covered by federal OSHA. Federally approved OSHA programs must be at least as effective as the federal program and adopt OSHA standards. Several other states administer needlestick or other job safety laws that are NOT federally approved and cover state and local government workers.

The OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030) gives workers important protections to prevent needlesticks and other types of exposures to blood at work. The full text of the standard is located on the OSHA Web site.  The rule includes, but is not limited to the following requirements:

Key Definitions {1901.1030(b)}:

• Engineering controls are sharps, disposal containers, self-sheathing needles and safer medical devices (such as sharps with engineered sharps injury protections and needleless systems) that isolate or remove the hazard. 
  
  
• Needleless system is a device that does not use a needle for the collection or withdrawal of body fluids after initial access to a vein or artery is established, or to administer medication. 
  
  
• Sharps with engineered sharps injury protections means a nonneedle sharp or needle device for withdrawing body fluids, accessing a vein or artery, or administering medications with built-in safety features. 

Exposure control plan {1910.1030(c)}:

In every workplace where there is a potential for exposure to blood or other potentially infectious materials (OPIM),employers must identify which workers might be exposed and which tasks or procedures can cause exposure.

• Worker input in selection of devices {1910.1030(c)(1)(v)}: Employers must solicit the input from non-managerial workers that provide direct patient care concerning the identification, evaluation and selection of effective safety needles and other engineering controls. 
  
  
• Safety equipment (engineering controls) {1910.1030(d)(2)(i)}: Employers must evaluate and provide safer needles to prevent injuries and possible exposure to bloodborne pathogens. The employers must continually evaluate and select the safest devices on the market. 
  
  
• Information and training {1910.1030(g)(2)}: Workers must be trained on the proper use and limitations of safety devices, work practices and personal protective equipment. Workers with occupational exposure must receive training during work hours when they are hired and at least once per year afterwards. 
  
  
• Prohibited practices {1910.1030(d)(2)(vii)}: The standard prohibits bending, recapping or removing contaminated needles unless the employer can demonstrate that no alternative is feasible or that such action is required by a specific medical or dental procedure. 
  
  
• Disposal of needles, materials and protective equipment {1910.1030(d)(2)(viii), (d)(2)(xiii), (d)(3)(viii)}:Contaminated materials must be discarded immediately or as soon as possible. The containers must be closed, puncture resistant, leak-proof, and color-coded. 
  
  
• Hepatitis B vaccination {1910.1030(f)(2)}: Employers must make the hepatitis B vaccine available at no cost to all workers who have potential occupational exposure to blood or OPIM. Workers may decline the vaccine but must sign a written "declination form." A worker may change his/her mind at any time, and the employer must then provide the vaccination. 

Steps to take before filing a complaint with OSHA

Workers who are covered by the OSHA Standard have the right to file a complaint if their employer is not following the requirements of the rule. There are certain steps a local union can take — before filing a complaint — to involve the membership as well as improve the chances that OSHA will take strong enforcement against an employer.

• Request to see the sharps injury log and other records the employer must keep, and allow workers and the union to review. 
  
  
• Talk with workers to educate them as to why workers are being stuck, how safer needles can prevent injuries and their rights under the standard. 
  
  
• Conduct a survey to document needlesticks and other injuries that do not appear on the employer’s records. 
  
  
• Get workers to sign petitions demanding that the employer provide training, safer needles and other working conditions that can prevent injuries. 
  
  
• Request a meeting with the employer to discuss the problem and provide safer equipment and other corrective action.

Filing a complaint with OSHA

An OSHA Complaint Form is in Appendix C. The PDF form is available at the OSHA Website. Check with your state’s safety and health agency for a copy of the form used where you are located.