SHARPS SAFETY: Understanding the Federal needlestick prevention law, Part II

SHARPS SAFETY: Understanding the federal needlestick prevention law, Part I

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For Part 1, click here.

By Lisa Black, RN, BSN

The first article in this series detailed the specific requirements of The Needlestick Safety and Prevention Act (H.R. 5178). The act codifies and strengthens federal OSHA's Bloodborne Pathogens Standard.

Now I'll examine how implementing the requirements of the bill depends on the OSHA structure of the state where you live.

State vs. Federal OSHA
States with state OSHA plans (AK, AZ, CA, CT, HI, IN, IA, KY, MD, MI, MN, NV, NM, NY, NC, OR, OR, SC, TN, UT, VT, VA, VI, WA, and WY) have designated a state agency to enforce occupational safety and health standards. In these states, OSHA standards cover private as well as public state and municipal employees.

The standards are set by the state and are required to be at least as stringent as the federal OSHA standards. States may, at their discretion, exceed the requirements set forth by federal OSHA through the passage of state legislation or regulation. So, while the new federal OSHA bloodborne pathogen standard will serve as the minimum level of needlestick protection in states with state OSHA plans, these standards can be strengthened and enhanced on a state-by- state basis.

States that don't have state OSHA plans (AL, AR, CO, DE FL, GA, ID, IL, KS, LA, ME, MA, MS, MO, MT, NE, NH, NJ, ND, OH, OK, PA, RI, SD, TX, WV and WI,) leave the responsibility for developing and enforcing occupational safety and health standards to federal OSHA. The new federal OSHA standard passed in Congress will be the standard used in these states. While private employees are covered under the new federal OSHA requirements, public, state and municipal employees are not, as these employees aren't included in any requirements promulgated by federal OSHA.

Reflecting on this shortcoming of federal OSHA legislation, Congressman Pete Stark (D-CA), who was an early champion of needlestick prevention legislation, commented, "We still have work to do to ensure that healthcare workers in public hospitals are also protected, but that does not minimize the importance of what we've accomplished." To achieve equal protection for all healthcare workers, representatives in these states may want to continue to pursue state needlestick protection that will address the needs of these public, state, and municipal employees.

State legislation an impetus
During the past three years, 17 states (AK, CA, CT, GA, HI, IA, MA, MD, ME, MN, NH, NJ, OH, OK, TN, TX and WV) have enacted legislation addressing needlestick injury prevention with another 13 states introducing legislation that hasn't yet passed. The state legislative arena has served as an impetus for the passage of federal legislation by signaling senators and representatives in Congress that this issue is important to their states.

State needlestick legislation that was passed prior to the passage of federal needlestick legislation strengthened the OSHA Standard in states with state OSHA plans. In states without state OSHA plans, legislation has served to cover public, state and municipal employees who would otherwise not be covered by the federal OSHA Standard.

Quicker effective date
One key victory of this bill is that it is worded to specifically state that the usual hearings process for amending an existing OSHA standard will be bypassed (such a process can take 5 or 6 years). It says that within six months of the bill's enactment, the modifications to the standard required by the bill must be published in the Federal Register. The revised standard will be in effect 90 days after it is published in the Federal Register. Thus, the revised standard will be in effect no later than nine months after the bill's enactment.

This monumental victory shows clearly what we, as representatives of the nursing profession, can accomplish when we present a strong, unified voice. This dramatic call for a higher standard of healthcare worker safety wouldn't be possible without the dedicated work of those who not only saw the need for such protection, but also took the initiative to fight for a safer profession for all of us. I urge you to be a part of this exciting process, take action, and make your voice heard.

Send questions or comments to Lisa at Please also visit her website dedicated to needlestick injury prevention at

Advances in Exposure Prevention, International Health Care Worker Safety Center (, 5(4) 2000.