June 27, 2001

The Honorable Steven C. LaTourette
U.S. House of Representatives
Washington, DC 20515

Dear Congressman LaTourette:

Thank you for your letter of April 2, addressed to Mr. Richard E. Fairfax, Director of the Occupational Safety and Health Administration's (OSHA's) [Directorate of Enforcement Programs (DEP)]. Your letter conveyed some concerns that you and Mr. Joe Adkins had about OSHA's enforcement of the Bloodborne Pathogens Standard, 29 CFR 1910.1030. Specifically, you expressed concerns about how needle destruction devices are viewed by our compliance program.

Let us reassure you again that needle destruction devices are indeed considered engineering controls as described by the standard. However, it is not the intent of the standard, as Mr. Adkins was quoted in the article that you enclosed, "that any device is acceptable if it decreases needlestick injuries." The intent of the standard is to eliminate the hazard of the needle. OSHA requires employers to use safer devices even if they have not yet had needlestick injuries; employers must not wait until their employees have been injured by contaminated needles before they attempt to eliminate their exposures.

The key to the prevention of needlesticks is using engineering controls to remove the hazard of a contaminated needle from the workplace. Congress acknowledged these preventative steps and purposely added the two key methods of doing this to the definition section of the standard: needleless systems and sharps with engineered sharps injury protection.

Ideally, the most effective way of removing the hazard of a contaminated needle is to eliminate the needle completely by converting to needleless systems. If this is not possible, removal of the hazard as soon as possible after contamination is required. This is best accomplished by using a "sharp with engineered sharps injury protection," which shields the sharp from exposure as soon as it is withdrawn from the patient.

However, simply using any device may not be appropriate. The device that most effectively eliminates the exposure can vary by procedure. The employer and employees must consider which device is best suited for a specific procedure. For some procedures a safer device may not be commercially available. In this case, the employer must use another method to remove the hazard from the workplace as soon as feasible. This is frequently done by placing the needle directly into a sharps container located as close to the patient as possible.

If a safer medical device is not available for a specific procedure, an employer could choose to use a needle destruction device to destroy the needle before placing it in a sharps container. Nonetheless, there are still 600,000 to 800,000 injuries occurring each year, many of which occur immediately after use and prior to placement in a sharps box.

Again, OSHA is aware that needleless systems or sharps with engineered sharps injury protection cannot be used in all situations. However, if their use is feasible for a given procedure, then they must be used.

In the article you sent, Mr. Adkins has identified home use of needles as another sector where there is a risk of needlesticks. The domestic use and disposal of needles has become an area of increasing concern for OSHA and several other agencies. Needles used in the home do not follow the same waste stream as the regulated waste from doctor's offices and hospitals; they are discarded in regular trash posing potential exposures to trash haulers downstream. Although the homes of self-injecting insulin patients are beyond OSHA's jurisdiction, this device may be useful in preventing these downstream exposures.

Thank you for your interest in occupational safety and health. We hope this provides the clarification you were seeking. OSHA requirements are set by statute, standards and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA's website at http://www.osha.gov. If you have any further questions, please feel free to contact the [Office of Health Enforcement] at (202) 693-2190.

Sincerely,


R. Davis Layne
Acting Assistant Secretary

[Corrected 6/2/2005]