April 19, 2001

OSHA reminds employers that changes in its bloodborne pathogens standard intended to reduce needlesticks among healthcare workers and others who handle medical sharps will go into effect April 18. The agency is planning a 90-day outreach and education effort before enforcing the new rules.

Mandated by the Needlestick Safety and Prevention Act, changes to OSHA's bloodborne pathogens standard were published January 18, 2001, to take effect April 18, 2001. The revisions clarify the need for employers to select safer needle devices as they become available and to involve employees in identifying and choosing the devices. The updated standard also requires employers to maintain a log of injuries from contaminated sharps.

Specifically, the revised OSHA bloodborne pathogens standard obligates employers to consider safer needle devices when they conduct their annual review of their exposure control plan. Safer sharps are considered appropriate engineering controls, the best strategy for worker protection.

Involving frontline employees in selecting safer devices will help ensure that workers who are using the equipment have the opportunity for input into purchasing decisions. The new needlestick log will help both employees and employers track all needlesticks to help identify problem areas or operations. The updated standard also includes provisions designed to maintain the privacy of employees who have experienced needlesticks.

Passed unanimously by Congress, the Needlestick Safety and Prevention Act took effect November 6, 2000. It specified revisions of OSHA's bloodborne pathogens standard and directed the agency to make these changes within six months. The legislation exempted OSHA from certain standard rulemaking requirements so that the revised bloodborne pathogens standard could be adopted quickly. These changes now go into effect as originally scheduled.


NIOSH recommends that employers adopt strategic measures to protect the nation's 8 million health care workers from job-related injuries caused by needles in syringes, intravenous delivery systems, and related medical devices.

Every year 600,000 to 800,000 occupational needlestick injuries are estimated to occur and can lead to serious or potentially fatal infections with bloodborne pathogens such as hepatitis B virus, hepatitis C virus, or human immunodeficiency virus (HIV). The precise number of injuries is not known because needlesticks often go unreported. The risk of a bloodborne infection may not be immediately recognized, and symptoms may not become apparent until weeks or months after the needlestick.

NIOSH recommendations for work-related needlestick injuries are outlined in a bulletin, "NIOSH Alert: Preventing Needlestick Injuries in Health Care Settings." Developed in collaboration with other CDC centers and with extensive outside scientific review by diverse industry, labor, and public health organizations, the Alert provides detailed guidance and assistance to employers, workers, and others in reducing needlestick injuries.

NIOSH recommends that the use of needles be eliminated where possible. If safe and effective alternatives to needles are not available, devices with safety features such as shields and sheaths should be used. Devices should be selected, used, and evaluated as part of a comprehensive program in which safe work practices, such as prohibiting recapping, are established under written procedures, and workers are trained in those practices. Each health care setting should have its own carefully tailored program, developed with front line worker input and review.

Hollow-bore needles such as those used in syringes present the greatest risk for needlestick, but potential for injury exists whenever any sharp device is used, the NIOSH Alert reports. Most reported needlesticks involve nurses, but laboratory staff, doctors, housekeepers, and other health care workers are also injured.

The Alert suggests examples of devices that may reduce the risk of needlesticks, but advises that no one device will be appropriate or effective for every workplace. Examples of such devices include but are not limited to:

  • Needle-less devices, such as connectors for intravenous delivery systems that use blunt or valved ends rather than needles for attaching one length of IV tubing to another.
  • Devices in which safety features are an integral part of the design, such as sheaths and shields over needles.
  • Devices that operate passively without requiring user activation, such as an IV connector with a permanent rigid housing over the needle.
  • Devices designed so that the user can tell easily whether the safety feature is activated, such as a visually obvious needle cover or the audible sound of a protective sheath being engaged.
  • Devices in which the safety feature cannot be deactivated and remains protective through disposal.
  • Devices that perform reliably, are easy to use and practical, and are safe and effective for patient care.

CDC is working with health care industry groups, employers, workers, unions, the public health community, and others to disseminate its guidance and recommendations. Copies of "NIOSH Alert: Preventing Needlestick Injuries in Health Care Settings," HHS (NIOSH) Publication No. 2000-108, are available at no charge from the NIOSH toll free information number, 1-800-35-NIOSH (1-800-356-4674). 


The U.S. Department of Labor's Mine Safety and Health Administration (MSHA) kicked off its annual "Stay Out?Stay Alive" national public awareness campaign to warn children and adults about the dangers of exploring and playing on active and abandoned mine sites.

Every year, dozens of people are injured or killed in recreational accidents on mine property. MSHA pioneered "Stay Out?Stay Alive" three years ago to educate the public about the existing hazards. The campaign is a partnership of more than 50 federal and state agencies, private organizations, businesses and individuals.

From April 16 through April 30, "Stay Out?Stay Alive" partners will visit schools, communities and youth organizations throughout the country to educate children about the importance of steering clear of active and abandoned mines.

Last year, at least 24 non-miners died in accidents on mine property that involved quarry drownings, overturned ATV vehicles and falls down mine shafts. Five such recreational accidents have been recorded so far this year.

Below are some of the hazards that explorers and adventure-seekers may encounter:

  • Vertical shafts can be hundreds of feet deep. At the surface, they may be completely unprotected, hidden by vegetation or covered by rotting boards.
  • Horizontal openings that appear sturdy may be supported by rotting timbers. Unstable rock formations make cave-ins a real danger.
  • Lethal concentrations of deadly gases can accumulate in underground passages.
  • Unused or misfired explosives can become unstable, and deadly vibrations from a touch or misstep can trigger an explosion.
  • Hills of loose material in stockpiles or refuse heaps can easily collapse upon an unsuspecting biker or climber.
  • Water-filled quarries and pits conceal rock ledges and old machinery. The water can be deceptively deep and dangerously cold. Steep, slippery walls make exiting these swimming holes extremely difficult.

There are approximately 14,000 active and as many as 500,000 abandoned mines in the United States. As cities and towns spread into the surrounding countryside and more people visit remote locations, the possibility of contact with an active or abandoned mine increases.

To report unsafe public mine access, abandoned mine emergencies or abandoned mine locations, call the MSHA hotline at 1-800-499-1038.