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GAO-01-60R 1 (2000-11-17)

handle is hein.gao/gaobaalri0001 and id is 1 raw text is: 




          GAO
SAccountability   Integrity * Reliability
United States General Accounting Office
Washington, DC 20548


             November 17, 2000

             The Honorable Pete Stark
             House of Representatives

             Subject:     Occupational Safety: Selected Cost and Benefit Implications of
                          Needlestick Prevention Devices for Hospitals

             Dear Mr. Stark:

             This letter responds to your request for an examination of the potential benefits
             and costs of changes that would be mandated under the proposed Health Care
             Worker Needlestick Prevention Act (HR 1899), which would require the use of
             needles with safety features.' Percutaneous injuries caused by needlesticks
             (puncturing of the skin by a needle or similar sharp object) are a serious concern
             for the approximately 10 million health care workers in the United States. These
             injuries pose a significant risk of occupational transmission of bloodborne
             pathogens such as human immunodeficiency virus (HIV), hepatitis B virus (HBV),
             and hepatitis C virus (HCV) to health care workers. In addition, the emotional
             distress of a needlestick injury can be severe and long lasting, even when a
             serious disease is not transmitted. According to the Centers for Disease Control
             and Prevention (CDC), approximately 384,000 percutaneous injuries occur
             annually in U.S. hospitals, with about 236,000 of these resulting from needlesticks
             involving hollow-bore needles. Although the proposed legislation applies to health
             care workers in all settings, we focus only on hospital settings, as there are no
             reliable data on percutaneous injuries sustained in other settings.2 It should be
             noted, however, that more than one-half of all health care workers are in
             nonhospital settings.

             This letter presents the number of needlestick injuries potentially prevented by
             the use of needles with safety features and the estimated ranges of the benefits
             and costs of using such needles in hospitals. Our analysis is based on data
             provided by CDC, the International Healthcare Worker Safety Center, the


             'Subsequent to the introduction of HR 1899, a similar bill, HR 5178, was introduced and enacted
             into law. On Nov. 6, 2000, the President signed the Needlestick Safety and Prevention Act (P.L.
             106-430), which mandates changes in the bloodborne pathogens standard in effect under the
             Occupational Safety and Health Act of 1970. The Act requires employers to document the
             consideration and implementation of safer medical devices, including safe needle devices, in their
             facilities.

             2CDC's National Institute of Occupational Safety and Health (NIOSH) is beginning a study to
             determine the incidence of nonhospital percutaneous injuries.


GAO-01-60R Needlestick Prevention

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