New Regulation Calls for Self-Sheathing Needles. (Office-Based Physicians Affected).

A pointedly worded federal regulation may put physicians on the spot if their offices are still using conventional sharps instead of safer sheathed or retracting models that protect health care workers from needle-stick injuries.

The Needlestick Safety and Prevention Act, overseen by the Occupational Safety and Health Administration, requires employers, including office-based physicians, to select safer medical devices, including self-sheathing needles, and to consult with staff members who deliver patient care in deciding which devices should be used.

Offices that have at least 11 employees also must maintain a confidential sharps injury log that details both how and where any incident occurred and the type and brand of device involved, the regulation says.

The new standard, which took effect in April and has been enforced since July, puts teeth into a 1991 recommendation on blood-borne pathogens that encouraged employers to evaluate and implement devices to improve workplace safety by minimizing the risk of blood exposure through needle-stick or other injuries.

States with OSHA-approved occupational health agencies and regulations must adopt the federal standards or establish their own, more stringent, requirements by Oct. 18. (See box.)

OSHA estimates that between 5 million and 6 million workers are at risk for occupational exposure to blood-borne pathogens, including human immunodeficiency virus and hepatitis. About 600,000-800,000 needle-stick or other percutaneous injuries are reported each year, many of which occur not during medical procedures but afterward during clean-up activities.

An estimated 62%-88% of these injuries are preventable, according to OSHA.