The Honorable Pete Stark House of Representatives Subject : Occupational Safety : Selected Cost and Benefit Implications of Needlestick Prevention Devices for Hospitals

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. It should be noted, however, that more than one-half of all health care workers are in nonhospital settings.