Use Of Safer Needles Urged

Hospitals and other health facilities could protect thousands of workers from dangerous infections by using safer needles and syringes types with retractable sharp ends or other safety features, the government says.

Some 600,000 to 800,000 health workers accidentally stick themselves each year with needles they are using on patients, putting themselves at risk for such diseases as the AIDS virus and hepatitis.

The Food and Drug Administration has approved sale of 50 types of specially protected needles and syringes, along with numerous other protective devices. But the American Nurses Association says just 15 percent of hospitals have adopted safer needles.

On Monday, the Centers for Disease Control and Prevention urged more health facilities to use protective devices as part of a comprehensive program to better prevent needle accidents.

"The public attention and awareness of this problem has lagged behind the scope of it," said Dr. Linda Rosenstock, director of CDC's National Institute for Occupational Safety and Health Administration. "For every 100 beds a hospital has, on average it has 30 needle stick injuries per year."

"Too many people see needle stick injuries as a routine part of doing business," she added. "We want to change that view -- it shouldn't be the case."

The CDC's strongly worded safety alert, to be sent to hospitals, nurses and physicians groups and other health facilities this week, is the latest in a trend toward safer needles that manufacturers say may soon increase sales.

California last summer ordered use of the protective devices, two other states have passed similar laws, and some 20 other states are considering the issue. In addition, the Occupational Safety and Health Administration this month strengthened its own rules in a way that may let OSHA inspectors cite health facilities for failing to use safer needles.

Now, "the game isn't just, 'Let's get a needle,' the game is, 'Let's get the most effective device,'" said Carol Coburn, a spokeswoman for Bio-Plexus Inc., which sells needles with a blunt tip that pops out to cover the sharp needle as soon as it's used.

The safety features often work as simply as a ball-point pen, said James Donegan, chief executive of Med-Design Corp., which develops retractable needles and syringes.

For example, push a syringe plunger an extra time and it makes the needle retract inside its plastic coating before it's ever removed from the patient, explained Donegan, whose company has licensed five safer needles to Becton-Dickinson, the world's largest needle manufacturer.

There is even a vaccine injector with no needle at all: BioJect's vaccine gun uses pressure to force certain vaccines through the skin.

Yet these safer needles have been slow to spread largely because they cost more, manufacturers and health experts say. A standard blood-collection needle, for example, costs about 6 cents, while a safer version cost about 25 cents. That adds up, considering the nation uses about half a billion of those needles each year.

Nurses are injured most often, but doctors, laboratory staff and other workers also get stuck, the CDC said. The accidents are estimated to give at least 1,000 injured workers a year HIV or hepatitis.

Rosenstock said worrying that safer needles cost more is "a shortsighted approach."

It can cost several thousand dollars to test injured workers for infection, and many times more to treat those actually infected, she said. That does not include the emotional toll on workers who must wait several months to learn if they escaped infection, she said.

But safety devices are only part of the solution, Rosenstock said. The CDC urged health workers to report all needle sticks promptly so they can receive appropriate care; safely dispose of any needle-like device and avoid recapping needles; tell their employers about needle hazards they observe; and get a hepatitis B vaccination.