Why Needlestick Legislation?

The facts listed below illustrate the dramatic effect that needlesticks and sharps injuries have on health care workers each year.

Needlestick injury

  • Health care workers (HCWs) suffer between 600,000 and 1 million injuries from conventional needles and sharps annually. These exposures can lead to hepatitis B, hepatitis C, and human immunodeficiency virus (HIV), the virus that causes AIDS.
  • At least 1,000 HCWs are estimated to contract serious infections annually from needlesticks and sharps injuries.
  • Registered nurses working at the bedside sustain an overwhelming majority of these exposures.
  • Needlestick injuries are preventable. More than 80% of needlestick injuries could be prevented with the use of safer needle devices.
  • Less than 15% of U.S. hospitals use safer needle devices and systems.
  • In 1992, the Food and Drug Administration (FDA) issued an alert to all health care facilities to utilize needleless IV systems wherever possible. This alert was merely a recommendation, not a mandate. Therefore, health care facilities are under no legal obligation to comply.
  • The first safe needle designs were patented in the 1970s, and the FDA has approved more than 250 devices for marketing as safety devices.
  • More than 20 other infections can be transmitted through needlesticks, including tuberculosis, syphilis, malaria, and herpes.

Hepatitis B

  • Hepatitis B is now preventable due to the vaccine that must be offered to HCWs and is given to children at birth.
  • Regulatory and legislative efforts were largely responsible for the reduction of deaths from hepatitis B as a result of vaccine programs.
  • Following these regulatory and legislative efforts, including the Occupational Safety and Health Administration Bloodborne Pathogens Standard, cases of hepatitis B in health care workers have dropped from 17,000 annually to 400 annually and continue to drop.
  • Transmission rate: 2% to 40%

Hepatitis C

  • Testing for hepatitis C after needlestick injuries was recommended first in 1998. It is a silent epidemic. There could be thousands of nurses with occupationally-acquired hepatitis C who do not know it.
  • Hepatitis C is the most frequent infection resulting from needlesticks and sharps injuries. Of health care workers who become infected, 85% become chronic carriers.
  • Chronic carriers have the potential to spread the disease to others, including their partners.
  • Drugs that slow the progression of hepatitis C are available, but cost an average of $1,700 each month.
  • Hepatitis C leads to liver failure, liver transplants, and cancer of the liver. A liver transplant costs $500,000.
  • At least 4 million Americans are infected with hepatitis C.
  • Transmission rate: 2.7% to 10%


  • HIV is the virus that causes AIDS, a fatal disease.
  • Advances in treatment prolong the time before HIV becomes AIDS. The drug treatment can cost up to $6,000 per month.
  • 16,000 of the 600,000 to 1 million yearly needlestick injuries result in HIV exposure.
  • There are more than 54 documented cases of HCWs with occupationally-acquired HIV, and at least 133 cases of possible transmissions of HIV.
  • There are 35 new cases each year. One in 300 contaminations stems from HIV.
  • Transmission rate: .2% to .4%

Source: American Nurses Association, Washington, DC. Web site: www.nursingworld.org.