The impact of U.S. policies to protect healthcare workers from bloodborne pathogens: the critical role of safety-engineered devices

J Infect Public Health. 2008;1(2):62-71. doi: 10.1016/j.jiph.2008.10.002. Epub 2008 Nov 26.


In the United States (U.S.), federal legislation requiring the use of safety-engineered sharp devices, along with an array of other protective measures, has played a critical role in reducing healthcare workers' (HCWs) risk of occupational exposure to bloodborne pathogens over the last 20 years. We present the history of U.S. regulatory and legislative actions regarding occupational blood exposures, and review evidence of the impact of these actions. In one large network of U.S. hospitals using the Exposure Prevention Information Network (EPINet) sharps injury surveillance program, overall injury rates for hollow-bore needles declined by 34%, with a 51% decline for nurses. The U.S. experience demonstrates the effectiveness of safety-engineered devices in reducing sharps injuries, and the importance of national-level regulations (accompanied by active enforcement) in ensuring wide-scale availability and implementation of protective devices to decrease healthcare worker risk.

Publication types

  • Historical Article
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Blood-Borne Pathogens*
  • Communicable Disease Control / history
  • Communicable Disease Control / legislation & jurisprudence
  • Communicable Disease Control / methods*
  • Communicable Diseases / blood
  • Health Personnel
  • Health Policy
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Needlestick Injuries / epidemiology
  • Needlestick Injuries / prevention & control*
  • Occupational Exposure / legislation & jurisprudence
  • Occupational Exposure / prevention & control*
  • Practice Guidelines as Topic
  • Protective Devices*
  • Safety Management / history
  • Safety Management / methods*
  • United States / epidemiology
  • United States Food and Drug Administration
  • United States Occupational Safety and Health Administration