OSHA to begin citing for reuse of tube holders
Agency states position firmly in clarification
If there was any remaining question about the reuse of blood tube holders, the U.S. Occupa-tional Safety and Health Administration (OSHA) has squelched it with a clarification: "Blood tube holders, with needles attached, must be immediately discarded into an accessible sharps container after the safety feature has been activated."
The reuse of blood tube holders actually has long been prohibited, except when required by a medical procedure.
Such language was included in the preamble to the 1991 bloodborne pathogens standard and in the 1999 updated compliance directive, but OSHA had not previously issued citations related to the practice. The compliance directive issued in 2001 after the bloodborne pathogen standard was revised made it clear that mechanical devices on sharps disposal containers didn’t make the practice safe:
"Some sharps containers have unwinders that are used to separate needles from reusable syringes or from reusable blood tube holders," OSHA said. "The use of these are generally prohibited."
This June, OSHA issued a press release and a letter of clarification focusing on the blood tube holder issue.
"Removing contaminated needles and reusing blood tube holders can expose workers to multiple hazards," OSHA Administrator John Henshaw said in the release.
"We want to make it very clear that this practice is prohibited in order to protect workers from being exposed to contaminated needles," he explained.
Janine Jagger, PhD, MPH, director of the International Health Care Worker Safety Center at the University of Virginia in Charlottesville and a leading expert in needle safety, lauded OSHA’s clarification. While she doesn’t have specific data on needlesticks from the back end of needles, she says she has anecdotal information about their occurrence.
"I think it’s an area that has just been overlooked [by hospitals]," she says. "This just makes it very explicit."
Until recently, the re-use of blood tube holders has been commonplace. Many hospitals have purchased larger sharps disposal containers to hold the increased bulk as the holders are discarded. OSHA’s latest statement will likely have a positive impact on compliance, says Katherine West, MSEd, CIC, an infection control consultant based in Manassas, VA.
"Hospitals are beginning to get the word that they are to be single use only," she says.
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