Needlestick Prevention Timeline

In November 2000, President Clinton signed the Needlestick Safety Prevention Act into law. It was the result of herculean effort on the part of SEIU healthcare workers (and loss of life).

Here’s a timeline of how we fought for and won this incredibly important law.

1983

The U.S. Center for Disease Control (CDC) estimates that in 1983, 10,000 healthcare workers contracted Hepatitis B occupationally and 200 died.

OSHA issues voluntary guidelines designed to reduce the risk of occupational exposure to hepatitis B virus. The guidelines, which were sent to employers in the healthcare industry, include a description of the disease, recommended work practices, and recommendations for use of immune globulins and the hepatitis B vaccine.

SEIU Local 250 Hospital and Healthcare Workers’ Union forms an AIDS Education Committee for healthcare workers. Produces educational brochure entitled “Can We Talk?”

1986

SEIU and AFSCME members lobby OSHA for a bloodborne pathogens standard, as opposed to simply voluntary recommendations.

1987

July 30—“Jane Doe,” R.N., an SEIU member, incurs a needlestick injury at San Francisco General Hospital (SFGH) that results in HIV infection.

August—CDC issues guidelines recommending the use of “Universal Precautions.”

September 30—SFGH administrators hold press conference to announce first known occupationally related seroconversion at SFGH.

November 27—OSHA announces the initiation of the rulemaking process (52 FR 45438) to move toward a new bloodborne pathogens standard. The Agency requested information and public comment relevant to reducing occupational exposure to HBV and HIV under section 6(b) of the OSH Act.

1988

New England Journal of Medicine publishes article reporting that up to 90% of needlestick injuries could be prevented with integrated needle features.

November—Jane Doe still has not procured guarantee of Workers Comp claim being processed confidentially. Her childhood friend urges San Francisco Chronicle to cover the issue.

1989

March 13— San Francisco Chronicle prints article entitled “No Benefits Yet for AIDS Infected Nurse.”

March 21—SEIU activist healthcare workers host press conference in main lobby of SFGH, wearing stickers that read, “We are all Jane Doe.”

March 22—San Francisco Chronicle prints article stating that the city has agreed to work with Jane Doe on her Workers Comp claim.

Late May—Dozens of healthcare workers and ACT UP members hold demonstration in San Francisco city attorney’s office on date of Jane Doe’s scheduled deposition, stating “We are all Jane Doe.”

June—Jane Doe reaches settlement with the city that only two to four persons would have access to her true identity in processing workers comp. SEIU Local 790 RN bargaining team wins MOU side letter stating that any nurse incurring occupational infection will have same protections as Jane Doe.

1990

“Jean Roe,” a clinical nurse assistant at Kaiser Permanente and SEIU Local 250 activist, incurs needlestick and becomes HIV infected.

Training for Development of Innovative Control Technologies (TDICT) Project begins, a collaborative effort of line healthcare workers, product designers, and industrial hygienists dedicated to preventing exposure to blood through better design and evaluation of medical devices and equipment.

1991

Federal Occupational Safety and Health Administration (OSHA) issues a standard (29 CFR 1910.1030) regulating occupational exposure to bloodborne pathogens, including HIV, hepatitis B Virus (HBV), and hepatitis C virus (HCV).  Standard discussed but did not mandate safer sharps devices.  SEIU provided testimony in support of this standard.

Medical student in Operating Room at SFGH is stuck with an IV needle used in an HIV positive patient. An SEIU OR RN discovers that there are safety IV needles being used in SFGH’s Emergency Room, but administration declines to provide them to other units in the hospital, due to cost.

SEIU “Trilocal” (Locals 250/790/535; now part of Local 1021) brings a grievance against SFGH for providing safety IV catheters only to ER staff.  SEIU Local 790 Chief Shop Steward Lorraine Thiebaud and others collected over 350 staff signatures demanding that the safety IV catheter be available hospital-wide with a training program on its use, and that a committee of working healthcare workers evaluate all the new needle safety technology.  Grievance won.

1992

February—At a U.S. House of Representatives hearing on “Healthcare Worker Safety and Needlestick Injuries,” SEIU member known as “Jean Roe” testifies about how she became HIV infected from a conventional needle left at a patient bedside. Other SEIU members also testify.

1996

March—A Nurse Practitioner working for both the SF Department of Public Health and UCSF system incurs needlestick while working in a clinic where she is not provided a safety phlebotomy device used in other clinics. She becomes infected with both Hepatitis C and HIV.

Her occupational injury came at a time when the SFGH needlestick committee was meeting resistance from hospital administration to pursue devices with improved technologies, and a researcher in charge of the needlestick hotline was withholding data on needlesticks from the committee and serving as an expert witness for needle companies.

1998

April—San Francisco Chronicle publishes Pulitzer-prize nominated 3-day series on politics of needlestick prevention, featuring this Nurse Practitioner’s story.  The series focuses on the role of healthcare employers, the needle manufacturers and the regulatory agencies in failing to protect workers.

Union members, hospital staff and county supervisor rally outside hospital for safer needles.

September—After an anonymous complaint, Cal/OSHA issues eleven violations to SFGH, six categorized as “severe,” for lack of training and deficiencies in SFGH’s needlestick prevention program.

October—After extensive lobbying by SEIU, including leadership from the SEIU California Nurse Alliance, the state legislature passes AB1208 (Migden-D), requiring OSHA to amend its Bloodborne Pathogens Standard. This legislation requires healthcare employers to provide safety devices with ESIP, “engineered sharps injury protection,” mandates a detailed sharps injury log be maintained, and requires a process for healthcare workers to have direct participation in the selection of safety devices.

November 4—“Jean Roe” dies of AIDS after years of activism for needlestick safety and support for HIV+ women. Shortly before her death, she calls the Governor’s office, urging him to sign AB 1208.

SEIU publishes and distributes “SEIU’s Guide to Preventing Needlestick Injuries.”

1999

Throughout 1998 and 1999, SEIU introduces efforts for similar safe needle laws in more than half of the states.

April 1—Dateline NBC airs segment on prime-time TV highlighting efforts of SEIU members to secure safer needles. Show features Ellen Dayton, N.P.

May 18—SFGH employees/SEIU members have “Public Information Interview” with Joint Commission on Accreditation of Healthcare Organizations (JCAHO) during accreditation visit to talk about series of issues, including inadequate needlestick prevention and related training.

July 1—Newly revised California Bloodborne Pathogens Standard (Title 8) goes into effect. The standard mandated employers to provide needleless systems or devices that include “engineered sharps injury protection,” maintain a detailed “sharps injury log,” and recruit active involvement by employees in selecting devices.

Spring—Members of SEIU Locals 790, 250 and CIR meet with SFGH management for series of negotiations to establish a new joint labor management needlestick prevention committee that would have authority to carry out Cal/OSHA mandate:  to evaluate devices with engineered sharps injury protections, to access and maintain sharps injury log, to direct purchase of safety devices and to plan training on devices and best work practices.

August—First meeting of joint Labor Management San Francisco Department of Public Health Bloodborne Pathogens Safe Devices Committee. Committee comprised of labor and management co-chairs and equal number of frontline workers and administrators. Committee given authority to review new technologies, carry out pilots of new devices by having frontline workers evaluate devices, select devices, create training programs and review Sharps Injury Log.

2000

June 22—Lorraine Thiebaud, RN, Local 790, testifies before U.S. House of Representatives Workforce Protections Subcommittee of the Education and the Workforce Committee on “OSHA’s Compliance Directive on Bloodborne Pathogens and the Prevention of Needlestick Injuries.”

November 6—President Bill Clinton signs Needlestick Safety Prevention Act.  Lorraine Thiebaud and “Jean Roe”’s widow are present.

 

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