The Legislation

UK Legislation:
The Health and Safety at Work Act, 1974, places a legal duty on NHS trusts to provide for the health and safety of their employees and requires employers to:

• Assess risks to the health and safety of their employees
• Arrange for implementing a comprehensive system of safety management.

In the NHS England & Wales produced Sharps and Needlestick Injury Prevention – Chapter 19 “Blue book”-  It states that NHS Employers should consider the following in relation to needlestick injuries:

• Risk Assessment, Risk Management, Training
• Where indicated, the provision of medical devices incorporating sharps protection mechanisms

The NHS in Scotland produced Needlestick Injuries: Sharpen Your Awareness:

• Recommends that all NHS employees carry out a full risk assessment when deciding whether to introduce safer devices.
• This should ensure that decisions are not taken solely on cost grounds, but also take into account a range of other factors such as risk and effectiveness of the device.

Additional UK legislation:
The Control of Substances Hazardous to Health Regulations 2002 (COSHH) specifically includes micro-organisms in the definition of substances that are hazardous to health. The law requires employers to make a suitable and sufficient assessment of the risks to the health of workers exposed to such substances, with a view to preventing or adequately controlling the risks. This includes the proper use of protective equipment and safety devices.
The Department of Health, Health Act 2006, Code of Practice For The Prevention and Control of Health Care Associated Infections (HCAIs) issued guidelines stating that: “Primary Care Trusts and Hospital Trusts should be encouraged to adopt safety devices in place of conventional devices, in order to prevent needlestick injuries in healthcare workers.”
In the UK Surveillance of Significant Occupational Exposures to Bloodborne Viruses in Healthcare Workers, November 2006, the Chief Medical Officer for England in his Hepatitis C Action Plan for England also endorsed the need for all NHS organizations to minimise the risk of transmission within healthcare settings by the adoption of rigorous infection control precautions and effective management of occupational blood exposure incidents.

EU Legislation
European Council Directive 2000/54/EC (the seventh individual directive within the meaning of article 16(1) of Directive 89/391/EC) contains provisions designed to protect workers from risks related to exposure to biological agents at work.
The following provisions are particularly relevant in this context: 

• Biological agents are classified into four groups according to their level of risk infection (Article 2).
• In the case of any activity likely to involve a risk of exposure to biological agents the employer must carry out a risk assessment (Article 3).
• Where it is not technically practicable to prevent exposure to risk, the risk must be reduced to as low a level as necessary to protect adequately the health and safety of the workers concerned. This includes individual protection measures, drawing up plans to deal with accidents and safe collection, storage and disposal of waste (Article 6).
• Procedures for taking, handling and processing samples of human or animal origin must be established (Article 8).
• Appropriate measures must be taken in health and veterinary care facilities in order to protect the health and safety of workers concerned (Article 5).
• European Council Directive 89/655/EEC concerning the minimum safety and health requirements for the use of work equipment by workers at work (second individual Directive within the meaning of article 16 (1) of Directive 89/391/EEC) is also relevant. Article 3 imposes an obligation on the employer:
• to ensure that work equipment is suitable for the work to be carried out and may be used by workers without impairment to their health and safety;
• to pay attention to the specific working conditions and hazards posed by the use of the equipment in question;
• to take measures to minimise the risks.

In addition, workers should receive information and training on the use of work equipment and any risks which such use may entail (Article 6 and 7).
and reasons the EU's second report, with recommendations to the Commission on protecting European healthcare workers from blood borne infections due to needlestick injuries, believes that legislation is necessary and imminent:

While the existing legislation should, theoretically, address the risk of needlestick injuries, in practical terms, this has not been the case. The Commission communication on the practical implementation of the Health and Safety at Work Directives (COM(2004)0062)specifically references problems with the public sector including hospitals.

Guidelines, awareness campaigns and other non-legislative initiatives can only make a partial contribution; they should be used in addition to directives [1];

The 2004 European Competitiveness Report (SEC(2004)1397) acknowledges the escalating shortage of healthcare workers as a cause for concern throughout Europe. There are many reasons why healthcare may not be seen as an attractive career, but the occupational safety risks that are present in the workplace are certainly a contributing factor.

US Legislation
In the USA The Needlestick Safety and Prevention Act requires health care facilities to provide employees with syringes and blood-drawing devices that retract, blunt or cover needles after use.

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