How the EU needlestick directive has been a positive move for healthcare workers

July 12, 2013

The deadline for member states of the European Union to implement appropriate changes in needlestick and medical sharp protection was May 11th 2013. Now this has passed and the UK, along with other EU states, has had to ensure its policy comes in line with the EU Directive 2010/32/EU in order to comply and reap the benefits for its healthcare workers.

Background

In 2006 the European Parliament adopted a policy which requested for the Commission to submit a legislative proposal in order to better protect the wellbeing of medical workers across the continent. The EU described needlestick injuries as "one of the most serious health and safety threats in European workplaces and estimated to cause one million injuries each year".

By December 2008, the Commission was told of the intention to bring into practice legislation to reduce the number of workers injured by medical sharps, and on July 17th 2009, the first framework agreement was signed and swiftly adopted by the Commission in October that year.
 
In March 2010, the EU Employment and Social Affairs ministers stipulated that a directive would be introduced and a council directive was published in the EU's official journal later that year, giving member states of the EU, three years to meet the standards.

What is the legislation?

All member states need to implement the Council Directive 2010/32/EU in both private and public domains, including prisons. Key requirements that need to be implemented include:

• Appropriate and thorough risk assessments will need to be carried out after every sharp injury to determine the potential risk of exposure to bloodborne pathogens. As part of this process, it will need to be judged whether or not the injury was preventable, and if so, how.

• Risk elimination and prevention will serve to eliminate unnecessary handling of sharps. This will also concern reducing the risk of exposure through the use of safety devices, improved education and reviewing staffing procedure. It is also part of the legislation that personal protective equipment and appropriate sharps disposal systems are available at the point of use.

• All employers must supply workers with the appropriate level of training concerning how to use medical sharps. This should encompass not only safe use and handling but also the disposal procedure and generally improving awareness such as risks associated with exposure to blood and body fluid, recognising the importance of hepatitis B immunisation and encouraging the reporting of all incidents.  

Employers will also be responsible for ensuring that, where possible, health monitoring and vaccinations are provided for staff. In short, the directive requires that healthcare providers undertake all that is "reasonably practical to protect healthcare professionals and other staff from harm".

UK implementation 

The directive serves as an addition to working standards for those employed in medical and healthcare sectors across the European Union. As a product of this, it demands that healthcare organisations can demonstrate that they are "providing medical devices incorporating safety-engineered protection mechanisms" which encompases both needles and intravenous catheters.

In the UK, many of the requirements contained in the directive were already addressed in the Health and Safety at Work Act 1974. However the legislation provides specific details on requirements which must be introduced in order to bring the country in-line with the new regulations. The new legal requirements, of both employer and employee, indicate that they must work together to ensure the "effective safe management of sharps, across all sectors, flows from the existing health and safety legislation. In particular, the needs to assess the risks, provide appropriate information and training, and consult with employees", according to a leaflet distributed by the Health and Safety Executive (HSE). This will be achieved by adjusting the current health and safety standards to explicitly meet the requirements of the legislation protocol. 

Britain's biggest trade union, Unison, has supported the need for safer needlestick regulation with its Safer Needles Network and is pleased the EU has enforced appropriate legislation. Robert Baughan, National Officer for Health & Safety for the union, said that workers had welcomed the introduction of the new policies.

He said: "The feedback we have had is positive for those affected by sharps injuries." However he added that it only "applies to healthcare workers" and Unison would like to see "the directive to extend to all workers who are working with sharps".

Benefits

A number of benefits can be attributed to the implementation of such legislation for medical workers in the UK. Financially, it is thought that needlestick injuries cost £500,000 per NHS Trust every year, according to a Memorandum submitted by the Safer Needle Network. Compare this to the £136,000 annual cost of introducing the safety-engineered devices and you can see it is a logical monetary step for state-funded organisations. 

However it will be the ethical considerations that drive many employers to support the legislation. A safer working environment will surely boost loyalty, job satisfaction and productivity among staff. 

Mr Baughan said that the legislation makes it very clear for employers about what they need to do to make work environments safe. It specifies the need for higher arbitrary controls which means they have to consider engineering controls and collective measures like the use of safe needle stick devices above measures which are aimed at individual behaviour which is always harder to enforce, according to the official. 

He said that a possible drawback would be that the legislation required a change in behaviour for many people which can't always be guaranteed. There is always the chance for human error so the union is always looking for measures that can reduce this as much as possible, according to Mr Baughan. 

How are other EU countries outside the UK affected?

Like the UK, many other EU countries haven't needed to implement the directive as local law already covers the area in one form or another. For these member states it was a matter of updating and adding elements to local law rather than passing new legislations.

In Italy, there was no need to introduce the guidelines because under law 81/2008 it is already supported. Needlestick legislation is referred to under the health and safety at work legislation which is regulated by the Legislative Decree Law 81/2008 (known as the Testo Unico Sicurezza Lavoro). This, though recently modified, decree removes the need for the European Directive as it already suffeciently protects the health and safety of its workers.
 
It reads: "The employer is under an obligation to provide employees with all general information on the risks present in the workplace and specific information on the risks associated with performance of the tasks assigned to individuals.

Similar occurrences happened in both Germany and the Netherlands as needlestick regulations were already included in their local laws. The Netherlands had the appropriate legislation under the Dutch Law 399-2011 for the Protection of Labour Regulations, although Article 2 of the EU legislation was incorporated into the Labour Law in 2011.

Similarly, Germany addressed the issue of needlestick injuries in its TRBA250 (Technische Regeln für Biologische Arbeitsstoffe) which has been in place since 2007.

Related Legislation and Guidelines: