title: Accidental needle sticks, the Occupational Safety and Health Administration, and the fallacy of public policy.
abstract: BACKGROUND
  Current Occupational Safety and Health Administration (OSHA) guidelines mandate the use of safety needles when allergy injections are given. Safety needles for intradermal testing remain optional. Whether safety needles reduce the number of accidental needle sticks (ANSs) in the outpatient setting has yet to be proven.
  
  
  OBJECTIVE
  To determine the rate of ANSs with new (safety) needles vs old needles used in allergy immunotherapy and intradermal testing.
  
  
  METHODS
  Allergy practices from 22 states were surveyed by e-mail.
  
  
  RESULTS
  Seventy practices (28%) responded to the survey. Twice as many ANSs occurred in practices giving immunotherapy when using new needles vs old needles (P < .01). The rate of ANSs was roughly the same for intradermal testing with new needles vs old needles.
  
  
  CONCLUSIONS
  These findings further question whether OSHA's guidelines for safety needle use in outpatient practice need revision and if allergy practices might be excluded from the requirement to use safety needles.
authors.affiliation: Department of Medicine, Vanderbilt University, Nashville, Tennessee 37205, USA. wolfatthelair@comcast.net
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Wolf
authors.forename: Albert
authors.initials: A
authors.lastname: Marks
authors.forename: John M
authors.initials: JM
authors.lastname: Fahrenholz
mesh_terms: D000056:Accident Prevention / Q000331:legislation & jurisprudence*; D000486:Allergy and Immunology / Q000295:instrumentation* / Q000331:legislation & jurisprudence; D000553:Ambulatory Care / Q000331:legislation & jurisprudence; D017848:Blood-Borne Pathogens; D003888:Desensitization, Immunologic / Q000295:instrumentation*; D004866:Equipment Contamination; D004867:Equipment Design; D004869:Equipment Safety / Q000592:standards*; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D007279:Injections, Subcutaneous / Q000295:instrumentation; D007428:Intradermal Tests / Q000295:instrumentation*; D009339:Needles / Q000592:standards*; D016602:Needlestick Injuries / Q000453:epidemiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011640:Public Policy; D012449:Safety; D013594:Syringes / Q000592:standards*; D014481:United States; D014489:United States Occupational Safety and Health Administration / Q000592:standards*