The needlestick safety and prevention Act was signed into federal law Nov. 6 by President Bill Clinton at a brief White House ceremony. The AFT's Federation of Nurses and Health Professionals, which was instrumental in its passage, was represented by FNHP division director Mary Lehman MacDonald at the signing ceremony.

"This is an important piece of legislation that will save lives," says MacDonald. "It's a tremendous victory for health care workers."

The act was lobbied for heavily by the AFT and was supported by "health care workers and their unions, as well as a bipartisan group of members of Congress," said the president in a written statement. It amends the Occupational Safety and Health Administration's bloodborne pathogens standard to include safer medical devices. Such devices might include engineered protections and needleless systems. The act will also require certain employers to review exposure-control systems; maintain an injury log; and get input from health care workers.

"It is particularly noteworthy that this health care safety bill was a bipartisan effort that put health care workers and patients above politics," says FNHP program and policy council leader Candice Owley.

Estimates for all health care settings are that 600,000 to 800,000 needlestick and other sharps injuries occur among health care workers annually. Such injuries can involve needles or other sharps contaminated with bloodborne pathogens, such as HIV, HBV or HCV.

On November 1, New York governor George Pataki signed a state needlestick prevention law that New York State United Teachers and its health care members had pushed for passage for several years.

The New York law amends the state's public health law to require that health care facilities and all health care settings use safe needle devices and that an advisory committee--including frontline health care workers and unions--be established to keep the governor and the legislature up to date on the development of safer medical sharps and needles.

This summer, needlestick protection legislation was also signed into law in Ohio.

Ergonomics standard finally sees daylight

n it took 10 years, but workers and their unions have finally prevailed with the passage Nov. 13 of the new Occupational Safety and Health Administration's ergonomics standard. Business, of course, is not happy about it. In fact, Republican congressional leaders, bowing to the pressure of business interests, scotched a deal on the passage of a $350 billion appropriations bill earlier this fall because of an ergonomics rider--which had already been modified by business.

"Every day, 1,500 people suffer ergonomic injuries," says Assistant Secretary for OSHA Charles Jeffress. Of the 1.8 million workers a year who report such work-related musculoskeletal disorders (MSDs) as carpal tunnel syndrome, tendonitis and back injuries, more than 600,000 are forced to take time off from work to recover. OSHA predicts that the new standard will prevent 4.6 million such injuries in the first 10 years.

The OSHA final standard requires employers to implement ergonomics programs and fix jobs where musculoskeletal disorders (MSDs) occur. Under the standards, employers are required to take action whenever a worker reports an MSD or signs or symptoms of an MSD. Employers must then determine if it's work-related and evaluate the ergonomic risk factors according to "Action Triggers," which include repetition, force, awkward postures, contact stress and vibration that meet specific duration and frequency measures. The standard does not require employers to take preventive measures to address MSD hazards.

When an injured worker's job has exposures that meet the triggers, the employer must provide injury management to the workers, analyze the job for MSD hazards, control those hazards and provide training to workers. Employers must also make sure they have no policies or practices that dissuade workers from reporting MSDs or from participating in the ergonomics program.

AFL-CIO president John Sweeney says the current evidence on ergonomic injuries "supports an even stronger standard--one that requires action when hazardous exposures are present, instead of delaying action until an injury occurs."

Women working in the health care field will benefit greatly in that they are represented in three of the top 10 occupations with the most MSDs for women. Women make up 46 percent of the work force and 33 percent of those injured at work, yet they account for 63 percent of repetitive motion injuries that result in lost-work time. Women also experience 70 percent of the carpal tunnel syndrome injuries that result in lost-work time and 62 percent of the lost-work time tendonitis injuries that occur among women workers.

The new OSHA standard will cover some 6 million workplaces and 10 million workers in nearly every line of business. The standard does not apply, however, to employers in construction, maritime, agricultural and railroad industries.

For more information about the ergonomics standard, go to the AFL-CIO Web site address www.aflcio.org/safety/ergo, and to OSHA's Web address www.osha-lc.gov/ergonomics-standard/regulatory/regtext.htm.

School nurses discuss federal programs

With some states proposing ratios of 7,000 students to 1 nurse and student health needs becoming increasingly more complicated, the life of the school nurse isn't getting any easier.

The Federation of Nurses and Health Professionals' school nurse subcommittee met Nov. 30 to discuss ways that school nurses can continue making a positive impact on the health of children, in spite of the obstacles set before them. The most fruitful discussions were yielded by the topics of IDEA and CHIP, two familiar acronyms to school nurses.

The AFT's Suzanne Shaw, who is training members on the provisions of the Individuals with Disabilities Education Act of 1997, talked with the subcommittee members about the importance of the school nurse's role in school team meetings that help determine a disabled student's most appropriate placement in the "least restrictive environment." For the school nurse, that means advising on the student's medical needs and training those who will provide that care while the student is in the classroom. Unfortunately, school nurses are sometimes left out of the instructional planning meetings for special education students, even though health and medical needs are a part of the student's plan.

Subcommittee members suggested to Shaw that whenever she is training teachers on the provisions of IDEA she should remind them about the need to involve school nurses when a child with a disability has medical needs requiring the attention of medical personnel.

The Children's Health Insurance Program (CHIP) is another program important to the health of children. Because of the varying eligibility and application guidelines throughout the states, millions of children are not benefiting from coverage through this low-income children's insurance program.

School nurses are in an ideal position for identifying kids who are uninsured and for helping parents with enrollment in the program. For instance, thanks to a simplification of the paperwork and the involvement of school nurses in New Mexico, some 3,000 eligible children were signed up for CHIP last year alone. Donna Cohen Ross, director of outreach for the non-governmental Center on Budget and Policy Priorities, explained to the subcommittee that there are some 4 million kids on free or reduced school lunch programs who are uninsured. Eligibility for the subsidized lunch program could be a good indicator for schools that the child is eligible for health insurance through CHIP.

If you want to get involved, contact the CHIP outreach coordinator in your area. More information about state CHIPs is available at www.hcfa.gov/init/children.htm. Also, more information is available from the Center on Budget and Policy Priorities online at www.cbpp.org.