Background

On 24 February 2005, the European Parliament (EP) adopted a resolution on promoting health and safety in the workplace.  Amongst other points, this resolution called on the European Commission to ensure that Member States implemented specific preventive measures necessary to protect healthcare workers from injuries caused by needles and other medical sharps in view of the risk of infection from serious blood-borne infections, such as Hepatitis B and C and HIV.  These measures were to include the appropriate application of training, safe working practices, and adoption of medical technology incorporating sharps protection mechanisms.  The resolution also specified that the European Agency for Safety and Health at Work should be employed to determine the minimum standard of protection, and that European Directive 2000/54/EC should be revised to specifically address the risk arising from work with needles and other medical sharps.

In the wake of this resolution, 6 July 2006 the European Parliament adopted a resolution on protecting European healthcare workers from blood-borne infections due to needlestick injuries.  The resolution requested the Commission to submit to the EP a legislative proposal for a directive amending Directive 2000/54/EC on biological agents at work.

In line with legislation, the Commission was required to consult management and labour before submitting proposals in the social policy field on the possible direction of the amendment to Directive 2000/54/EC.

First stage consultation

To this end in December 2006, the Commission approached the social partners at Community level.  Management and employee organisations within local and regional government, hospitals, the cleaning industry and insurance were invited to give their opinion on the following questions:

1. Do you consider it useful to take an initiative to strengthen the protection of European healthcare workers from blood-borne infections due to needlestick Injuries?
2. Do you think that a joint initiative by the European social partners under Article 139 of the Treaty establishing the European Community would be appropriate?

The Commission received 10 replies from different social partner organisations.  On the whole, the employees’ organisations were in favour of a Community initiative in the form of legislation, taking the view that, while the existing legislation covered the risks in general terms, more specific legislation would reinforce worker protection.  The employers’ organisations, on the other hand, were unanimously opposed to any Community initiative in the form of legislation.  They took the view that such a move was neither justified nor necessary, since the existing legislation already afforded appropriate protection.  According to the employers’ organisations, the emphasis should rather be on effective application of the legislation and on information and awareness-raising activities or the promotion of best practice in this area.

As regards the possible negotiation of an agreement between the social partners, most of the employees’ organisations did not rule out the possibility of negotiating sectoral agreements (in hospitals sector in particular), nor did the majority of employers rule out this possibility.

Outcomes from the first stage consultations

Having analysed the first stage consultation replies from the social partners, the Commission considered that the protection of workers again blood-borne infections resulting from needlestick injuries should be improved.

Although Commission legislation already covers the risks in question, the Commission felt that currently too many European health sector workers are exposed to needlestick injuries.  The Commission therefore considered that Member States must make a particular effort to apply strictly and effectively national legislation transposing the Community legislation in this field, in order to afford more effective protection against the risks of needlestick injury.  This will be brought about through legislative and non-legislative initiatives, with an amendment to the “biological agents at work” directive, Directive 2000/54/EC, providing the main legislative framework for the initiative.

Legislative initiative

The legislative amendments will specify more closely the employer’s obligations.  As regards risk prevention, the application of stricter and clearer measures with an emphasis on safe procedures and the training and information for workers.

The legislation is expected to contain the following measure in particular:

• The use of instruments – such as syringes and needles – with safety devices;
• The use of safe and effective systems to minimise the use of cannulae;
• The modification of work practices which pose a risk of needle injury in order to make them safer;
• A complete end to the recapping of needles;
• The training of workers in the safe use and disposal of needles and other medical sharps in special containers intended for this purpose, and in the correct handling of these containers;
• The general provision of written instructions and notices indicating the procedures to be followed in the event of an accident or incident involving needles or other medical sharps;
• Immediate and effective response and follow-up to any accidental exposure, including rapid post-exposure prophylaxis;
• The offer of vaccination against hepatitis B to all workers who may come into contact with needles and other medical sharps;
• The recording in a special register of all injuries caused by needles or other medical sharps.

Non-legislative initiatives

The Commission has also proposed a series of non-legislative initiatives.

1. The preparation of a guide to prevention and good practice in the hospital and health sector, covering the main risk groups in the sector, including those presented by biological agents.  An invitation to tender was published in August 2007, and the guide is expected to be available towards the end of 2008.
2. The European Agency for Safety and Health at Work will be requested to step up information, guidance and awareness-raising activities to improve the prevention of needlestick injuries in the healthcare sector.  Such activities, including a possible European information and awareness campaign, will be carried out with the close involvement of the Member States and social partners.
3. The Commission also wishes to encourage sectoral social dialogue initiatives at EU level in order to establish policy frameworks defining the strategies for prevention of needlestick injuries in given sectors, not only in the health services but also in associated sectors where workers are likely to be exposed to the same risks, such as healthcare cleaning and laundry services and clinical waste processing.  This is considered to ensure that sectoral social dialogue committees are provided with a central role in the exchange of best practice, dissemination of research results and the development of user guides adapted to the needs of each sector.

Second stage consultation

In line with EU legislation, the Commission is, again, required to consult on these new proposals.  Opinion and recommendations have been sought on the content of the legislative and non-legislative proposals, and on the willingness of the social partners to be involved in the initiatives.  The consultation period is due to end in early February 2008.