Originally Published MDDI April 2002NEWS & ANALYSIS John Bethune

April 1, 2002

3 Min Read
Group Seeks to Make Primary Prevention a Household Phrase

Originally Published MDDI April 2002


John Bethune

Brad Poulos00

In an effort to bring more awareness to hospitals of the alternatives to sharps devices, a needlestick prevention group has unsuccessfully petitioned the National Institute for Occupational Safety and Health (NIOSH) to issue a new alert to clinicians. According to the National Association for the Primary Prevention of Sharps Injuries (NAPPSI; Carlsbad, CA), few healthcare professionals understand the difference between primary and secondary prevention of sharps injuries. The request to NIOSH was made in a December 6, 2001, letter to the agency.

The group defines primary prevention as "practices and technologies that eliminate the need to introduce sharps into the workplace." Secondary prevention, by contrast, refers to practices and technologies that make sharps safer, such as retractable blades and shielded hypodermic needles.

Declining the request in a March 6, 2002, letter, NIOSH acting director Kathleen Rest wrote that the agency had already underscored the concept of primary prevention in its previous alert. In addition, she wrote, "we will continue to promote the use of needleless technology and safer medical devices."

The NIOSH response suggests the agency believes the primary prevention concept is already well understood. But according to NAPPSI's executive director, Brad Poulos, many clinicians remain unaware of the alternatives to sharps. "We get calls all the time," he says, "asking what's available. All too often, clinicians themselves don't know that there is a needleless alternative."

Although NIOSH already recommends the use of needleless devices when possible, that statement "is buried in the regulations," Poulos says. "We are asking that it be put in a high-priority place for people to see."

NAPPSI also wanted NIOSH to reorganize its list of needlestick engineering controls—that is, types of devices that reduce the risk of injuries. "We asked them to separate the list into a dual list of primary and secondary prevention devices," says Poulos. "We also asked that NIOSH strongly advise healthcare facilities to evaluate primary devices first."

According to Poulos, primary prevention is the wave of the future for device design. In the beginning of the sharps-injury crisis, he says, device makers focused on the design of products for secondary prevention. But "more recently, primary devices have become an industry emphasis."

As an example of this trend, he points to recent NAPPSI member Becton Dickinson. He says that only a few of their many safety products so far are aimed at primary prevention. But Poulos says the company is "moving towards primary prevention." By joining NAPPSI, he says, "BD is implicitly supporting primary prevention as a way to reduce sharps injuries."

Though disappointed that NIOSH "has decided not to issue a specific new advisory," Poulos notes that "many clinician organizations will be issuing the advisory or informing their membership about it."

If NAPPSI is right that many clinicians remain unaware of primary prevention devices, manufacturers may have a substantial untapped market to explore.

Copyright ©2002 Medical Device & Diagnostic Industry

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