Safety syringes are increasingly used as a substitute to ordinary syringes in the United States when former president Bill Clinton signed the Needlestick Safety and Prevention Act in November 2000.

The Act was in response to strong lobby by the American Nurses Association (ANA) for a new legislation that will require all health care facilities to use needleless systems or needles with engineered protection.

This came following a 1998 accident in which Massachusetts Nurses Association president Karen Daley was confirmed to have contracted HIV and Hepatitis C from a needlestick injury.

She was infected with the two diseases while disposing of used needles.

"This injury did not have to happen and would not have happened if a safer system had been in place in my work setting," Daley had said then.

ANA said about 800,000 to o­ne million cases of needlestick injuries were reported among US healthcare workers annually, and that 80 percent of these injuries could be prevented with special, safer devices.

High cost

The association also complained that many US hospitals chose not to use safety syringes, which have been available since 1970s, because they are more expensive than standard o­nes.

"But the cost of not using these safe devices is much higher. Any increase in cost is minimal compared with the overwhelming expenses and tragic losses that occur when less expensive devices are used," ANA warned then.

It said when a nurse is injured by needlestick but no infection occurs, the average cost is USD2,809; whereas if an infection occurs, the average cost rises up to USD500,000.

"These costs do not even begin to include the emotional trauma the nurses and their families face when they learn (the nurses) have contracted HIV or Hepatitis C from an occupational needlestick injury," it said.

The Act signed by Clinton stated that:

All medical facilities should use safer devices to protect their workers from sharp injuries;

Employers must solicit the input o­n non-managerial employees responsible for direct patient care, who are potentially exposed to sharp injuries, in the identification, evaluation and selection of effective engineering and work-practice controls; and

Employers must maintain a sharp injury log to contain the type and brand of device involved in the incident, the department or work area where it occurred, and an explanation of how it occurred

However, needlestick probblem was not restricted to the US.

Global problem

In 1998, A World Health Organisation study revealed that 10 million people contracted lethal diseases through the reuse of contaminated syringes.

Following that, San Francisco Chronicle wrote an article about the danger of contaminated syringes, calling it a "crisis that could have been defused more than a decade ago".

"It is about soaring disease rates in Egypt and plunging life expectancies in Brazil; children combing garbage dumps for syringes to sell in Kenya and India, and ignorance, poverty and corruption driving medical workers in Cambodia and Russia to reuse needle dozens sometimes hundreds of times.

"It is about a promising generation of non-reusable syringes that got lost in a multibillion-dollar corporate battle over the global syringe market. It is about how the world's leading syringe manufacturers first ignored the problem, then either delayed the new technology or did little to get it into the hands of health workers," said the Chronicle.