In response to health care workers' worries about HIV, Maryland might follow the lead of California and require hospitals to use syringes designed to reduce the risk of accidental needle-pricks.
The General Assembly will hold a hearing this week on a proposal to direct the state Occupational Safety and Health Advisory Board to develop rules by 2001 requiring safer needles.
The legislation, drafted by Del. Dan K. Morhaim, a Baltimore County Democrat who is also an emergency room doctor, is part of a national trend. Maryland is one of 19 states to consider a law setting new safety standards for syringes since California passed such legislation last year.
Nurses and doctors who treat patients infected with hepatitis or the human immunodeficiency virus, which causes AIDS, or with other diseases say they need more protection than is offered by conventional needles and latex gloves.
Denise Poland, an emergency room nurse at North Arundel Hospital, was drawing blood from an unconscious, intravenous drug user last year when the patient suddenly woke up.
With a jerk, the needle slipped from his arm and plunged into Poland's index finger, passing through the glove and puncturing the flesh.
"I panicked," Poland recalls. "I grabbed my finger and squeezed and squeezed, hoping to push his blood out with mine."
Her fear -- that the blood exchange would send HIV through her veins -- has, after months of preventive drug therapy and repeated testing, not been realized. But in the process, Poland has joined other health care workers in a nationwide campaign for safer injection methods.
Cost worries hospitals
Maryland hospital officials gave Morhaim's bill a chilly reception.
Linda Janzik, spokeswoman for the Maryland Hospital Association, said her group will support the bill only if lawmakers lop off the portion that calls for new regulations, making it merely a mandate to study the issue.
The chief concern of hospital officials, she said, is the cost of replacing every conventional needle with a more expensive safety model.
Common needles typically cost about a dime each, but that price could double -- or even quadruple -- if they are replaced by ones with safety features.
Becton Dickinson and Co., the New Jersey-based company that has long had a corner on the vastly profitable worldwide needle market, estimates it would cost a 300-bed hospital an additional $75,000 a year to use the new needles.
Becton, which has a Hunt Valley plant that manufactures other health care products, is one of several companies that has developed syringes and intravenous lines with safety features.
One model has a plastic shield that slides over the needle tip once it's been used.
Another retracts the needle back into the plunger once a shot is given.
Union supports effort
Health care workers acknowledge the measure will bring added costs, but say it's a small price to pay.
"Every day, 3,000 health care workers get stuck by a needle, and for some of them it will be a death sentence," said Andrew Stern, president of the Service Employees International Union (SEIU), which represents 600,000 nurses, doctors and other medical staff nationwide.
"We're talking about a situation where a small advance in technology can save lives," Stern said. "It would be no more outrageous for us not to require seat belts in cars."
The union has been the driving force behind the national reform effort.
It has promised to be a presence in Annapolis, hiring a local lobbyist and inviting Linda Arnold, a nurse from Pennsylvania who contracted HIV from a needle stick, to testify Wednesday.
Nurses in Maryland said they hoped Arnold's presence would convey to legislators a fear they live with every day.
"Before I was injured, I had never put myself in a high-risk category for AIDS," said Poland, who is married and has two young children. "But that day was a turning point."
After being jabbed, Poland had to undertake the standard treatment for health care workers who are exposed to blood that might be tainted. That includes immediately starting the daunting 16-pill-a-day regimen commonly known as the AIDS cocktail.
Susan Pafel, an emergency room technician at North Arundel who was gouged while drawing blood in December, described the treatment as something akin to "the stomach flu, times 10."
"It feels like something eating your stomach," she said. "I laid on the sofa for a week like I was waiting to die."
Such episodes have led some hospitals to convert to safety equipment without legislation, according to Kathy Hall, executive director of the Maryland Nurses Association. But with new technology on the market for nearly a decade, Hall said it is time to bring everyone on board.
About 20 percent of the needles sold in the United States have safety features, a fact that is a sore subject for Becton Dickinson.