The statistics show "the power of a good OSHA standard," says Bill Borwegen, health and safety director of the Service Employees International Union.

Passage of the Needlestick Safety and Prevention Act of 2000 required OSHA to revise its bloodborne pathogen standard to require healthcare facilities to adopt safer devices. OSHA revised its bloodborne pathogen rule as a result and began enforcing it in July 2001.

Researchers found "substantial declines" in injury rates for nearly all the conventional needles that commonly injure nurses. Categories with major drops include intravenous catheters, phlebotomy needles, prefilled syringes, winged steel needles, and lancets.

The 51 percent reduction for nurses at teaching hospitals is an overall rate, including injuries from conventional and safety devices. The rate fell from 19.5 injuries per 100 occupied beds in 1993 to 9.6 injuries per 100 occupied beds in 2001, as compiled by the EPINet Multihospital Sharps Injury database, coordinated at the university.

One of the biggest challenges to seeing that the number of needlesticks continues to decrease is that employers are not buying the safest products, but the cheapest ones, Borwegen says.

Companies still are purchasing safety products developed ten years ago, he says. An example would be a needle system that requires a worker to use both hands to manually sheath the device after use.

"We need to convert to safer needles, but stop marketing the primitive first products," Borwegen said. In addition, he said, "it's high time for needle manufacturers to stop peddling their conventional products."

SEIU would like to see employers purchasing more of the passive devices, such as retractable needles or self-blunting devices.

The University of Virginia researchers note that the acceptance of safer medical devices varies depending on their use.

In laboratory equipment and surgical instruments, relatively small numbers of safety devices are in use," according to the study.

For example, most surgeons have yet to accept blunt-tipped suture needles over the traditional sharp-tip suture needles.