LabNotes - Volume 16, No.1, 2006

National Phlebotomy Association Statement

In a statement issued in July 2005 at the International Congress of Clinical Chemistry in Orlando, the National Phlebotomy Association (NPA) urged phlebotomists and other healthcare workers to stop reusing blood tube holders for patient blood collections.

The statement cited a study completed by the NPA, which revealed that 99 percent of sampled reusable holders were contaminated with blood, creating an unnecessary risk of exposure to HIV, hepatitis C virus, hepatitis B virus, and other bloodborne pathogens for healthcare workers and patients. (The complete statement along with more information about this organization is available at www.nationalphlebotomy.org).

According to NPA Chief Executive Officer Diane Crawford, the association has always supported single-use devices. However, the results of the NPA study, the rise in antibiotic-resistant pathogens and the prevalence of healthcare associated infections prompted the association to strengthen its stance against reusing blood tube holders. "We'd like to see all phlebotomists, nurses, and physicians use blood collection needles and holders that are designed for single use—preferably with pre-attached holders," Crawford says. "There is simply no reason to jeopardize the safety of healthcare workers or patients when devices that can virtually prevent reuse are readily available. Holders that are pre-attached to safety-engineered blood collection needles and sets may offer the highest level of infection prevention and control."

The NPA joins other prominent healthcare associations and regulatory agencies that have recognized the risks of reusing blood collection holders.

• A 2003 OSHA Safety and Health Information Bulletin prohibited the reuse of tube holders to protect healthcare workers from contaminated back-end needles (SHIB 10-15-03).
• That same year, the Society for Healthcare Epidemiology of America recommended the adoption of single-use medical devices to prevent the spread of microbes and the rise of new antibiotic-resistant infections.

On average, for every 100 BD Vacutainer® blood collection needles or sets sold, only 51 BD Vacutainer® single-use holders were sold as well. This implies that up to 49 percent of blood collection needles and sets are used with holders that have been previously used. A study conducted by the NPA revealed that 99 percent of sampled reusable holders were contaminated with blood, potentially exposing healthcare workers and patients to a variety of bloodborne pathogens, including HIV, hepatitis C virus, and hepatitis B virus.¹ Since tube holders that are reused are not disinfected or sterilized between uses, the potential for airborne pathogens and other microbes and contaminants may occur.²

1. National Phlebotomy Association: www.nationalphlebotomy.org
2. Muto CA, Jernigan JA, Ostrowsky BE, et al. SHEA guideline for
   preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and Enterococcus. Infect Control Hosp Epidemiol. 2003;24:362-386.