eedlestick injuries pose a recognized occupational hazard to health care workers. The first case of occupationally acquired human immunodeficiency virus (HIV) infection was reported in 1984 and highlighted the risk of occupational exposure to HIV and hepatitis (Anonymous, 1984). During the past decade, the Occupational Safety and Health Administration (OSHA) of the U.S. Department of Labor has led government efforts to decrease the risk of exposure through needlestick injuries. In 1991, OSHA promulgated the first Bloodborne Pathogen Standard, requiring employers to maintain a written exposure control plan. This action was followed by the publication of a compliance directive urging employers to consider using new technologies to minimize or eliminate employee exposure to bloodborne pathogens through effective engineering and work practice controls (OSHA, 1992). Over time, the Standard and the compliance directive have been amended to account for the increased availability of improved technologies and interventions, such as vaccination and post-exposure prophylaxis (OSHA, 1998, 1999, 2001a, 2001b). The revised standard, which went into effect on April 18, 2001, redefined engineering controls to include sharps injury protection devices and needleless systems and required (OSHA, 2001a): • Annual review of exposure control plans to reflect the