The sharps market has undergone a major transformation during the last 15 years. In the mid-1980s, manufacturers of needle-based I.V. access systems took up the challenge of providing needleless or recessed needle systems that eliminated a source of unnecessary needles (and unnecessary needlesticks). At the same time, designs for safety-engineered needles, which cover the sharp after use, expanded rapidly.

Now an announcement by two major manufacturers of medical needles and other sharps indicates just how far that trend has come. BD (Becton, Dickinson and Company) plans to discontinue U.S. sales of many conventional needles and other sharp devices across a range of product categories. Baxter Healthcare Corporation, where needleless systems represent more than 90 percent of the sales volume for I.V. access products, is in the process of phasing out needle-based products.

Making the shift
Since the Needlestick Safety and Prevention Act was passed in November 2000, sales of safety-engineered sharp devices have surged. U.S. hospitals have shifted more than 80 percent of their sharps product usage to safety designs in various categories, according to BD. This includes I.V. catheters, needleless or recessed needle I.V. connectors, blood-drawing needles, winged or "butterfly" needles and lancets.

Problems remain
Device categories where there has been lower adoption of safety alternatives include syringes, surgical blades and scalpels. In a December 2000 letter to customers, BD noted that syringes with needles are used for a variety of purposes, including non-patient applications, such as preparing medications in hospital pharmacies, and that it will continue to make conventional syringes available for such purposes.

A published telephone survey conducted in March 2002 found that nearly 60 percent of private-practice physicians, and the nurses who work for them, were still using non-safety devices, compared with 20 percent of hospital-based physicians. Market data indicate that outpatient facilities also have had a lower rate of safety-device adoption. In fact, surgical settings have been one of the hardest areas to convert to safety. A comparison of data from 1993 and 2001 shows that suture needles had the smallest decline in percutaneous injury rates of all device categories. The decline was 70 percent for phlebotomy needles and 55 percent for I.V. catheters, compared with only 5 percent for suture needles.

What's to come
The ongoing conversion to safety devices represents a bellwether in needle safety. Conventional (non-safety) needle devices may be a dying breed and become all but extinct in most product categories in the next few years.