Institutions and employees in the healthcare industry recently have been flooded with a variety of new preventive devices, with the promise of reducing the risk of needlestick accidents. With the known risk of occupational human immunodeficiency virus (HIV) infection and the greater risk of morbidity and mortality of occupational hepatitis B virus (HBV) infection, it is hard not to get swept away by the tsunami of “safer devices.” The ultimate question of course, is whether these new or improved products actually contribute to the reduction of accidents and diminish the transmission of these diseases. With the demand for safer working conditions in the context of the HIV epidemic and in times of shrinking budgets, the safest and most cost-effective devices must be determined. Although the Occupational Safety and Health Administrations (OSHA) final ruling on occupational exposure to bloodborne pathogens may not directly address the issue of needlestick prevention devices, institutions should be prepared to justify their practices and selection of equipment, given its emphasis on engineering and work practices that states “Engineering and work practice controls shall be used to eliminate or minimize employee exposure.”