In 1983 - 84, recognizing that it was essential
to set standards of competence, the acupuncture profession in
the United States established the National Certification Commission
for Acupuncture and Oriental Medicine (NCCAOM). One of the primary
reasons for setting national standards was - and is - to protect
the public from unqualified practitioners.
Potential harm to the public falls into two primary
categories, the risk of accidental injury to internal organs and
complications due to improper sterilization and clean needle technique,
including the possible spread of infectious disease.
The chart (available for download below),
Safety Record of Acupuncture, reflects
reports in the medical literature in English since 1958 from the
United States, West Germany, England, Israel, Ireland, Australia,
Japan, China, Spain, Belgium and Switzerland. Three additional
articles in foreign languages cited in the English literature
are also included, one each from Belgium, West Germany and Japan.
The chart shows a remarkable safety record for
acupuncture throughout the world. This is particularly true considering
that in three of the countries listed, China, Korea and Japan,
acupuncture is a frequent form of health care for hundreds of
thousands of people.
Regarding the risk of injury to
internal organs, the first risk, acupuncturists are trained in
exact needle placement, angle and insertion depth. This results
in an extremely low risk of injury when acupuncture is performed
by a competent individual. This is demonstrated by the following:
- In China and Japan, both of
which have excellent training programs for acupuncturists and
thousands of treatments annually, only ten injuries to internal
organs have been reported since 1972.
- No injuries have been reported
from Korea.
- In the United States, only
ten incidents of injury have been reported since 1965.
- Of the ten cases in the United
States, one was noted as a "one-in-a-million" complication,
another as a bizarre set of circumstances involving self-inflicted
injury by an untrained individual.
- Of the reports from the United
States, only one specified that the treatment had been performed
by a licensed or certified acupuncturist and that individual
was licensed without examination or standards of competency.
- In the reports from the other
Western countries, in most of which only M.D.s may practice
acupuncture, it was unclear who had performed the treatment.
- In the seventeen years that
the NCCAOM has certified over 10,000 individuals in acupuncture,
NCCAOM has never had reason to take action against a Diplomate
due to negligent or harmful treatment to a patient.
Additionally, in the cases in which there was
damage to internal organs, in most cases, except the two unusual
cases noted above, the patient recovered and the damage was minimal.
In fact, in the cases of retained or broken needle, the needle
had been in place up to 35 years without complications.
From the outset, the acupuncture profession in
the United States recognized the second risk of harm to the public,
the risk inherent in the use of unsterile needles and lack of
clean needle technique. Thus, one of the first tasks of the profession
was to establish standards for clean needle technique (CNT). Therefore,
in concert with the Center for Disease Control in Atlanta, Georgia,
the profession developed the Clean
Needle Technique Manual, published by the National Acupuncture
Foundation. The CNT Manual serves
as the basis for questions on the NCCAOM written examination as
well as for the national CNT Course offered by the Council of
Colleges of Acupuncture and Oriental Medicine (CCAOM). Passage
of the CNT Course is required for NCCAOM certification and for
licensure in most states.
The chart demonstrates that complications due
to improper clean needle technique occur in countries, states
or professions that have not set standards of clean needle technique
for acupuncture practice. Additionally, of the seven complications
due to improper clean needle technique in the United States, only
three were due to treatment by acupuncturists. One individual
was not licensed or certified, one was licensed without exam and
the status and background of the third was not mentioned. No such
incident to date has been reported involving a nationally certified
acupuncturist who has met national CNT requirements.
In the entire literature search, only four fatalities
were reported. Three of these involved patients with significant
health problems which the authors stated contributed to the death.
The fourth involved self-treatment for a heart condition.
The second series of charts beginning
on page 5, Safety Record of Certified, Licensed or
Registered Acupuncturists, reemphasizes the safety
of acupuncture when performed by trained individuals. These charts
show the responses received from three surveys of state licensing
boards regarding injuries due to acupuncture reported to them.
It shows a remarkable record, particularly considering several
of the states have permitted practice for over twenty years and
have hundreds of licensed acupuncturists
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