Five years have passed since the release of the Safety Guidelines for Japanese Acupuncture and Moxibustion Practice 2020. The original plan was to amend the guidelines every five years.The devising of a revision plan (draft plan) began in 2024. This revision organized a working group in the committee for safe acupuncture, and this revision was pushed forward.In the working group, we investigated domestic and foreign adverse event reports added newly in the last five years and reviewed the additions or the contents that needed revisions. In April 2025, we took a plan that was drafted since March 2025 and displayed it on the Society's homepage to encourage public comments. We completed the Safety Guidelines for Japanese Acupuncture and Moxibustion Practice 2025 after referring to the public comments. Three main revisions were incorporated in the new guidelines.First, under "Ⅱ. General Requirements and Precautions for Safety," we arranged problems about a moxa cautery surgery to the facial region. In addition, we omitted a mention of direct moxibustion (scarring moxibustion) cautery and changed the notation.Second, under "Ⅳ. Preventing Adverse Events," we mentioned pneumothorax (including hemopneumothorax) as an item independent of an organ and nerve injury and subsequent care. In addition, in an item related to the difficulty in removing the needle due to a side effect (adverse response), we added that we must not perform prickle acupuncture as an instruction related to the prevention of acupuncture in such cases.Third, under "Ⅴ. Safety in Related Therapies," we performed a full-scale review of an item of electro-acupuncture therapy. We revised the definition of low-frequency acupuncture electricity treatment that was previously unclear in the Guidelines for Japanese Acupuncture and Moxibustion Practice 2020. We proposed the new definition after vetting the attached documents of a medical instrument in a surgery we performed following this definition.We discussed the main revisions in the Guidelines for Japanese Acupuncture and Moxibustion Practice 2025 while referring to the public comments sent for the draft plan.

The Safety Committee, Clinical Information Department, Japan Society of Acupuncture and Moxibustion (JSAM) held a workshop at their 72nd Annual Meeting in Kobe titled "Forgotten Needles: Present Conditions and Measures."In the workshop, the following information was offered by the three committees, and a question and answer session was conducted with the audience afterward. 1. Patient's affection for forgotten needles: analysis of a contribution to Twitter 2. The present conditions and measure plans of forgotten needles: based on the present conditions of Kansai University of Health Sciences 3. Forgotten needles at the Suzuka University of Medical Science: the real condition of prevention of outbreak We performed a thorough cross- and/or double-check to prevent forgotten needles. The reports suggested various ideas as check methods, and the results of the study helped the practice from the next day.

In The 63rd Annual Congress of JSAM (Ehime 2014), the Committee for Safe Acupuncture of Research Department in the Japan Society of Acupuncture and Moxibustion (JSAM) conducted a workshop entitled "The Regional Anatomy Q&A for safety needling"which provided information on organ damage and neurological injuries that may occur after acupuncture treatments. This workshop stated the need for improvements in safe practices of acupuncture.
This workshop was divided into three parts:(1) results of questionnaire surveys conducted in Japan for acupuncturists on their clinical experience of adverse events and for orthopaedic doctors on their clinical experience of patients who suffered adverse events after acupuncture treatment;(2) a literature search of severe adverse events e.g., pneumothorax and neurological injuries, associated with acupuncture treatment in Japan;(3) the regional anatomy of the upper part of the body, which is based on several anatomical studies on acupoints.
The incidence of severe adverse events is considered to be very low during all acupuncture treatments;however, the real incidence is estimated to be higher than the number of case reports in the literature. In order to prevent severe adverse events, regional anatomical knowledge of needling points is very important, and furthermore, safe needling techniques are required.
We hope that this workshop can aid in enhancing the knowledge and techniques and contribute to safe practices of acupuncture.