Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-04T21:29:07.743Z Has data issue: false hasContentIssue false
  • English
  • Français

Occupational Injuries and Exposures Among Canadian Dentists: The Results of a National Survey

Published online by Cambridge University Press:  02 January 2015

Gillian M. McCarthy ,
John J. Koval  and
John K. MacDonald
Gillian M. McCarthy*
Affiliation:
School of Dentistry, The University of Western Ontario, London, Ontario, Canada Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
John J. Koval
Affiliation:
Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
John K. MacDonald
Affiliation:
School of Dentistry, The University of Western Ontario, London, Ontario, Canada Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
*
Division of Oral Biology, Faculty of Medicine and Dentistry, The University of Western Ontario, London, Ontario N6A 5C1, Canada
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To measure the frequency of occupational exposures reported by dentists in Canada and to identify factors associated with occupational exposure.

Design:

A national mailed survey of a stratified random sample of 6,444 dentists with three follow-up attempts. Weighted data were analyzed using t tests, analysis of variance, and multiple logistic regression.

Results:

The response rate was approximately 66%. Occupational exposures, percutaneous injuries, and mucous membrane exposures in the last year were reported by 67%, 62%, and 29% of respondents, respectively. Fewer than 1% reported exposure to human immunodeficiency virus or hepatitis B virus (HBV). Respondents reported means of 1.5 mucous membrane and 3.0 percutaneous exposures per year. HBV immunization was reported by 91% of dentists, but of these 28% reported no post-immunization serology. Other reports of suboptimal compliance included use of a postexposure protocol by only 41% and HBV vaccination of all assistants or of hygienists by 74% and 77% of respondents, respectively. Factors associated with percutaneous exposure included non-use of postexposure protocol or puncture-proof containers for sharps disposal, treating ⩾20 patients per day, and male gender. Risk factors for mucous membrane exposure included non-use of eye protection or masks.

Conclusion:

This study provides evidence of the protective effect of puncture-proof containers, eye protection, and masks and raises concerns related to HBV post-immunization serology and postexposure protocols. To reduce risk of infection, educational interventions are required to improve compliance with Universal Precautions, with emphasis on comprehensive HBV immunization and post-immunization serology, the use of barriers, puncture-proof containers for sharps disposal, and postexposure protocols.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 5 , May 1999 , pp. 331 - 336
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Lee, ES, Forthofer, RN, Lorimor, RJ. Analyzing Complex Survey Data. In: Sage University paper series on quantitative applications in the social sciences, 07-001. Beverly Hills, CA: Sage Publications; 1989:16–17.Google Scholar
2. Landis, JR, Koch, GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159–174.Google Scholar
3. Dillman, DA. Implementing mail surveys. In: Dillman, DA ed. Mail and Telephone Surveys. The Total Design Method. Toronto, Ontario, Canada: John Wiley & Sons; 1978:160–200.Google Scholar
4. Hosmer, DW, Lemeshaw, S. Applied Logistic Regression. New York, NY: John Wiley & Sons; 1989:106–118.Google Scholar
5. McCarthy, GM, MacDonald, JK. Non-response bias in a national study of dentists' infection control practices and attitudes related to HIV. Comm Dent Oral Epidemiol 1997;57:59–62.Google Scholar
6. Bond, WW, Peterson, NJ, Favero, MS, Ebert, JW, Maynard, JE. Transmission of type C viral hepatitis via eye inoculation of a chimpanzee. J Clin Microbiol 1982;15:533–534.Google Scholar
7. Sartori, M, LaTerra, G, Aglietta, M, Manzin, A Navino, C, Verzetti, G. Transmission of hepatitis C via blood splash into conjunctiva. Scand J Infect Dis 1993;25:270–271.Google Scholar
8. Ippolito, G, Puro, V, De Carli, G. The risk of occupational human immunodeficiency virus infection in health care workers: Italian Multicenter Study. The Italian Study Group on Occupational Risk of HIV infection. Arch Intern Med 1993;153:1451–1458.Google Scholar
9. Roy, E, Robillard, P Effectiveness of and compliance to preventive measures against occupational transmission of human immunodeficiency virus. Scand J Work Environ Health 1994;20:393–400.CrossRefGoogle ScholarPubMed
10. Gerberding, JL. Limiting the risks of health care workers. In: Sande, MA Volberding, PA, eds. The Medical Management of AIDS. 4th ed. Philadelphia, PA WB. Saunders Co; 1995:89–101.Google Scholar
11. Gooch, BF, Siew, C, Cleveland, JL, Gruninger, S, Lockwood, SA. Occupational exposures reported by oral surgeons—United States, 1992. J Dent Res 1995;74:22. Abstract 85.Google Scholar
12. Siew, C, Chang, S, Gruninger, SE, Verrusio, AC, Neidle, EA Self-reported percutaneous injuries in dentists: implications for HBV, HIV transmission risk. J Am Dent Assoc 1992;123:37–44.Google Scholar
13. Siew, C, Gruninger, SE, Miaw, C, Neidle, EA Percutaneous injuries in practicing dentists. J Am Dent Assoc 1995;126:1227–1234.Google Scholar
14. Cleveland, JL, Lockwood, SA, Gooch, BF, Chamberland, ME, the Dental Cooperative Study Group. Percutaneous injuries during dental procedures: an observational study. J Am Dent Assoc 1995;126:745–751.Google Scholar
15. Soto, JC, Levi, MD, AUard, R, Franko, EL. Determinants of AIDS preventive behaviour among dental professionals. Can J Public Health 1993;84:128–131.Google Scholar
16. Cleveland, JL, Gooch, BF, Lockwood, SA Occupational blood exposures in dentistry: a decade in review. Infect Control Hosp Epidemiol 1997;18:717–721.CrossRefGoogle ScholarPubMed
17. Nash, KD. How infection control procedures are affecting dental practice today. J Am Dent Assoc 1992;123:67–73.CrossRefGoogle ScholarPubMed
18. Beekmann, SE, Vlahov, D, Koziol, DE, McShalley, ED, Schmitt, JM, Henderson, DK. Temporal association between implementation of Universal Precautions and a sustained, progressive decrease in percutaneous exposures to blood. Clin Infect Dis 1994;18:562–569.Google Scholar
19. Hazelcorn, HM, Bloom, BE, Jovanovic, BD. Infection control in the dental office: has anything changed? J Am Dent Assoc 1996;127:786–790.Google Scholar
20. Canadian Dental Association. Recommendations for infection control procedures. J Can Dent Assoc 1988;54:383–384.Google Scholar
21. Canadian Dental Association. Recommendations for infection control procedures. Communiqué 1992;10.Google Scholar
22. US Department of Labor, Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens, final rule (29 CFR Part 1910.1930). Federal Register December 6, 1991;56(235):64004–64182.Google Scholar
23. Centers for Disease Control and Prevention. Update: provisional public health service recommendations for chemoprophylaxis after occupational exposure to HIV. MMWR 1996;45:468–472.Google Scholar
24. McCarthy, GM, Haji, FS, Mackie, IDF. HIV-infected patients and dental care. Nondisclosure of HIV status and rejection for treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;80:655–659.Google Scholar
25. Health Canada, Laboratory Centre for Disease Control. HIV testing among Canadians: an estimated 11,000-17,000 current HIV infections may not be diagnosed. HIV/AIDS Epi Update May 1998. http://www.hc-sc.gc.ca/hpb/lcdc/bah/epi/epi911-e.html.Google Scholar
26. Porter, S, Scully, C, Samaranayake, L Viral hepatitis. Oral Surg Oral Med Oral Pathol 1994;78:682–695.CrossRefGoogle ScholarPubMed
27. Gore, SM, Felix, DH, Bird, AG, Wray, D. Occupational risk and precautions related to HIV infection among dentists in the Lothian region of Scotland. J Infect 1994;28:209–222.Google Scholar
28. Cleveland, JL, Siew, C, Lockwood, SA Gruninger, SE, Chang, SB, Neidle, EA, et al. Factors associated with hepatitis C vaccine response among dentists. J Dent Res 1994;73:1029–1035.Google Scholar
29. Health Canada, Laboratory Centre for Disease Control. Nosocomial hepatitis B associated with orthopedic surgery, Nova Scotia. Canada Communicable Disease Report 1992;18:89–90.Google Scholar
30. Public Health Laboratory Service. Lessons from two linked clusters of acute hepatitis B in cardiothoracic surgery patients. Communicable Disease Report Review 1996;6:R119–R125.Google Scholar
31. Public Health Laboratory Service. Response to the discovery of two practising surgeons infected with hepatitis, B. Communicable Disease Report Review 1996;6:R126–R128.Google Scholar
32. Bell, DM, Shapiro, CN, Ciesielski, CA Chamberland, ME. Preventing bloodborne pathogen transmission from health-care workers to patients. The CDC perspective. Surg Clin North Am 1995;75:1189–1203.Google Scholar
33. Health Canada, Laboratory Centre for Disease Control. Preventing the transmission of bloodborne pathogens in health care and public service settings. Canada Communicable Disease Report Supplement 1997:23S3.Google Scholar
34. Health Laboratory Centre for Disease Control. Proceedings of the consensus conference on infected health care workers: risk for transmission of bloodborne pathogens. Canada Communicable Disease Report Supplement 1998:24S4.Google Scholar
35. Joint Working Party of the Hospital Infection Society and the Surgical Infection Study Group. Risks to surgeons and patients from HIV and hepatitis: guidelines on precautions and management of exposure to blood or body fluids. BMJ 1992;305:1337–1343.CrossRefGoogle Scholar
36. Public Health Laboratory Service. Hepatitis B virus transmission from HCWto patient. Communicable Disease Report Review 1995;5:R121.Google Scholar
37. Henderson, DK, Chiarello, LA, Dickinson, GM, Fraser, VJ, Gerberding, JL, Greaves, WL, et al. Management of healthcare workers infected with hepatitis B virus, hepatitis B virus, human immunodeficiency virus, or other bloodborne pathogens. Infect Control Hosp Epidemiol 1997;18:349–363.Google Scholar