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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
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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

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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