Epidemiology of needlestick injury exposures among dental students during clinical training in a major teaching institution of China: A cross-sectional study

Awareness and Reporting of Sharps Injuries: A Study Involving Dental Students, Trainees, and Assistants in a Dental Teaching Hospital in Saudi Arabia

BACKGROUND

Sharps injury constitutes one of the major occupational hazards in dental practice with practitioners under training being the most exposed group. This study aimed to assess the level of awareness about sharps injury, its prevalence, and reporting rates among dental students, trainees, and assistants.

METHODS

The study was conducted at the Dental Teaching Hospital, Umm Al Qura University, Saudi Arabia, through an online self-designed questionnaire which comprised 21 items. Data was collected, tabulated, and statistically analyzed.  Results: Among 182 responding participants, the mean awareness score was satisfactory in 117 participants (64.3%) and average in 64 (35.2%). Exposure to sharps injury in the last 24 months was reported by 31.3% (n=20) with needle stick injury being the most frequent cause and only 59.6% (n=34) reported the injury. Interns and sixth-year students were the most injured participants. There was a significant difference in knowledge between exposed and non-exposed participants regarding the safe technique of recapping needles (p=0.037). After the injury, 77.2% (n=44) of participants washed their hands with soap and water.

CONCLUSIONS

A considerable percentage of study participants have average to satisfactory awareness about the risk of sharps injury with a high under-reporting rate. So, comprehensive preclinical education and training must be provided to our hospital's students, trainees, and assistants to increase awareness about potentially risky behavior. More orientation about reporting and its role in prevention is highly recommended to ensure safe practice and improve the quality of dental care.

The Knowledge, Attitude, and Perception of Needlestick Injuries Among Dental Students in Riyadh, Kingdom of Saudi Arabia: A Cross-Sectional Survey

INTRODUCTION

Needlestick injuries (NSIs) represent a significant source of bloodborne viruses in the healthcare sector, particularly in dentistry. Developing effective infection control programs necessitates access to surveillance data. A comprehensive evaluation, encompassing human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and serological testing, is crucial due to the potential lack of immediate symptoms in infected patients. It is essential to verify hepatitis B and tetanus immunization statuses and seek guidance from infectious disease experts for post-exposure prophylaxis. Aim and objective: This study aims to assess the knowledge, attitudes, and perceptions of NSIs among dentistry students in Riyadh, Saudi Arabia.

METHODS

Conducted during the 2023-2024 academic year in Riyadh, Saudi Arabia, this cross-sectional study evaluated the knowledge, attitudes, and perceptions of undergraduate dental medicine students regarding NSIs. Ethical approval was obtained, and informed consent was meticulously collected. Before participation, potential subjects were furnished with a comprehensive information sheet outlining the study's purpose, the survey's nature, expected duration, and potential risks or benefits. The document emphasized their unequivocal right to withdraw from the study at any point without any adverse consequences. Data collection relied on an online survey administered to third and final-year dental students selected from specific universities. This selection criterion ensured that participants were directly relevant to the dental education context under investigation. Careful exclusions were made to minimize potential bias, particularly by excluding students from academic years other than the third and final years, thus maintaining a specific focus on this subgroup. Data analysis primarily compared NSI occurrences and awareness based on dental college and academic year. Detailed findings are presented in the results section.

RESULTS

The study unveiled high vaccination rates (95.23%) and significant levels of education regarding bloodborne infections (81.38%) among participants. However, it was noteworthy that 72.72% believed their vaccinations offered complete protection. Only 47.18% believed that wearing surgical gloves reduced the risk of NSIs, while a substantial majority (93.07%) opposed the practice of needle recapping. Moreover, 76.19% demonstrated knowledge of post-exposure prophylaxis, indicating room for improvement in healthcare safety practices. Statistical analysis identified significant associations between the Dental College attended and both NSI occurrence (χ²=12.164, p=0.058) and awareness (χ²=14.629, p=0.023). Conversely, the academic year exhibited no significant relationship with either NSI occurrence (χ²=1.2, p=0.55) or awareness (χ²=0.44, p=0.8). Additionally, the study revealed non-normal distributions for both NSI occurrence (p<0.001) and awareness (p<0.001) among participants.

CONCLUSION

In conclusion, this study underscores the pivotal role of awareness in mitigating NSI occurrences among dental students. Irrespective of their academic year, heightened awareness significantly correlated with reduced NSI incidence. These findings bear significant implications for dental education and practice, emphasizing the imperative need for comprehensive education and awareness initiatives to bolster healthcare safety among dental professionals.

Prevalence and characteristics of needlestick injuries among dental interns during their first-year clinical training: an observational study

BACKGROUND

Dental interns are vulnerable to needlestick injuries (NSI). The objectives of this study were to examine the prevalence and characteristics of NSI exposures among dental interns during their first-year clinical training, assess risk factors, and evaluate reporting behaviours.

METHODS

An online survey was conducted among dental interns of Class 2011-2017 at Peking University School and Hospital of Stomatology (PKUSS), China. The self-administrated questionnaire consisted of information on demographic profiles, NSI characteristics, and reporting practices. The outcomes were presented by descriptive statistics. A multivariate regression analysis was performed to assess NSI sources using a forward step-wise approach.

RESULTS

A total of 407 dental interns completed the survey (response rate 91.9%, 407/443), and 23.8% sustained at least one NSI. The mean number of NSIs per intern was 0.28 during the first clinical year. More occupation exposures occurred from October to December, between 13:00-15:00. Syringe needles were the most frequent sources, followed by dental burs, suture needles, and ultrasonic chips. The risk of peer-inflicted NSIs in the department of Paediatric Dentistry was 12.1 times higher than that in Oral Surgery (OR 12.1, 95% CI: 1.4-101.4). Appropriately 64.9% NSIs occurred when chairside assistants were absent. Compared to working alone, the risk of peer-inflicted NSIs was 32.3 times higher when providing chairside assistance (OR 32.3, 95% CI: 7.2-145.4). The left-hand index finger was the most commonly injured site. About 71.4% of exposures were reported in paperwork.

CONCLUSIONS

Dental interns are susceptible to NSIs during their first-year clinical training. Extra attention should be paid to syringe needles, dental burs, suture needles, and ultrasonic chips. The lack of chairside assistance is hazardous regarding NSIs. The training of chairside assistance of the first-year dental interns should be enhanced. First-year dental interns are required to increase their awareness of ignored behaviors related to NSI exposures.

A Cross-Sectional Questionnaire-Based Survey on Blood-Borne Infection Control among Romanian Dental Students

Background and Objectives: According to the CDC estimates, 5.6 million healthcare workers worldwide are exposed to the risk of occupationally contracting blood-borne pathogens, including human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and others. The aim of the present study was to assess the knowledge level on blood-borne infection control (IC) among Romanian undergraduate dental students. Materials and Methods: A cross-sectional, questionnaire-based survey with 21 items was conducted from May 2022 to June 2022. The study had α = 0.620 and Cronbach’s Alpha = 0.660. The Chi-square test was used for data comparison. The data were analyzed using IBM SPSS version 26 (IBM, Armonk, NY, USA), and p ≤ 0.05 was considered statistically significant. Results: The study sample included 207 subjects with a mean age of 21.38 (±1.9) years, 59.9% F (female), 40.1% M (male), 38.2% students from year II and 61.8% from year III. Most of the subjects did not have knowledge on the indirect mode of IC, the persistence of HBV, HCV, or HIV, or the existence of rapid tests (p < 0.05). PEP (post-exposure prophylaxis) was known as follows: HBV, 32.36% (67); HCV, 25.60% (53); and HIV, 36.71% (76); p < 0.05. Only 50.24% (104) had knowledge on the recommended testing moments (p = 0.019 by gender, p = 0.752 by year of study). The optimal time to access PEP was considered by 28.01% (58), p ˃ 0.05. Only 37.68% (78) strongly agreed that the one-hand covering technique of the needle was efficient in IC (p < 0.05). Conclusions: The evaluation of the knowledge regarding IC highlighted major gaps in the perception of the subjects, which underlined the need to implement sustained forms of continuing medical education on this topic.

Global prevalence, risk factors and reporting practice of needlestick and sharps injuries among dental students: A systematic review and Meta-analysis

BACKGROUND

Dental students are vulnerable to needlestick injuries (NSI) due to their inadequate training. However, the global prevalence of NSI among dental students is unknown.

AIM

To determine the pooled prevalence among dental students, epidemiological profile, and risk factors for NSI.

METHODS

A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The review protocol was registered at the International Prospective Register of Systematic Reviews (CRD 42022312778). Eligible studies were identified from PubMed, Scopus, Web of Science, Embase, OVID, and EBSCO databases. A meta-analysis with a random effects model was performed to estimate the pooled prevalence, and meta-regression was conducted to explore heterogeneity among studies.

FINDINGS

A total of 25 studies from 15 countries met the inclusion criteria. The estimated pooled prevalence of NSI among dental students was 44% (95% CI: 38-51%). Local anesthesia, tooth cleaning or scaling, and waste disposal were associated with highest risk for NSI. Most studies observed under-reporting of NSI. Dental students had inadequate knowledge regarding post-exposure management.

CONCLUSION

Dental students had a high prevalence and low reporting rate of NSI exposure. Inadequate knowledge might increase the probability of NSI exposure.