Occupational exposure to blood and body fluids in a department of oral sciences: results of a thirteen-year surveillance study

Occupational exposures to bloodborne pathogens and its underreporting in dental teaching environment in an Indian dental school

Introduction

The aims of this study were 1) to find out the prevalence of occupational exposures to contaminated biological material among undergraduate students and interns; 2) to find out how many cases of occupational exposures to bloodborne pathogens are reported; and 3) to know the reasons for non-reporting of occupational exposures.

Materials and Methods

The study was conducted in a Dental School in Navi-Mumbai, India. An anonymous self-administered questionnaire was formulated. 210 dental students were given a questionnaire out of which 150 students attending clinical postings in their third year, final year, and internship responded. Approval was obtained from the Institutional Ethical Committee.

Results

The study revealed a very high prevalence (66.7%) of exposures among the students. Only 12% of the students reported the exposures to the staff. Students from III year and final year BDS (Bachelor of Dental Surgery) had mean exposure of 2.40 as compared to 1.94 among interns. 46% of the students stated that they did not report about the exposure because they thought that injury was of minor nature.

Conclusion

There is a very high prevalence of occupational exposures among students which are not reported. There is a need for the development of a post exposure protocol which has to be strictly implemented. The principle of infection control has to be emphasised to the students periodically and they should be encouraged to report incidences of exposures to biological material.

Self-reported percutaneous injuries of students and interns at the School of Dentistry in Trinidad: A follow up study of an updated sharps protocol

Objective To report the results of a survey of all percutaneous injuries that occurred between 2009 – 2014 among students and interns at the dental school in Trinidad and to evaluate compliance with the protocol for the management of percutaneous injuries. Methods Data was collected via questionnaires administered to 186 clinical students and interns in 2012 and 2014. Data were analysed using SPSS® 17.0 Statistical software. Results A 90% response rate was obtained. Forty-eight persons (29%) reported one or more sharps injuries at the dental school. Of the 76 sharps injuries reported, 55 were percutaneous. Needle sticks and burs accounted for the majority of injuries and mostly occurred while working on patients. There were no significant relationships (p>0.05) between sex nor student year with the occurrence of injuries. 76% of the respondents described their concern for contracting blood borne injuries from sharps injuries as “high.” After injury, 41% of the respondents followed the school’s protocol for sharps injuries. Conclusion The prevalence of percutaneous injuries among students and interns at the UWI dental school in Trinidad is 23% and occur most commonly while working on patients. Compliance with the protocol for percutaneous injuries needs to be improved. The protocol needs to be audited to improve efficiency and reinforced to the students, interns and clinical supervisors during their clinical years.

Evaluation of the Knowledge and Attitudes of Dental Students toward Occupational Blood Exposure Accidents at the End of the Dental Training Program

Aims and Objectives:

This study was conducted to assess knowledge, attitudes, and behavior regarding occupational blood exposure accidents (OBEA) among dental students at the end of the whole dental education program.

Materials and Methods:

The survey was performed using a student self-administered questionnaire during July 2015 in the dental teaching hospital in Rabat. It was conducted on 117 dental students registered in the 5^th year. The results were analyzed by SPSS Software, Version 13.0. Univariate analysis was performed by descriptive statistics, and bivariate analysis was used to identify correlations between different variables.

Results:

Eighty-three students answered the questionnaire (participation rate: 70%). Most participants had incomplete knowledge about the management and the risks of OBEA. Thirty-five participants (42%) experienced at least one occupational exposure to patients' blood. Needle recapping has been the main cause of such injuries (41%). Most accidents occurred, respectively, in the oral surgery (51%) and the restorative dentistry (17%) departments. According to many participants, they had received insufficient education concerning this topic.

Conclusions:

More effective education on prevention and management of OBEA is highly recommended to reduce the prevalence of such injuries. Dental schools should set up a local management unit for following and supporting the exposed students.

The Prevalence and Underreporting of Needlestick Injuries among Dental Healthcare Workers in Pakistan: A Systematic Review

Needlestick injuries (NSIs) are a major occupational health problem among dental healthcare workers (HCWs) in Pakistan, which places them at a significant risk of acquiring blood-borne infections. However, not all NSIs are reported, leading to an underestimation of the actual prevalence. The harmful impacts of NSIs on the healthcare delivery necessitate an urgent need to measure its actual prevalence. Objectives. The aim of this study was to review literature to estimate the prevalence and reporting rates of NSIs among dental-HCWs in Pakistan. Methods. 713 potentially relevant citations were identified by electronic databases and hand searching of articles. Nine primary studies were subsequently identified to be included in the review. Results. The results of the included studies indicate that the prevalence of NSIs among Pakistani dental-HCWs was between 30% and 73%. The rate of reporting of NSIs was between 15% and 76%, and the most common reason was found to be the lack of awareness regarding the reporting system, or of the need to report NSIs. Conclusion. It is evident from the review of the included studies that there is a significantly high prevalence and a low rate of reporting of NSIs among dental-HCWs in Pakistan, suggesting the need to setup an occupational health department in dental settings, for preventing, managing, recording, and monitoring NSIs.

Preliminary Evidence Supports Modification of Retraction Technique to Prevent Needlestick Injuries

A modified retraction technique was introduced into the DDS degree preclinical anesthesia course in 2011 with the goal of reducing needlestick exposure incidents. In numerous studies of dental exposures, injuries from dental anesthetic needles account for the highest proportion of all exposures. The purpose of this study was to assess the preliminary impact of a modified retraction technique on the incidence of blood and body fluids (BBF) exposure incidents associated with needles during injection. Data from evaluations of students from 2014 and 2015 were obtained and tracked to determine whether the modified retraction technique was "excellent," "clinically acceptable," or "clinically unacceptable." Data were collected to determine if the patient perceived the modified retraction technique as "comfortable" or "correctable when addressed" to help improve student technique for future injections. Likewise, data from the blood-borne exposure database where all information related to BBF exposures is recorded were reviewed and the information separated by year and class. This study presents preliminary data only and because of the small sample size does not lend itself to validation by statistical analysis. However, the technique effectively removes the operator's hand from the field during injection, reducing the risk of accidental intraoral needlestick to the nondominant hand of the operator.

Needlestick and Sharp Instruments Injuries among Brazilian Dentistry Students

BACKGROUND

The occurrence of occupational accidents is common among students and dentists. The present study is aimed to evaluate the prevalence and characteristics of needlestick and sharp instrument injuries among dentistry students.

MATERIALS AND METHODS

A documentary research was carried out with data being obtained from the analysis of 137 medical records of injuries caused by needlestick and sharp instruments occurring in the period from 2012 to 2016 and were analyzed regarding the characteristics of the victim (gender and age) and the accident (year, time, environment, and time interval between exposure and search for care). Data were organized in the Statistical Package for Social Sciences software version 18 and were presented through descriptive statistics.

RESULTS

The occurrence of accidents was high (43.1%), with the predominance of female victims (66.1%) and aged up to 23 years (55.9%). The majority of events occurred in the afternoon (54.4%), in the clinical setting (70.7%), and in 75% of the cases, the search for care occurred within 2 h after exposure.

CONCLUSION

Accidents with needlestick and sharp instruments have high frequency and involve mainly female students. They are more common in the afternoon and in the clinical setting and the time interval was between exposure and the search for care complied with recommendations of the Brazilian legislation.