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Occupational risk to dental anaesthetists

 

Clinical bottom line

Dental anaesthetists have a finite annual risk of acquiring a bloodborne virus infection.


Reference

JP Suljak et al. The occupational risk to dental anesthesiologists of acquiring 3 bloodborne pathogens. Anesths Prog 1999 46: 63-70.


Study


This was a questionnaire study of 32 dental anaesthetist sin Canada and 123 in the United States. The questionnaire sought information about treating patients under deep sedation or general anaesthesia only. Information was requested about percutaneous injuries and mucocutaneous exposure and the circumstances in which each occurred in the preceding six months.

The results were used to calculate a risk of acquiring bloodborne pathogens, assuming a random selection from the general population.

Results

101 of 155 questionnaires were returned (65%); three had not practiced within the six month window.

Mucous membrane exposure

of the 98 practicing anaesthetists, 77 had no exposure, 10 had one, and seven had two or more exposures, with 43 exposures in six months. There were 0.9 exposures per anaesthetist per year.

Percutaneous exposure

There were 89 percutaneous exposures in the six months, giving 1.8 per anaesthetist per year. Most reported no percutaneous injuries, and the distribution is shown in Figure 1.

Figure 1: Distribution of percutaneous exposures by dental anaesthetists in six months




Risk of acquiring pathogen


Using literature data for prevalence of pathogens and transmission, plus information on number of patients seen and hours worked, an annual risk could be calculated. These were somewhat smaller for Canada than the United States, and the values are shown in Table 1.


Table 1: Cumulative annual risk of acquiring a pathogen


Pathogen Cumulative annual risk
HBV 0.15%
HCV 0.05%
HIV 0.001-0.003%

Comment

There is a finite annual risk of acquiring a bloodborne pathogen by dental anaesthetists. Some of the risks were dental specific, like hitting a bur in a handpiece, but recapping needles, and use of needles made up a significant minority, and these risks are not dissimilar to other clinical situations.