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Occupational exposure in dental teaching

 

Clinical bottom line

Injuries in a dental teaching environment are documented thoroughly, and occured at a rate of 2-4 per 100 person years. There was no trend over time.


Reference

FS Younai et al. Occupational exposures to blood in a dental teaching environment: results of a ten-year surveillance study. Journal of Dental Education 2001 65: 436-448.


Study

This study was a prospective investigation of all occupational exposure in the New York University College of Dentistry between 1987 and 1997. Reports were made using a standard form (that evolved over 10 years), and with considerable detail on each exposure. Several strategies were used to maximise compliance with reporting, including dissemination of post-exposure management, detailed education about the programme, discussions with students and staff and infection control newsletters.

Results

Over 10 years, with just over 2 million patient visits, there were 504 occupational exposures. The first two years had very low reporting rates. Most (98%) were percutaneous, the others being a splash to the eye. The severity of the percutaneous injuries is shown in Figure 1.

Figure 1: Severity of percutaneous injury



The types of instruments involved in the exposures is shown in Table 1. Hollow bore needles were involved in 37% of injuries. About 40% of injuries occurred during a procedure, but most occurred postoperatively, particularly during clean up and needle handling and re-capping.

Table 1: Instruments involved in injuries


Instrument Percent
Hollow bore needle 37
Periodontal instrument 24
Miscellaneous 22
Restorative instrument 10
Endodontic instrument 5.0
Surgical 2.2
Solid needle 0.6

Injury rates to students were about 4 per 100 person years, twice the rate in teachers and staff of 2 per 100 person years.

Comment

An interesting study because of its detail, because it was prospective and because it was comprehensive. It made strenuous attempts to capture all injuries, and had details of all those that did occur. Interestingly, there was no trend over the 10 years, apart from an apparent under-reporting during the first two years.