Occupational injuries and exposures among Canadian dentists: the results of a national survey.
OBJECTIVE
To measure the frequency of occupational exposures reported by dentists in Canada and to identify factors associated with occupational exposure.


METHODS
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 > or =20 patients per day, and male gender. Risk factors for mucous membrane exposure included non-use of eye protection or masks.


CONCLUSIONS
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.
McCarthy
G M
GM
School of Dentistry, Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Canada.
Koval
J J
JJ
MacDonald
J K
JK
D000328:Adult; D002170:Canada / Q000453:epidemiology; D003428:Cross Infection / Q000635:transmission*; D003815:Dentists / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D017053:Infection Control / Q000379:methods; D017758:Infectious Disease Transmission, Patient-to-Professional; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D011364:Professional Practice / Q000706:statistics & numerical data; D012308:Risk Management / Q000379:methods; D014950:Wounds, Penetrating / Q000453:epidemiology / Q000517:prevention & control