The risk of blood exposure incidents in dental practices in the Netherlands.
OBJECTIVE
An awareness of the risk of blood-borne infections among dentists has been promoted by the Dutch Dental Association (NMT) as part of their quality and safety programme, and a nationally operating expert counselling centre was contracted to manage all reported incidents.


METHODS
We analysed data on hepatitis B vaccination status, sex and age for all reported incidents recorded by this centre during 2008. We compared this with data collected at same time during a national survey to assess the performance of the centre. The number of blood exposure injuries among dentists and their assistants, and reporting behaviour, were also assessed.


RESULTS
In 2008, 387 incidents were reported to the counselling centre. The percentage of high-risk incidents was 16, with a risk of hepatitis B, hepatitis C and HIV infections. In the hepatitis B cases, 12% had no or insufficient immunization. Eight per cent of those injured were unable to start HIV Post-Exposition Prophylaxis because they reported too late. Of the 1442 surveys sent, 487 (34%) were returned. Dentists estimated levels of hepatitis B vaccination at 98%. Thirty-two per cent reported to have had one or more injuries in their practice in 2008. Of these, 37% were counselled by the expert centre, 18% were counselled by others and 45% sought no medical attention. The performance of the counselling centre received a positive score (95%). A need for more information about vaccination and blood-borne infections in dentistry (52%) was reported.


CONCLUSIONS
Nationwide data show blood exposure incidents occur frequently in dental settings, with a considerable number of high-risk incidents. Administering anaesthetics and cleaning-up are major risk factors. There is a need to intensify measures for safe working conditions in dental care settings in the Netherlands, irrespective of the type of dental practice.
Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands. p.vanwijk@vumc.nl
P T L
PT
van Wijk
A E
AE
Meiberg
J J M
JJ
Bruers
M H
MH
Groenewold
A L
AL
van Raalten
B A F M
BA
Dam
P M
PM
Schneeberger
D017848:Blood-Borne Pathogens; D003625:Data Collection; D003729:Dental Care / Q000009:adverse effects; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D006509:Hepatitis B / Q000517:prevention & control; D017325:Hepatitis B Vaccines / Q000627:therapeutic use; D006526:Hepatitis C / Q000517:prevention & control; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016273:Occupational Exposure / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors
D017325:Hepatitis B Vaccines