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Overview
In new research from the Centers for Disease Control and Prevention (CDC) and the University of the Pacific, dental health care personnel (HCP) were found to be at risk for percutaneous injuries, particularly needlesticks, but half of those injuries were considered preventable with proper use of safety devices. The study is featured as the cover story in the February 2007 JADA  .
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The study reviewed data from 54 hospital-based dental clinics over a nine-year period (December 1995 through August 2004). 29 of the 54 hospitals reported percutaneous injuries among dental HCP (dentists, oral surgeons, assistants, students and hygienists), and 25 hospitals reported no such injuries. In total, over the nine years, 88 injuries from anesthetic syringes were reported (roughly 10 per year). The total number of patients treated during this period was not reported, so it is not possible to determine an incidence rate.
Data from the CDC’s National Surveillance System for Health Care Workers (NaSH) were evaluated to identify the specific circumstances of percutaneous injuries reported by hospital-based dental HCP. The authors profiled several injury-related variables, including: location and timing in relation to use of the sharp device (e.g., cleanup, syringe disposal); how injuries were sustained; type of procedure, device and dental HCP involved.
The authors estimated that safety syringes (e.g., with retractable sheaths) might have prevented up to 53 percent of the percutaneous injuries sustained after needle use (given sufficient training and integration into practice). Dental safety devices, such as safer scalpels and anesthetic syringes, could protect dentists at key points in their workflow, where acceptable safety syringes and safer work practices could assist in injury prevention.
As previous studies have reported (including a 1995 ADA report ),2 occupational transmission of bloodborne pathogens is rare in dental offices, where injury rates in general are relatively low. To protect employee safety, the Occupational Safety and Health Administration (OSHA) requires that employers establish a written Exposure Control Plan designed to eliminate or minimize employee exposure. OSHA also stipulates that employers annually document in their exposure control plans “consideration and implementation of appropriate commercially available and effective safer medical devices designed to eliminate or minimize occupational exposure.” This requirement is presented in the revised 2001 OSHA Bloodborne Pathogen Standard .
The authors of the study note several available safety devices, but do not evaluate them for effectiveness in a clinical setting. The authors also acknowledge several study limitations, including insufficient data to calculate injury rates among dental HCP (since the total number of dental HCP in the NaSH database was unknown). As the authors explain, “[a]lthough NaSH data may be representative of some hospital-based and private practice dental HCP, they may not represent all types of dental HCP.“
If an exposure incident occurs in clinical practice, dentists can follow the steps listed in the OSHA Postexposure Protocol: A Step–by–Step Guide to Compliance. For additional information on selecting and evaluating dental safety programs and devices, visit JADA online to read the full study in the February 2007 issue.
Footnotes
1Cleveland JL, Barker LK, Cuny EJ, Panlilio AL. Preventing percutaneous injuries among dental health care personnel. J Am Dent Assoc. 2007 Feb;138(2):169-78.
2
Siew C, Gruninger SE, Miaw CL, Neidle EA. Percutaneous injuries in practicing dentists. A prospective study using a 20-day diary. JADA 1995 Sep;126(9):1227-34. Abstract available at:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed
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Science in the News is a service by the American Dental Association (ADA) to present current information about science topics in the news. The ADA is a professional association of dentists committed to the public's oral health, ethics, science and professional advancement; leading a unified profession through initiatives in advocacy, education, research and the development of standards. As a science-based organization, the ADA's evaluation of the scientific evidence may change as more information becomes available. Your thoughts would be greatly appreciated.
Page Posted February 2007
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