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M9480535.TXT
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Document 0535
DOCN M9480535
TI Occupational risk and precautions related to HIV infection among
dentists in the Lothian region of Scotland.
DT 9410
AU Gore SM; Felix DH; Bird AG; Wray D; MRC Biostatistics Unit, Institute of
Public Health, Cambridge,; U.K.
SO J Infect. 1994 Mar;28(2):209-22. Unique Identifier : AIDSLINE
MED/94308580
AB This retrospective study used a postal questionnaire to measure
occupational risks and to assess infection control procedures among 310
dental practitioners. The study comprised general dental practices in
the Lothian region of Scotland, Lothian Health Board Community Dental
Service and Edinburgh Dental Hospital. Altogether, 217 dental
practitioners responded by the due date giving recall of inoculation
injuries within the previous 5 years and infection control measures
employed. The study revealed that 191 practitioners (88%) had completed
a course of hepatitis B vaccination but one-third of them had not been
tested for post-vaccination antibody. In 1991, two thirds of dentists
(66%: 137 of 207 respondents) wore the same pair of gloves, and 80% of
dentists (142 of 177 respondents) wore the same mask, for dealing with
more than one patient. The usual practice was to change gloves during
sessions (44%: out of 71 dentists) and to change masks for each session
or less often (75%: 73 out of 97 dentists). The proportion of dentists
who never used gloves fell from 56% in 1981 to 1% in 1991. An autoclave
was used for sterilisation by 85% of practitioners in 1991. Reported
non-sterile inoculation injuries averaged 1.7 (S.D. = 3.2) injuries per
dentist in the previous year with 56% of practitioners having had an
injury. The average was 6.8 (S.D. = 15.9) injuries per dentist in the
previous 5 years with 76% of practitioners having had an injury. Of
recent non-sterile inoculation injuries described by dental
practitioners, 30% constituted a moderate or high risk of transmission
of infection to the practitioner (43 of 141 described injuries).
Combined with HIV seroprevalance rates, probabilities of transmission
and numbers of practising dentists, the mean reported number of
non-sterile inoculation injuries in the previous 5 years may be used to
provide estimates of expected numbers of dental practitioners
occupationally infected with HIV in the previous 5 years. U.K. estimates
were 0.004 dentists in Lothian region and 0.05 dentists in the Thames
region occupationally infected with HIV in the previous five years.
Non-sterile inoculation injuries appear to be a common hazard of dental
practice. In any year, most dentists are exposed to the risk of
blood-borne viral infection. Despite a high reported incidence of such
injuries, dental practice within the U.K. appears to carry a low risk of
acquiring HIV infection from occupational exposure.
DE Comparative Study Dentists/*STATISTICS & NUMER DATA Disease
Transmission, Patient-to-Professional/*PREVENTION & CONTROL Female
Gloves, Protective/UTILIZATION Hepatitis B Vaccines Human HIV
Infections/EPIDEMIOLOGY/*PREVENTION & CONTROL Infection
Control/METHODS/*STATISTICS & NUMER DATA Male Masks/UTILIZATION
Occupational Diseases/EPIDEMIOLOGY/*PREVENTION & CONTROL Questionnaires
Retrospective Studies Risk Factors Scotland/EPIDEMIOLOGY
Vaccination/STATISTICS & NUMER DATA JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).