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      Factors Affecting Occupational Exposure to Needlestick and Sharps Injuries among Dentists in Taiwan: A Nationwide Survey

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          Abstract

          Background

          Although the risks of needlestick and sharps injuries (NSIs) for dentists are well recognized, most papers published only described the frequency of occupational exposure to NSIs. Less has been reported assessing factors contributing to exposure to NSIs. The purpose of this study was to update the epidemiology of NSIs among dentists in Taiwan and identify factors affecting NSIs in order to find preventive strategies.

          Methodology/Principal Findings

          A nationwide survey was conducted in dentists at 60 hospitals and 340 clinics in Taiwan. The survey included questions about factors supposedly affecting exposure to NSIs, such as dentist and facility characteristics, knowledge and attitudes about infectious diseases, and practices related to infection control. Univariate and multivariate logistic regression analyses were conducted to determine the association between risk factors and exposure to NSIs. In total, 434 (74.8%) of 580 dentists returned the survey questionnaires, and 100 (23.0%) reported that they had experienced more than one NSI per week. Our data showed that the risk of occupational NSIs is similarly heightened by an older age (odds ratio [OR], 3.18; 95% confidence interval [CI], 1.62–6.25), more years in practice (OR, 2.57; 95% CI, 1.41–4.69), working in clinics (OR, 1.73; 95% CI, 1.08–2.77), exhibiting less compliance with infection-control procedures (OR, 1.82; 95% CI, 1.04–3.18), having insufficient knowledge of blood-borne pathogens (OR, 1.67; 95% CI, 1.04–2.67), and being more worried about being infected by blood-borne pathogens (OR, 1.82; 95% CI, 1.05–3.13).

          Conclusions/Significance

          High rates of NSIs and low compliance with infection-control procedures highly contribute to the chance of acquiring a blood-borne pathogen infection and threaten occupational safety. This study reveals the possible affecting factors and helps in designing prevention strategies for occupational exposure to NSIs.

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          Guidelines for infection control in dental health-care settings--2003.

          William Kohn, Amy Collins, Jennifer L. Cleveland … (2003)
          This report consolidates previous recommendations and adds new ones for infection control in dental settings. Recommendations are provided regarding 1) educating and protecting dental health-care personnel; 2) preventing transmission of bloodborne pathogens; 3) hand hygiene; 4) personal protective equipment; 5) contact dermatitis and latex hypersensitivity; 6) sterilization and disinfection of patient-care items; 7) environmental infection control; 8) dental unit waterlines, biofilm, and water quality; and 9) special considerations (e.g., dental handpieces and other devices, radiology, parenteral medications, oral surgical procedures, and dental laboratories). These recommendations were developed in collaboration with and after review by authorities on infection control from CDC and other public agencies, academia, and private and professional organizations.
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            Hepatitis B virus infection in children and adolescents in a hyperendemic area: 15 years after mass hepatitis B vaccination.

            Yen-Hsuan Ni, Mei-Hwei Chang, Li-Min Huang … (2001)
            Hepatitis B virus (HBV) infection is hyperendemic in Taiwan. Before universal HBV immunization was started in Taiwan in 1984, the carrier rate for hepatitis B surface antigen (HBsAg) was 15% to 20% in the general population. To quantify the population impact of a mass vaccination program for HBV 15 years after its implementation. Descriptive analysis of serologic markers of HBV in healthy children and adolescents. Chung-Cheng District, Taipei City, Taiwan, in 1999. 1357 persons younger than 15 years of age, who were born after the implementation of universal HBV vaccination, and 559 persons 15 to 20 years of age, who were born before the program began. Repeated serologic surveys similar to those done before and 5 and 10 years after the national vaccination program was implemented. All participants were tested for serum HBsAg, its antibody (anti-HBs), and hepatitis B core antibody (anti-HBc). During the 15 years since the vaccination program was implemented, the prevalence of HBsAg among persons younger than 15 years of age decreased from 9.8% in 1984 to 0.7% in 1999; among persons 15 to 20 years of age, the 1999 prevalence of HBsAg was 7% (P < 0.001). Hepatitis B core antibody seropositivity, which represents HBV infection, was found in 2.9% of persons younger than 15 years of age and in 20.6% of persons 15 to 20 years of age (P < 0.001); in the same age groups, the rate of anti-HBs seropositivity was 75.8% and 70.7%, respectively (P = 0.02). Universal vaccination significantly decreased the HBV carrier rate and infection rate among children and adolescents born since the program began. By decreasing the carrier pool, continuation of the national HBV immunization program should prevent HBV infection in the children of Taiwan, and, subsequently, adults as well.
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              Occupational exposure to needlestick injuries and hepatitis B vaccination coverage among health care workers in Egypt.

              S Oun, Iman Khairy, Amr Kandeel … (2003)
              The health care worker (HCW) is at substantial risk of acquiring bloodborne pathogen infections through exposure to blood or infectious body fluids. Hepatitis B vaccination of HCWs and optimal HCW practices regarding management of sharps can minimize these risks. This study explores the frequency of exposure to needlestick injuries and the hepatitis B vaccination coverage among HCWs in Egypt. All HCWs available in a 25% random sample of different types of health care facilities from 2 governorates in Egypt (Nile Delta and Upper Egypt) were included in the study. A total of 1485 HCWs were interviewed. History of exposure to needlestick injuries, vaccination status, and socioeconomic data were collected. Of the 1485 HCWs interviewed, 529 (35.6%) were exposed to at least 1 needlestick injury during the past 3 months with an estimated annual number of 4.9 needlesticks per worker. The most common behavior associated with needlestick injuries was 2-handed recapping. Overall, 64% of HCWs disposed of needles unsafely in nonpuncture-proof containers. Overall 15.8% of HCWs reported receiving 3 doses of hepatitis B vaccine. Vaccination coverage was highest among professional staff (38%) and lowest among housekeeping staff (3.5%). Using Kane's model to predict infections after needlestick exposures, we estimate 24,004 hepatitis C virus and 8617 hepatitis B virus infections occur each year in Egypt as a result of occupational exposure in the health care environment. High rates of needlestick injuries and low vaccination coverage contribute highly to the rates of viral hepatitis infections among HCWs. Prevention of occupational infection with bloodborne pathogens should be a priority to the national program for promotion of infection control. Training of HCWs on safe handling and collection of needles and sharps, and hepatitis B vaccination of all HCWs is required to reduce transmission.
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                Author and article information

                Contributors
                : Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, USA )
                ISSN (Electronic): 1932-6203
                Publication date Collection: 2012
                Publication date (Electronic): 3 April 2012
                Volume: 7
                Issue: 4
                Electronic Location Identifier: e34911
                Affiliations
                [1 ]School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
                [2 ]Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
                [3 ]Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
                [4 ]School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
                [5 ]School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
                Vanderbilt University, United States of America
                Author notes

                Conceived and designed the experiments: HCC CYS CFH. Performed the experiments: HCC CYS CFH. Analyzed the data: HCC CYS AMFY. Contributed reagents/materials/analysis tools: HCC CYS AMFY CFH. Wrote the paper: HCC CYS AMFY CFH.

                Article
                Publisher ID: PONE-D-11-14737
                DOI: 10.1371/journal.pone.0034911
                PMC ID: 3318009
                PubMed ID: 22509367
                SO-VID: 053f57d3-9809-4365-82b6-28bb5cf707fd
                Copyright © Cheng et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                Date received : 1 August 2011
                Date accepted : 10 March 2012
                Page count
                Pages: 7
                Categories
                Subject: Research Article
                Subject: Biology
                Subject: Population Biology
                Subject: Epidemiology
                Subject: Medicine
                Subject: Epidemiology
                Subject: Infectious Diseases
                Subject: Non-Clinical Medicine
                Subject: Health Care Policy
                Subject: Oral Medicine
                Subject: Public Health

                ScienceOpen disciplines: Uncategorized
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                ScienceOpen disciplines: Uncategorized

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