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      Prevalence and associated factors for needlestick and sharp injuries (NSIs) among dental assistants in Jeddah, Saudi Arabia

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          Abstract

          Background

          Dental personnel are subject to exposure to a number of occupational factors including needlestick and sharp injuries (NSIs). Our study aims to address knowledge gaps on prevalence and associated factors for needlestick and sharp injuries (NSIs) for the first time in Saudi Arabia.

          Methods

          This cross-sectional study was conducted on a sample of 450 dental assistants recruited from 40 randomly selected private clinics in Jeddah, Saudi Arabia. Data on demographic characteristics, history of NSIs, nature of work, compliance with infection control protocols, and knowledge of infection control procedures and disease transmission were collected using a self-administered questionnaire. Logistic regression analysis was used to assess factors associated with NSIs; unadjusted and adjusted odds ratios (aORs) and their respective 95% confidence intervals (CIs) were computed.

          Results

          About three in ten dental assistants experienced at least one NSI (29.8%, 95% CI 25.6–34.2%) in private dental clinics. Lack of adequate knowledge of infection control procedures and disease transmission, non-compliance with infection control protocol of vaccination against hepatitis B virus, and attending 12 or less number of patients daily were significantly associated with increased risk of NSIs ( p ≤ 0.05); adjusted odds ratios (95% CI) were 1.87 (1.18–2.97), 1.89 (1.05–3.41), and 1.63 (1.03–2.56), respectively. In addition, dental assistants working in 45.8% of dental clinics that had no infection control unit were positively associated with higher NSI risk (aOR = 2.28, 95% CI 1.45–3.57).

          Conclusion

          Our study reported the prevalent nature of NSIs among dental assistants in Saudi Arabia and identified key factors that could be targeted to mitigate this preventable condition. Dental assistants would benefit from proper training on infection control protocols and procedures.

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          Most cited references24

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          Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers.

          The global burden of hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) infection due to percutaneous injuries among health care workers (HCWs) is estimated. The incidence of infections attributable to percutaneous injuries in 14 geographical regions on the basis of the probability of injury, the prevalence of infection, the susceptibility of the worker, and the percutaneous transmission potential are modeled. The model also provides the attributable fractions of infection in HCWs. Overall, 16,000 HCV, 66,000 HBV, and 1,000 HIV infections may have occurred in the year 2000 worldwide among HCWs due to their occupational exposure to percutaneous injuries. The fraction of infections with HCV, HBV, and HIV in HCWs attributable to occupational exposure to percutaneous injuries fraction reaches 39%, 37%, and 4.4% respectively. Occupational exposures to percutaneous injuries are substantial source of infections with bloodborne pathogens among health-care workers (HCWs). These infections are highly preventable and should be eliminated. 2005 Wiley-Liss, Inc.
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            Preventing needlestick injuries among healthcare workers: a WHO-ICN collaboration.

            Effective measures to prevent infections from occupaonal exposure of healthcare workers to blood include mmunization against HBV, eliminating unnecessary injections, implementing Universal Precautions, eliminating needle recapping and disposing of the sharp into a sharps container immediately after use, use of safer devices such as needles that sheath or retract after use, provision and use of personal protective equipment, and training workers in the risks and prevention of transmission. Post-exposure prophylaxis with antiretroviral medications can reduce the risk of HIV transmission by 80%. In 2003, the World Health Organization and the International Council of Nurses launched a pilot project in three countries to protect healthcare workers from needlestick injuries. The results of the pilot will be disseminated worldwide, along with best policies and practices for prevention.
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              Percutaneous injury, blood exposure, and adherence to standard precautions: are hospital-based health care providers still at risk?

              To examine factors associated with blood exposure and percutaneous injury among health care workers, we assessed occupational risk factors, compliance with standard precautions, frequency of exposure, and reporting in a stratified random sample of 5123 physicians, nurses, and medical technologists working in Iowa community hospitals. Of these, 3223 (63%) participated. Mean rates of hand washing (32%-54%), avoiding needle recapping (29%-70%), and underreporting sharps injuries (22%-62%; overall, 32%) varied by occupation (P<.01). Logistic regression was used to estimate the adjusted odds of percutaneous injury (aOR(injury)), which increased 2%-3% for each sharp handled in a typical week. The overall aOR(injury) for never recapping needles was 0.74 (95% CI, 0.60-0.91). Any recent blood contact, a measure of consistent use of barrier precautions, had an overall aOR(injury) of 1.57 (95% CI, 1.32-1.86); among physicians, the aOR(injury) was 2.18 (95% CI, 1.34-3.54). Adherence to standard precautions was found to be suboptimal. Underreporting was found to be common. Percutaneous injury and mucocutaneous blood exposure are related to frequency of sharps handling and inversely related to routine standard-precaution compliance. New strategies for preventing exposures, training, and monitoring adherence are needed.
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                Author and article information

                Contributors
                +966114295436 , zoughoolm@ksau-hs.edu.sa
                Journal
                Environ Health Prev Med
                Environ Health Prev Med
                Environmental Health and Preventive Medicine
                BioMed Central (London )
                1342-078X
                1347-4715
                10 October 2019
                10 October 2019
                2019
                : 24
                : 60
                Affiliations
                [1 ]ISNI 0000 0004 0580 0891, GRID grid.452607.2, King Abdullah International Medical Research Center (KAIMRC), ; Riyadh, Kingdom of Saudi Arabia
                [2 ]ISNI 0000 0004 0608 0662, GRID grid.412149.b, Department of Community and Environmental Health, College of Public Health and Health Informatics, , King Saud bin Abdulaziz University for Health Sciences, ; Mail Code 2350, P.O. Box 22490, Riyadh, 11426 Kingdom of Saudi Arabia
                [3 ]ISNI 0000 0001 0619 1117, GRID grid.412125.1, College of Dentistry, , King Abdulaziz University, ; Jeddah, Kingdom of Saudi Arabia
                Author information
                http://orcid.org/0000-0001-8154-1359
                Article
                815
                10.1186/s12199-019-0815-7
                6788026
                31601166
                1ddbf1c5-09d5-4005-8331-6d3f1745a44f
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 5 February 2019
                : 3 September 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Occupational & Environmental medicine
                healthcare workers,dental assistants,needlestick and sharp injuries,infection control,saudi arabia

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