These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. An exposure can be defined as a percutaneous injury (e.g., needlestick or cut with a sharp object) or contact of mucous membrane or non-intact skin (e.g., exposed skin that is chapped, abraded, or with dermatitis) with blood, saliva, tissue, or other body fluids that are potentially infectious. Exposure incidents might place dental health care personnel at risk for hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV) infection, and therefore should be evaluated immediately following treatment of the exposure site by a qualified health care professional.What body fluids are potentially infectious during an occupational exposure? When evaluating occupational exposures to fluids that might contain hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV), health care workers should consider that all blood, body fluids, secretions, and excretions except sweat, may contain transmissible infectious agents. Blood contains the greatest proportion of infectious bloodborne virus particle titers of all body fluids and is the most critical transmission vehicle in the health-care setting. During dental procedures it is predictable that saliva will become contaminated with blood. If blood is not visible, it is still likely that very small quantities of blood are present, but the risk for transmitting HBV, HCV, or HIV is extremely small. Despite this small transmission risk, a qualified health care professional1 should evaluate any occupational exposure to saliva in dental settings, regardless of visible blood. What is the risk of infection after an occupational exposure? Hepatitis B Virus (HBV) Health care workers who have received hepatitis B vaccine and have developed immunity to the virus are at virtually no risk for infection. For an unvaccinated person, the risk from a single needlestick or a cut exposure to HBV-infected blood ranges from 6%–30% and depends on the hepatitis B e antigen (HBeAg) status of the source individual. Individuals who are both hepatitis B surface antigen (HBsAg) positive and HBeAg positive have more virus in their blood and are more likely to transmit HBV. Hepatitis C Virus (HCV) Based on limited studies, the estimated risk for infection after a needlestick or cut exposure to HCV-infected blood is approximately 1.8%. The risk following a blood splash is unknown but is believed to be very small; however, HCV infection from such an exposure has been reported. Human Immunodeficiency Virus (HIV)
What should be done following an occupational exposure? (Oral healthcare providers should check their provincial standards to ensure there are no additional registries they should contact following a significant exposure in their offices). Post-exposure Protocol: all oral healthcare workers should know their Hepatitis B immunization status and serology results (antibodies are equal to or greater than 10 IU/litre).
What factors must qualified health care professionals consider when assessing the need for follow-up of occupational exposures? The evaluation must include the following factors to determine the need for further follow-up: Type of exposure
Blood
Infectious status of source
Susceptibility of exposed person
After conducting this initial evaluation of the occupational exposure, a qualified health care professional must decide whether to conduct further follow-up on an individual basis using all of the information obtained. What are some measures to reduce the risk of blood contact? Avoiding occupational exposures to blood is the primary way to prevent transmission of HBV, HCV, and HIV in health care settings. Methods used to reduce such exposures in dental settings include engineering and work practice controls and the use of personal protective equipment (PPE). Engineering controls isolate or remove the bloodborne pathogens hazard from the workplace. These controls are frequently technology-based and often incorporate safer designs of instruments and devices. Examples include sharps disposal containers, rubber dams, and self-sheathing anesthetic needles. Whenever possible, engineering controls should be used as the primary method to reduce exposures to bloodborne pathogens following skin penetration with sharp instruments or needles. Work practice controls are behavior-based and are intended to reduce the risk of blood exposure by changing the manner in which a task is performed. Examples include using the “scoop” technique to recap an anesthetic needle, removing burs before placing the hand piece in the dental unit, and restricting the use of fingers during suturing and when administering anesthesia. Personal protective equipment consists of specialized clothing or equipment worn to protect against hazards. Examples include gloves, masks, protective eyewear with side shields, and gowns to prevent skin and mucous membrane exposures. What happens if you get a patient's blood in your eye?Washing the injured area with soap and water will wash off the residual body fluids. If you sustain a splash, flush the nose, mouth, or skin with water. If body fluids splash into your eyes, irrigate them with clean water, saline, or sterile irrigants.
What should be your first response if you are exposed to blood or bodily fluids?Flush splashes to nose, mouth, or skin with water. Irrigate eyes with clean water, saline, or sterile wash. Report all exposures promptly to ensure that you receive appropriate followup care.
|