Suljak J P, Leake J L, Haas D A
Faculty of Dentistry, University of Toronto, Ontario, Canada.
Anesth Prog. 1999 Spring;46(2):63-70.
To estimate the occupational risk to dental anesthesiologists of contracting 3 bloodborne pathogens: hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV).
Through an anonymously returned, mailed questionnaire, dental anesthesiologists in Canada and the United States provided information regarding percutaneous and mucocutaneous contacts with contaminated fluid during the treatment of patients under deep sedation and general anesthesia as well as other general practice information. A mathematical model was applied to determine the occupational risk.
Of the 101 (65%) returned questionnaires, 98 reported having treated patients within the previous 6 months. Of these, 41 (42%) had at least one percutaneous accident (89 accidents in total), and the projected mean annual injury rate for dental anesthesiologists overall was 1.82. The most common causes of injury were burs, intraoral needles, and dental instruments. Operator error during use was associated with 31% of reported accidents. Significantly more injuries were reported by those who also reported a mucocutaneous contact and by those working more than 25 hours per week. The projected mean annual number of mucocutaneous exposures was 0.88 for dental anesthesiologists overall.
The calculated annual risk to the average dental anesthesiologist of acquiring HBV (if not immune), HCV, and HIV following percutaneous injury was very low for all infections (HBV the most; HIV the least). The risk of contracting HIV following mucocutaneous contact was extremely low.
评估牙科麻醉医生感染三种血源性病原体(乙型肝炎病毒、丙型肝炎病毒和人类免疫缺陷病毒)的职业风险。
通过一份匿名邮寄回的问卷,加拿大和美国的牙科麻醉医生提供了有关在深度镇静和全身麻醉下治疗患者期间与受污染液体发生经皮和黏膜皮肤接触的信息以及其他一般执业信息。应用数学模型来确定职业风险。
在101份(65%)回收的问卷中,98份报告在过去6个月内治疗过患者。其中,41份(42%)至少发生过一次经皮事故(共89起事故),牙科麻醉医生总体预计年均受伤率为1.82。受伤的最常见原因是牙钻、口腔内注射针和牙科器械。使用过程中的操作失误与31%的报告事故相关。报告有黏膜皮肤接触的人和每周工作超过25小时的人报告的受伤情况明显更多。牙科麻醉医生总体预计年均黏膜皮肤暴露次数为0.88次。
对于所有感染(乙型肝炎病毒感染率最高;人类免疫缺陷病毒感染率最低),计算得出的普通牙科麻醉医生在发生经皮损伤后感染乙型肝炎病毒(如无免疫力)、丙型肝炎病毒和人类免疫缺陷病毒的年度风险非常低。黏膜皮肤接触后感染人类免疫缺陷病毒的风险极低。