Persoon I F, Kaan A M, Su N, de Soet J J, Volgenant C M C
Department of Preventive Dentistry, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Oral Public Health, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
J Hosp Infect. 2025 Jun;160:26-33. doi: 10.1016/j.jhin.2025.03.009. Epub 2025 Apr 9.
Oral healthcare practitioners (OHCPs) face risks for blood-borne viruses following blood exposure accidents (BEAs).
This study aimed to investigate occupational BEAs in Dutch oral healthcare clinics, explore BEA risk factors, and identify reasons for non-reporting.
Two questionnaires were distributed: one prospective questionnaire was sent to BEA reporters who contacted a nationally operating reporting centre for occupational BEAs (issued before and after European legislation on recapping), and a retrospective questionnaire was sent to clinics which did not report any BEA in the previous four years. Data were analysed and logistic regression was applied to identify factors associated with BEA occurrence and reporting. This study is reported according to the STROBE-statement.
A total of 516 questionnaires were returned (37.7%), with 445 OHCPs having experienced a BEA, compared with 69 who had not. Most BEAs occurred with anaesthetic needles (43.3%) while cleaning up instruments (51.6%). Recapping remained an important cause after its prohibition (P=0.076). Dentists were less informed on safety protocols (P<0.001) and BEA consequences (P<0.001) compared with non-dentists (oral hygienists and dental assistants). OHCPs with accurate knowledge of BEA protocols were more likely to experience BEAs (OR = 2.9, 95% CI 1.5-5.6, P=0.001) and to report a BEA (OR = 8.0, 95% CI 3.9-16.5, P<0.001) than those without. Dentists had 0.3 times lower odds (95% CI 0.1-0.7, P=0.004) of reporting BEAs than non-dentists.
Implementation of guidelines more effectively is crucial to prevent and reduce blood-borne disease transmission. Changing attitudes and behaviours towards recapping and safety-engineered devices is essential, as recapping needles continues to cause many BEAs.
口腔保健从业者(OHCPs)在血液暴露事故(BEAs)后面临血源性病原体感染风险。
本研究旨在调查荷兰口腔保健诊所的职业性血液暴露事故,探究血液暴露事故的风险因素,并找出未报告的原因。
分发了两份问卷:一份前瞻性问卷发送给联系全国职业性血液暴露事故报告中心的报告者(在欧洲关于重新盖帽的立法前后发放),一份回顾性问卷发送给在过去四年中未报告任何血液暴露事故的诊所。对数据进行分析,并应用逻辑回归来确定与血液暴露事故发生和报告相关的因素。本研究按照STROBE声明进行报告。
共收回516份问卷(回收率37.7%),其中445名口腔保健从业者经历过血液暴露事故,69名未经历过。大多数血液暴露事故发生在清理器械时使用麻醉针的过程中(43.3%),且发生在重新盖帽时(51.6%)。重新盖帽在被禁止后仍是一个重要原因(P = 0.076)。与非牙医(口腔卫生员和牙科助手)相比,牙医对安全规程(P < 0.001)和血液暴露事故后果(P < 0.001)的了解较少。与不了解血液暴露事故规程的口腔保健从业者相比,准确了解规程的从业者更有可能经历血液暴露事故(比值比 = 2.9,95%置信区间1.5 - 5.6,P = 0.001)并报告血液暴露事故(比值比 = 8.0,95%置信区间3.9 - 16.5,P < 0.001)。牙医报告血液暴露事故的几率比非牙医低0.3倍(95%置信区间0.1 - 0.7,P = 0.004)。
更有效地实施指南对于预防和减少血源性病原体传播至关重要。改变对重新盖帽和安全设计器械的态度及行为至关重要,因为重新盖帽针头仍会导致许多血液暴露事故。