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[牙医面临的肝炎风险。慕尼黑地区及上巴伐利亚行政区牙医肝炎发病频率研究]

[Hepatitis risk to dentists. Studies on the frequency of hepatitis in dentists in the Munich region and in the district of Upper Bavaria].

作者信息

Eisenburg J, Holl J, Kruis W, Weinzierl M, Grunst J, Puttkammer D, Wendl N

出版信息

Fortschr Med. 1977 May 19;95(19):1249-58.

PMID:863366
Abstract

Dentists have a particular risk of acquiring viral hepatitis because of their close contact with blood and saliva during dental manipulations--especially as the majority of dentists do not use gloves during work and often have small cuts and abrasions on their hands. On the other hand personnel in the dentist's office offers several potential modes of parenteral and oral-intestinal transmission of hepatitis. In order to find out the risk of dentists exposing themselves to hepatitis-infection (especially hepatitis B-infection) we performed a questionnaire-study among practicing dentists all over Oberbayern. 858 replies were received after distribution of 1030 questionnaires (participation: 83.3%) and could by analyzed. 116 dentists had had a hepatitis during their professional work (13.5%). The frequency of hepatitis among the younger colleagues--who were practicing from 1 to 14 years--was about 5%. The number of hepatitis-infections increased continually up to 33% after 35--39 years of professional activity. In a second study blood samples were taken from 773 dentists and were tested for HB3Ag by radioimmunoassay. Of these 773 blood samples taken 25 (3.5%) were found to be antigen-positive. Compared to the general population the risk of infection is 6- to 30 times higher in dentists. The challenge of hepatitis-virus-infection can at present be met only-and at least in part-by scrupulous attention to prophylactic measures, such as using disposable gloves, needles and syringes and in autoclaving all non-disposable equipment. Besides dental personnel and patients should be screened at regular intervals for the presence of HBsAG.

摘要

由于牙医在牙科操作过程中与血液和唾液密切接触,他们感染病毒性肝炎的风险尤为突出——特别是大多数牙医在工作时不戴手套,手上常有小伤口和擦伤。另一方面,牙科诊所的工作人员提供了几种肝炎经肠道外和经口肠道传播的潜在途径。为了了解牙医感染肝炎(尤其是乙型肝炎)的风险,我们对巴伐利亚州北部所有执业牙医进行了一项问卷调查研究。在发放1030份问卷后,收到了858份回复(参与率:83.3%)并可进行分析。116名牙医在其职业生涯中曾患过肝炎(13.5%)。在执业1至14年的年轻同事中,肝炎发病率约为5%。在执业35至39年后,肝炎感染人数持续增加至33%。在第二项研究中,采集了773名牙医的血样,并用放射免疫分析法检测HBsAg。在采集的这773份血样中,有25份(3.5%)被发现抗原呈阳性。与普通人群相比,牙医的感染风险要高6至30倍。目前,应对肝炎病毒感染的挑战只能——至少部分地——通过严格注意预防措施来实现,比如使用一次性手套、针头和注射器,以及对所有非一次性设备进行高压灭菌。此外,牙科工作人员和患者应定期进行HBsAg筛查。

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