Dental CPD Australia

PERCUTANEOUS EXPOSURE INCIDENTS

The word percutaneous is of Latin descent which means „by way of the skin‟, pertaining to something that is effected through the skin. In the generality of the medical field, the term percutaneous exposure incidents, or PEI, pertains to blood-borne infections that are due to cuts caused by sharp objects (such as needles and other tools used in medical practice) or any non-intact skin or mucous membrane that become exposed to potentially infectious blood, saliva, tissue and other bodily fluids. Such exposure incidents are quite prevalent in the dental health setting. Coming into contact with blood-borne pathogens, which are disease-producing microorganisms, may place dental health professionals and representatives at risk for human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B virus (HBV).


Prevalence of PEI


PEI is a familiar and fairly frequent concern amongst dental personnel. In Thailand and the United Kingdom, studies have shown that about half of all dentists report a recent PEI within the previous year. These reports indicate that „sharps‟ injuries and needle stick tend to be the most common causes of PEI cases. Previous studies conducted in Australia also show that both are also commonplace amongst their dental students. A study in Sydney showed that 72% of dental students experienced injuries caused by „sharps‟ throughout the duration of their clinical training. Meanwhile, in Lithuania, 78.5% of dental personnel reported exposure during their dental career.


In Brazil, 84.6% was recorded for Baccarat while Brasilia garnered a high percentage of 86.5%. These frequencies, as with most dental education occupational hazards, are not universal however. About only 13.8% of South African dentists reported injuries from needle stick. These significant differences in percentage of exposure may be due to other factors such as the differences in recall period investigations, which usually range from six months to one year, and even throughout the entire career of dental personnel. According to a study done in the US, dental students and dental assistants have the highest exposure rates and were more at risk for PEI mainly because one of their primary tasks is the handling of syringe needles.


In a study of PEI in Queensland, Australia, 78.5% of respondents reported glove damage at least once within the last 12 months prior to the survey. Roughly about one-quarter reported at least one needle stick or „sharps‟ injury and 16% reported having been exposed to injuries whilst in the middle of a clinical procedure (see table below).


According to the study conducted in Queensland, albeit the commonplace reports of glove damage, the number of needle stick injuries, particularly those that were exposed to the bodily fluids of a patient, are relatively low as compared to the numbers produced by previous surveys in the dental field.


What is most interesting about their findings perhaps is that in the review of 10 years of literature on PEI, the occurrence of per cutaneous injuries seems to be steadily declining. However, it is still important to execute strict guidelines and implementation of infection protocols for glove tears, and to make sure that grazes and wounds are completely covered in waterproof dressings to prevent exposure and contamination of a patient’s bodily fluids into the bloodstream of dental personnel. The guidelines for protection using gloves will be discussed in further detail as we go on.


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