Occupational Exposure PDF

Ajman University Occupational Exposure Dr. Raghad Hashim Associate Professor Course Learning Outcomes (CLOs) CLO1– Identify the principles and advantages of four-handed dentistry. CLO2– Describe different dental delivery systems and arrangements for dental clinics according to ergonomi...

Ajman University Occupational Exposure Dr. Raghad Hashim Associate Professor Course Learning Outcomes (CLOs) CLO1– Identify the principles and advantages of four-handed dentistry. CLO2– Describe different dental delivery systems and arrangements for dental clinics according to ergonomic issues. CLO3– Describe different infection control methods and universal precautions in the dental clinic. CLO4– Demonstrate observation reports on different infection control practices in clinical dental facilities.  Four-Handed Dentistry Occupational Exposure Objectives: i) Explain how to prevent occupational exposure in the dental clinic. ii) Explain what to do in case of occupational exposure. ❑ Occupational exposure incident: defined as a needlestick or any puncture wound with a contaminated object, a splash of blood or body fluids onto non-intact skin (i.e exposed skin that is chapped, abraded or afflicted with dermatitis) ❑ Percutaneous injuries: an injury that penetrates the skin i.e (needlesticks or cuts with a sharp object). CRITICAL or NON- CRITICAL items ? ❑ Saliva: considered as OPIM by CDC. ❑ Post Exposure Prophylaxis (PEP): refers to comprehensive medical management to minimize the risk of infection among Health Care Personnel (HCP) following potential exposure to bloodborne pathogens (HIV, HBV, HCV). Infection Risk Variables: Pathogen involved – HBV, HCV, or HIV. Type of exposure Percutaneous injury (needlestick or cut). Splash onto mucous membrane or non- intact skin. Amount of blood involved in the exposure. Amount of virus in the patient’s blood at the time of exposure. ANY OTHER FACTOR ? Hepatitis B Virus Occur by direct exposure to blood and other infected body fluids. Infection risk from needlestick or cut is 6%–30%. Vaccination response lower risk to near zero. Individual with (HBeAg)- positive have much higher concentration of virus in their blood & are more likely to transmit HBV than those who are HBeAg –negative. What make it a “stubborn” virus ?? Hepatitis C Virus Infection risk from needlestick or cut is 1.8%. HCV infection from a blood splash to the eye has been reported. Greater infection risk than HIV. Far less risk than HBV. Human Immunodeficiency Virus Infection risk from needlestick or cut is 0.3%. Blood splash to eye, nose, or mouth is 0.1%. Small amount of blood on intact skin – no risk. Before Any Occupational Exposure Risk Provide written policies and procedures. Educate HCP about infection control. Before Any Occupational Exposure Risk Prompt care should be provided to personnel who experienced work- related exposure Confidentiality Before Any Occupational Exposure Risk Follow-up testing should be available DHCP misconceptions and fears should be alleviated. Post-exposure Management Wash wound or skin with soap and water – 15 minutes. No squeezing or “milking” of the wound. Report and document incident. Maintain confidentiality. Provide follow-up testing. HBV Post-exposure Prophylaxis ▪ Hepatitis B immune globulin (HBIG) and/or Hepatitis B vaccine – only if unvaccinated or inadequate anti-Hbs response. ▪ Begin as soon as possible – preferably within 24 hours and no later than 7 days. Note : If a source patient is determined to be HIV-negative, PEP not required. HCV Post-exposure Procedure ▪ No postexposure treatment will prevent HCV infection. HIV Post-exposure Prophylaxis Treatment should start ASAP, preferably within hours. If the source patient is determined to be HIV- negative, PEP (Post Exposure Prophylaxis) should be discontinued. Consult an expert in antiviral medication highly advisable multi-drug regimens might be required. Adverse side effects. Risk Reduction Measures Personal protective equipment. Engineering controls. Work practice controls. Hepatitis B vaccination. Training and education.  Engineering controls (physical changes to the work area or process that effectively minimize a worker's exposure to hazards). ▪ Primary method to reduce exposure to BBPs (bloodborne pathogens). Eg. Sharp disposal containers, self-sheathing needles, safety scalpels with retractable blades or covers, etc. Work practice controls (Behavior- based and intended to reduce the risk of blood exposure by changing the manner in which a task is performed) ▪ Use one-handed scoop technique capping devices for capping syringes. ▪ Do not bend or break needles before disposal. ▪ Avoid passing a syringe with an unsheathed needle. ▪ Remove burs before disassembling the handpiece from the dental unit. ▪ Use instruments, rather than hand to grasp needles, retract tissue, and load/unload needles and scalpels. Ajman University