Risk Factors for Blood Exposure Accidents and Their Reporting in Dentistry in the Netherlands

OBJECTIVE: 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.

DESIGN AND PARTICIPANTS: Two questionnaires were distributed; one prospective questionnaire 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 4 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.

RESULTS: 516 questionnaires were returned (37.7%), with 445 OHCPs having experienced a BEA, compared to 69 who have 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 to non-dentists (oral hygienists and dental assistants). OHCPs with accurate knowledge on BEA protocol were more likely to experience BEAs (OR=2.9, 95% CI1.5-5.6, p=0.001) and to report a BEA (OR=8.0, 95% CI3.9-16.5, p<0.001) than those without. Dentists have 0.3 times less odds (95% CI0.1-0.7, p=0.004) to report BEA than non-dentists, CONCLUSIONS: 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 still causes many BEAs.