[The spread of aerosols and splashes during the removal of dental deposits with an ultrasonic scaler]. / Rasprostranenie aerozolei i bryzg vo vremya udaleniya zubnykh otlozhenii ul'trazvukovym skalerom.

There is an increased prevalence of respiratory infections among dentists, which is associated with a heavily polluted breathing area in the dental office. Patients and dentists are at high risk of cross-infection due to the spread of aerosols in the form of droplets suspended in the air. The ultrasonic scaler is the largest source of aerosols and spatter in the dental office. Aerosols remain in the air for a long time even after the completion of a dental procedure and have a potential risk of inhalation. PURPOSE OF THE STUDY: To evaluate the spatial distribution of aerosols and splashes during a dental appointment during ultrasonic dental treatment. MATERIAL AND METHODS: The study was conducted on a mannequin equipped with phantom jaws, where dental plaque removal was simulated using an ultrasonic scaler filled with fluorescein. The amount of contamination was measured using a transparent grid with a square marking of 1 cm2. The grid was placed on top of a disk of filter paper and the area of contamination was measured by counting the number of soiled squares. If a square had at least 1 yellow area, then it was considered polluted. RESULTS: Aerosols and splashes were distributed up to 60 cm from the head restraint. Aerosols can spread over more than 1 m. CONCLUSIONS: The study showed the spread of aerosols and splashes during dental appointments. The risk of infection can be minimized by following simple protective measures.

Rate of Splashes When Opening Microfuge Tubes with Various Methods.

Introduction: Snap-cap microcentrifuge tubes are ubiquitous in biological laboratories. However, limited data are available on how frequently splashes occur when opening them. These data would be valuable for biorisk management in the laboratory. Methods: The frequency of splashes from opening snap-cap tubes using four different methods was tested. The splash frequency for each method was measured on the benchtop surface and on the experimenter's gloves and smock, using a Glo Germ solution as a tracer. Results: Splashes occurred very frequently when opening microcentrifuge snap-cap tubes, no matter which method was used to open the tube. The highest rate of splashes on all surfaces was observed with the one-handed (OH) opening method compared with two-handed methods. Across all methods, the highest rate of splashes was observed on the opener's gloves (70-97%) compared with the benchtop (2-40%) or the body of the researcher (0-7%). Conclusions: All tube opening methods we studied frequently caused splashes, with the OH method being the most error-prone but no two-handed method being clearly superior to any other. In addition to posing an exposure risk to laboratory personnel, experimental repeatability may be affected due to loss of volume when using snap-cap tubes. The rate of splashes underscores the importance of secondary containment, personal protective equipment, and good protocols for decontamination. When working with especially hazardous materials, alternatives to snap-cap tubes (such as screw cap tubes) should be strongly considered. Future studies can examine other methods of opening snap-cap tubes to determine whether a truly safe method exists.

[The specific features of the blood stains depending on their volume]. / Osobennosti sledov kapel' krovi pri ikh razlichnom ob''eme.

The objective of the present study was to determine the minimal and maximum volume of blood droplets freely falling from various droplet-forming surfaces and to characterize the specific morphological features of the resulting stains. The experiments were designed so that the blood droplets were allowed to fall down from the height of 10 cm to 1.5 m. The drop volume varied from 5 mcl to 134 mcl depending on the shape of the objects and the area of the droplet-forming surfaces. The size of the blood stains ranged from 0.4 to 2.4 cm. The stains of a smaller size were regarded as splashes while a stain resulting from the fall of a droplet having a volume greater than 200 mcl was considered to be a result of merging of several droplets and was termed 'blood volume'. The morphological features of the blood stains of different volume are described.

Occurrence of Needlestick and Injuries among Health-care Workers of a Tertiary Care Teaching Hospital in North India.

INTRODUCTION: Occupational hazards such as accidental exposure to sharp, cuts, and splashes are common among health-care workers (HCWs). AIMS AND OBJECTIVES: To determine the occurrence of self-reported occupational exposures to these hazards and to know the prevalent practices following the exposure. The second aim was to know the baseline antibody levels against hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) immediately after these accidents. METHODS: An observational prospective study was done in the HCWs of a tertiary care academic health organization of North India from January 2011 to December 2013. At the time of self-reporting of injury, a questionnaire was administered. Blood sample of HCWs and of the source, if identified, was collected for baseline HBV, HCV, and HIV serum markers. The exposed HCWs were followed up and repeat testing was done after 3-4 weeks for seroconversion up to 6 months. RESULTS: A total of 476 injuries were reported. Needlestick injury of fingers was the most common. Doctors were found to have the highest exposure rate (73.7%) distantly followed by nurses (19.1%). A significant number of the HCWs (125, 26.3%) vaccinated in past had hepatitis B surface antibody (anti-HBs) titers <10 mIU/mL (protection defined as anti-HBs level ≥10 mIU/ml). Only 44 sources were found to be seropositive (11 for HIV, 9 for HCV, and 24 for HBV). No seroconversion was seen in any of the exposed HCWs after 6 months. CONCLUSIONS: The incidence of needlestick and sharp injuries is most often encountered in emergency wards. Anti-HBs titers were suboptimal in many of the HCWs requiring a booster dose of HBV vaccination.

Prevalence and risk factors of needlestick injuries, sharps injuries, and blood and body fluid exposures among operating room nurses in Thailand.

BACKGROUND: Operating room nurses are at high risk for occupational exposure to bloodborne pathogens. This study examined the prevalence of and risk factors for needlestick injuries (NSIs), sharps injuries (SIs), and blood and body fluid exposures (BBFEs) among operating room nurses in Thai hospitals. METHODS: A cross-sectional study was performed in 247 Thai hospitals. Questionnaires eliciting demographic data and information on injury occurrence and risk factors were distributed to 2500 operating room nurses, and 2031 usable questionnaires were returned, for a response rate of 81.2%. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multiple logistic regression analysis. RESULTS: The prevalence of NSIs, SIs, and BBFEs was 23.7%, 9.8%, and 40.0%, respectively. Risk factors for NSIs were training without practice (OR, 1.67; 95% CI, 1.29-2.17), haste (OR, 4.81; 95% CI, 3.41-6.79), lack of awareness (OR, 1.36; 95% CI, 1.04-1.77), inadequate staffing (OR, 1.60; 95% CI, 1.21-2.11), and outdated guidelines (OR, 1.69; 95% CI, 1.04-2.74). One risk factor was identified for SIs: haste (OR, 2.43; 95% CI, 1.57-3.76). Risk factors for BBFEs were long working hours per week (OR, 2.07; 95% CI, 1.06-4.04), training without practice (OR, 1.55; 95% CI, 1.25-1.91), haste (OR, 1.66; 95% CI, 1.30-2.13), lack of awareness (OR, 1.54; 95% CI, 1.22-1.95), not wearing protective equipment (OR, 1.61; 95% CI, 1.26-2.06), and inadequate staffing (OR, 1.63; 95% CI, 1.26-2.11). CONCLUSION: This study highlights the high prevalence of NSIs, SIs, and BBFEs among Thai operating room nurses. Preventable risk factors were identified. Appropriate guidelines, adequate staffing, proper training, and self-awareness may reduce these occurrences.

Work-related ocular events among Nigerian dental surgeons.

OBJECTIVE: Daily clinical activities in dental operatory expose dental surgeons to varied forms of ocular events. The purpose of the study was to determine the prevalence and pattern of ocular splashes and foreign bodies among dental surgeons in Nigeria. METHODS: This questionnaire-based cross-sectional of dental surgeons in Southern Nigeria was conducted between September 2010 and August 2011. The information elicited were demography, experience and type of ocular event, implicated dental procedure and action taken. RESULTS: Of the 185 studied, 148 of them responded. Of these 148 respondents, 56 (37.8%) reported foreign body, 18 (12.2%) splash, 33 (22.3%) both foreign body and splash while 41 (27.7%) reported no ocular event. It therefore means that the overall prevalence of ocular events among the respondents was 107 (72.3%). The prevalence of ocular events was significantly associated with age (p = 0.014), years of practice (p = 0.033) and safety eye goggle use (p = 0.023). The main dental procedures implicated in the ocular events among the respondents were scaling 77 (72.0%), tooth/cavity preparation 17 (15.9%), polishing 11 (10.3%) and forcep tooth extraction 10 (9.3%). The major implicated aetiological agents in the ocular events were calculus 74 (69.2%), saliva 29 (27.1%), mixed blood & saliva 19 (17.8%), tooth particles 15 (14.0%) and blood 9 (8.4%). The predominant action taken by the respondents was to rinse the eye under running water 89 (83.2%). CONCLUSION: Ocular splash and foreign body events are high among dental surgeons in Nigeria. Age, years of practice and safety eye goggles wear were also found to be associated with ocular events. Eye safety awareness is therefore deemed a necessity for dental surgeon in Southern Nigeria.

A prospective look at the burden of sharps injuries and splashes among trauma health care workers in developing countries: true picture or tip of iceberg.

OBJECTIVES: Health care workers (HCWs) face constant risk of exposure to cuts and splashes as occupational hazard. Hence, a prospective observational study was conducted to observe the exposure of HCWs to various sharp injuries and splashes during health care and to work up a baseline injury rate among HCWs for future comparison in trauma care set ups. METHODS: A 2 year and 5 month study was conducted among the voluntarily reported exposed HCWs of the APEX trauma centre. Such reported cases were actively followed for 6 months after testing for viral markers and counselled. The outcomes of such exposed HCWs and rate of seroconversion was noted. To form a future reference point, the injury rate in trauma care HCWs based on certain defined parameters along with the rate of under reporting were also analysed in this study. RESULTS: In our study, doctors were found to have the highest exposure (129, 36.2%), followed by nurses (52, 14.6%) and hospital waste disposal staff (27, 7.6%). Of the source patients, a high number of them were HBV positive (11, 3.1%), followed by HIV positive patients (8, 2.2%). No seroconversion was seen in any of the exposed HCWs. Injuries by sharps (303, 85.1%) outnumber those due to splashes (53, 14.9%) which were much higher in those working in pressing situations. Underreporting was common, being maximally prevalent in hospital waste disposal staff (182, 51.1%). CONCLUSIONS: High rates of exposure to sharp injuries and splashes among HCWs call for proper safety protocols. Proper methods to prevent it, encouraging voluntary reporting and an active surveillance team are the need of the hour.