Risk factors for blood exposure accidents and their reporting in dentistry in The Netherlands

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.

Two questionnaires were distributed: one prospective questionnaire was sent 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 four 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.

A total of 516 questionnaires were returned (37.7%), with 445 OHCPs having experienced a BEA, compared with 69 who had 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 with non-dentists (oral hygienists and dental assistants). OHCPs with accurate knowledge of BEA protocols were more likely to experience BEAs (OR = 2.9, 95% CI 1.5-5.6, P=0.001) and to report a BEA (OR = 8.0, 95% CI 3.9-16.5, P<0.001) than those without. Dentists had 0.3 times lower odds (95% CI 0.1-0.7, P=0.004) of reporting BEAs than non-dentists.

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 continues to cause many BEAs.