Adesão a protocolo pós-exposição ocupacional de acidentes entre cirurgiões dentistas

Abstract

OBJECTIVE:To analyze the compliance with occupational post-exposure protocol for accidents and factors associated with compliance among dental surgeons. METHODS:A cross-sectional study was performed in the municipality of Montes Claros, Southeastern Brazil, from 2007 to 2008, with accident reports from needles and sharp instruments among practicing dental surgeons. Variables describing the dentists' characteristics, work conditions, clients, injuries from needles and sharp instruments and post-accident actions were evaluated by means of a previously tested, structured questionnaire. The data underwent descriptive analysis and chi-square testing (p<0.05). RESULTS:A total of 241 dentists (89.2%) answered the questionnaire. Compliance with occupational post-exposure protocol was reported by 51.5%. The majority of the professionals reported seeing blood at the time of the accident. Burs were the instrument most often involved in accidents, and the fi nger was the most injured body part. Compliance with a post-exposure protocol was more prevalent among those with greater monthly income (OR=2.42; 95% CI=1.03;5.71), continuing education in the last two years (OR=2.16; 95% CI=1.09;4.27) and who took regular breaks every four hours (OR=1.23; 95% CI=1.23;4.92). Dental surgeons who attended to children (OR=0.50; 95% CI=0.27;0.93) and to individuals from the middle, middlehigh and high socioeconomic classes (OR=0.54, 95% CI=0.31;0.95) showed less compliance with the occupational post-exposure protocol. The frequency of compliance to a post-exposure protocol was signifi cantly greater among individuals who followed the actions described in post-exposure protocols. CONCLUSIONS:There is low compliance with occupational post-exposure protocols among dentists, which is infl uenced by the knowledge and monthly income of professionals, by taking regular breaks, by age group and the socioeconomic class of the clientele.

Knowledge, risk perception and attitudes of Dentistry students with regard to HIV/AIDS

“…However, the more advanced semesters, as might be presumed, showed better risk perception than those less advanced, as students in the latter stages are just beginning to form their perceptions of risk. The same result has been described in other studies 2,[9][10][11][14][15][21][22] . In contrast, research performed by Jafari et al 23 demonstrated that students in the final years of an Iranian university's dentistry course showed good risk perception regarding the prevention and transmission of HIV due to their constant contact with sick patients, since these students helped out in a care center for patients with diseases.…”

“…Other studies demonstrated the same results for both working professionals and students, who demonstrate fear and negative tendencies toward HIV+ patients, as well as occasional discrimination [3][4][5][8][9][10][11][14][15][17][18]20 . What attracts particular attention in the findings of this study is the fact that students in semesters that have had little contact with the dental clinic, showed less apprehensive or fearful attitudes regarding the treatment of infected patients compared to students in more advanced semesters, of whom greater psychological preparation would be expected due to their greater practical experience.…”

“…As for post-accident measures, it may be inferred from this study that students have not been properly instructed or do not seek to apply the knowledge they have acquired, as only 12% filled in the biological accident notification forms and only 16% asked for the source-patient's serology. Other studies in the literature also revealed poor adherence to postexposure protocols and unsatisfactory knowledge in this regard 2,9,10,[21][22] .…”

“…On the other hand, several studies report knowledge of HIV/AIDS by students and dental surgeons as being unsatisfactory or poor 3,[9][10][11][12]15,18,[22][23][24] . We propose further research, in other institutions, on the same topics as the present study, in order to assess the knowledge acquired by students and whether it is enough to provide an awareness that can generate attitudes of ethical and legal responsibility, as well as improvements in the academic curriculum, which may include approaches involving precautionary standards, cross infections and doctor-patient relationships in all matters associated with the clinic, demanding from students greater interrelation between theory and practice.…”

“…Higher scores indicate that the student has good perception with regard to the risks involved when treating any patient, whether infected with HIV or not, the maximum score being 20 (10 x 2). Lower scores suggest poor perception Controlling infectious diseases is an aspect that deserves close attention in dentistry, due to both the environment in which a dental surgeon works (the oral environment, with its numerous microorganisms) and to the wide range of sharp instruments and invasive procedures, exposing the dentist to various infectious/ contagious diseases, such as AIDS and Hepatitis B and C, depending on factors including depth of the cut, the volume of potentially infectious fluid on dental instruments and the patient's viral load during seroconversion [8][9][10][11][12][13] . Therefore it is essential to seek and constantly update knowledge on occupational diseases to which the dental professional may be exposed, routes of infection, modes of transmission, bio-security standards, sterilization and disinfection of the materials used, proper disposal of waste, respect for the environment and on post-exposure measures.…”