Dental Tribune United Kingdom Edition

A new study published in the scientific journal Occupational Medicine has found that those who ex- perience needlestick injuries can suffer persistent and sub- stantial psychiatric illness or depression. Needlestick or ‘sharps’ in- juries are a daily risk to nurs- es, medical and health ancil- lary workers. The physical health effects of a needlestick injury are well known but this new research has demon- strated the mental health con- sequences of sharps injuries. The researchers found that those affected suffered psy- chiatric trauma that is similar in severity to trauma caused by other events such as road traffic accidents. This had a major impact on work attend- ance, family relationships and sexual health. The duration of the psychiatric symptoms were linked to the length of time the person injured by the sharp had to wait for blood test results. Although sharps injuries mostly occur in healthcare settings, many other employ- ees are also at risk including prison and police officers, park wardens, street cleaners and refuse collectors, tattoo artists and others who may come across carelessly or ma- liciously discarded hypoder- mic needles. A sharp contami- nated with infected blood can transmit more than 20 diseas- es including hepatitis B, C and human immunodeficiency vi- rus (HIV). This transmission risk causes worry and stress to the estimated 100,000 people who experience a needlestick accident every year. Professor Ben Green who undertook the research said: “The psychological aspects of needlestick injuries are often overlooked. The chances of physical damage - infection and so on - are what are fo- cused on by society, but these risks are in reality very small. The main health implica- tion of needlestick incidents is probably psychiatric injury caused by fear and worry.” The Society of Occupation- al Medicine called for a much greater awareness of the psy- chiatric and physical effects of needle stick injuries. Workers who experience a needle stick injury need fast access to oc- cupational health support, rapid results from blood tests and access to psychological support where appropriate. Occupational health special- ist can help employers by un- dertaking a risk analysis and preventing and minimising exposure. DT Dentists at risk of psychiatric trauma from needlestick injuries Sharps injuries are a daily risk to health workers R esearchers at Tufts Uni- versity School of Dental Medicine and the For- syth Institute have published a study that found that a signifi- cant proportion of dental bib clips harboured bacteria from the patient, dental clinician and the environment even af- ter the clips had undergone standard disinfection proce- dures in a hygiene clinic. Although the majority of the thousands of bacteria found on the bib clips immedi- ately after treatment were ad- equately eliminated through the disinfection procedure, the researchers found that 40 per cent of the bib clips test- ed post-disinfection retained one or more aerobic bacte- ria, which can survive and grow in oxygenated environ- ments. They found that 70 per cent of bib clips tested post-disinfection retained one or more anaerobic bacteria, which do not live or grow in the presence of oxygen. “The study of bib clips from the hygiene clinic demonstrates that with the current disinfection protocol, specific aerobic and anaero- bic bacteria can remain viable on the surfaces of bib clips immediately after disinfec- tion,” said Addy Alt-Holland, M.Sc., Ph.D., Assistant Pro- fessor at the Department of Endodontics at Tufts Univer- sity School of Dental Medi- cine and the lead researcher on the study. “Although actual transmission to patients was not demonstrated, some of the ubiquitous bacteria found may potentially become op- portunistic pathogens in ap- propriate physical conditions, such as in susceptible patients or clinicians.” Led by Dr. Bruce Paster, Chair of the Department of Microbiology at the Forsyth Institute, microbiologists at the Forsyth Institute used standard molecular identifica- tion techniques and a propri- etary, one-of-a-kind technol- ogy that can detect 300 of the most prevalent oral bacteria, to analyse the sampled bac- teria from the bib clips. The analyses found: • Immediately after treat- ment and before the clips had been disinfected, oral bacteria often associated with chronic and refractory periodontitis were found on 65 per cent of the clips. • After disinfection, three of the bib clips (15 per cent) still had anaerobic Strepto- coccus bacteria from the oral cavity and upper respiratory tract. • Additionally, after disin- fection, nine clips (45 per cent) retained at least one an- aerobic bacterial isolate from skin. DT Dental bib clips harbour oral and skin bacteria 40 per cent of bib clips tested reported aerobic bacteria 2 News United Kingdom Edition April 15-21, 2013 page 1DTß rect Access if they are not com- fortable with it, or do not fulfill the training, competence and indemnity criteria – nor can em- ployers oblige them to offer it.” BSDHT President Julie Rosse commented: “This decision is one that BSDHT have advocated since the debate on Direct Access began and I’m delighted that the efforts of many within the Society have been rewarded with a posi- tive outcome. But the hard work now begins and there is much to be done to prepare for the intro- duction of this important devel- opment for dental hygienists and therapists, and BSDHT will con- tinue to take an active role in the implementation process in sup- port of its members”. “As president of BADT, I along with the Executive Council am absolutely delighted with this decision and personally appreci- ate all the support and coopera- tion that I have received over the years. This is a day which will go down in our history as a major leap forward for our profession,” Bal Chana, President BADT. However, not everyone is happy about the change. Dr Ju- dith Husband, Chair of the BDA’s Education, Ethics and the Dental Team Committee, said: “This is a misguided decision that fails to consider best practice in es- sential continuity of care, patient choice and cost-effectiveness, and weakens teamworking in dentistry which is demonstrated to be in patients’ best interests. Dental hygienists and therapists are highly-valued and competent members of the dental team, but they do not undertake the full training that dentists do and on their own are not able to provide the holistic, comprehensive care that patients need and expect. Our fear is that this could lead to health problems being missed in patients who choose to access hygiene and therapy appoint- ments directly. “The decision also ignores the stated limitations of the lit- erature review on which the de- cision has been based and goes against the findings of the GDC’s own patient survey last year, which found that just three in ten people favoured a move to allow direct access. “The undue haste with which the decision is to be implement- ed does nothing to alleviate the impression that this is an inade- quately-considered decision that is being pushed through without proper reference to the risks it creates.” DT