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Compliance with infection control procedures in a dental hospital clinic.

Dental hospital staff and students were observed during clinical work for their compliance with infection control procedures, as recommended by the British Dental Association. A total of 183 contacts between health care worker and patient were scrutinised during December 1990. Nearly all health care workers (96%) wore gloves to carry out dental treatment, but in some cases gloves were neither changed nor hands washed between patients. Only one half wore protective eyewear and about one third (38%) wore no mask. Some dental surgery assistants used heavy duty gloves and some even scrubbed dirty dental instruments without wearing any gloves. Strict audit is clearly needed in every clinical setting in order to ensure compliance with infection control.

Attitude of Health Personnel↗

Attitudes to cross-infection measures of UK and Hong Kong patients.

The knowledge and attitudes of dental patients in the UK and Hong Kong towards aspects of cross-infection control have been surveyed. Almost all patients expected dentists to wear protective gloves but only 73% and 40% expected dental staff to wear protective face masks and spectacles respectively. Most patients were aware that such measures were for the benefit of both dental staff and patients. Just over 50% of patients believed that they could contact HIV from an HIV-infected dentist. UK and Cantonese patients had generally similar attitudes to cross-infection protection, but the latter were positively influenced by the routine use of masks and spectacles and were more concerned about HIV transmission than UK patients.

Attitude to Health↗

Improvements in cross-infection control in general dental practice.

A questionnaire about cross-infection control was sent to all GDPs in five FHSAs in the North Western Region. Replies came from 312 dentists, a response rate of 74%. They worked in 185 practices, a response rate of 85%. Gloves were worn routinely by 86% of dentists and 80% of DSAs. Handpieces were autoclaved between patients in 77% of practices. Much however, remains to be improved. DSAs could be better protected if more ultrasonic cleaners were used, eye protection encouraged and heavy duty gloves were available for cleaning instruments. BDA guidelines were reported as being the most influential factor, though it would appear that the media did persuade many practitioners to use autoclavable handpieces and sterilise them after each use.

Dental Equipment↗

Cross-infection control in dental laboratories.

The attitudes to cross-infection control of 800 dental laboratories registered with the Dental Laboratories Association have been surveyed. Considering the topicality of the subject material and the need for careful cross-infection control within and beyond the dental surgery, the response rate of 22% (175) was disappointingly low. As a result of the low response rate, the results should be seen as a guide only. Forty-nine percent of respondents had a cross-infection policy and of those with no policy 64% intended to implement one in the future. Thirty percent of laboratories receive known undisinfected work from the dental surgery. Of those items disinfected on arrival at the laboratory, those most frequently disinfected are dental impressions (77%) and dentures (51%). The most popular chemicals used for disinfection are household bleach, chlorhexidine and glutaraldehyde. Forty-four percent of the respondents generally (90% or more of the time) wear gloves when handling dental work received and opened in the laboratory. Seventy-four percent wear protective eye spectacles when trimming or polishing prostheses. Sixty-one percent used no disinfectant in the pumice and 93% did not disinfect the polishing instruments, eg wheels and mops. Forty-six percent had a policy for immunisation of staff against Hepatitis B.

Attitude of Health Personnel↗

Eye safety in operative dentistry - a study in general dental practice.

AIM: In this safety conscious age all general dental practitioners should be promoting the use of eye protection. The aim of this study was to highlight the uptake of eye protection by all clinical staff and patients within the general dental practice setting, with regard to adequate protection and its use at appropriate times. METHOD: Questionnaires were sent to 200 GDPs, chosen at random, to accumulate information on the use of protection, the preferred methods of eye protection and any experience of ocular injury. FINDINGS: Eighty-seven per cent of GDPs wore eye protection routinely, but their choice of protection was not always adequate and not worn for all procedures. Forty-eight per cent of GDPs had experience of ocular trauma or infection which occurred during a variety of procedures; 75% of these injuries resulted from not wearing eye protection. In contrast less than half of the DNs and Hygienists use protection routinely, particularly when cleaning contaminated instruments. However, hygienists did wear eye protection for the majority of their patient work (96%). CONCLUSION: Eye protection use by all staff and patients is currently suboptimal to conform to published guidelines. Risks encountered within the dental environment do cause harm to the unprotected eye, which can be reduced or even eliminated by improving the uptake of suitable eye protection; several choices for eye protection are available. Each individual dentist is responsible for the uptake of eye protection for all persons in their surgery environment.

Adult↗

Unseen evidence.

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Dentistry, Operative↗

Poor practice.

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Cross Infection↗

South Australian adolescent ophthalmic sun protective behaviours.

AIMS: To study student's knowledge of the effects of sunlight on the eyes, as well as their sun protective behaviours. METHODS: In total, 640 [corrected] students aged 13-18 years were surveyed in South Australia, during August-September 2004, using a standardized previously used survey. Scores were calculated regarding knowledge about ultraviolet light, sunlight effects on eyes, as well as eye and body protection. Risk factor scores were produced for each student. The data were analysed by the analysis of variance (ANOVA), as well as the Cochran-Mantel-Haenszel methods. Results were compared to the same survey conducted in 1995 in Queensland Australia. RESULTS: This group demonstrated a moderate level of knowledge, similar to the 1995 survey. Students in the older age groups demonstrated significantly higher knowledge. The majority of students (74%) owned a pair of sunglasses; however, 44.5% almost never wore their glasses. The reported frequency of wearing sunglasses was significantly related to advertising, believing sunglasses protect the eyes, as well as personal, family, and peer attitudes towards wearing sunglasses. CONCLUSION: The results of our survey suggest no significant change in knowledge and behaviours of students, compared to the 1995 survey. We feel it is imperative that adolescents be made more aware of the damaging effects of sunlight and the benefits of eye protection. Health promotion campaigns should target the youth and consider that as a group, they are significantly influenced by the media, peers, and family attitudes.

Adolescent↗

The impact of new regulations on the incidence and severity of ocular injury sustained in hurling.

AIM: To prospectively evaluate, and compare, the incidence of hurling-related eye injuries in the South East of Ireland before and after implementation of new rules rendering the use of protective head gear and face masks compulsory for players aged 18 years or under. METHODS: Details relating to patients attending the regional ophthalmic department with injuries sustained during hurling were prospectively recorded between 1 October 2003 and 31 March 2006. RESULTS: Sixty players attended with hurling-related ocular injuries during the study period. Of these, 43 (71.6%) and 17 (28.3%) sustained the ocular injuries during the 15-month period before, and after implementation of the new rules (1 January 2005), respectively. Restricting our analysis to players aged 18 years or under, and, for statistical validity, to the 12-month period immediately before and immediately after implementation of the new rules, a statistically significant reduction in the number of hurling-related injuries was seen (1 January 2004 to 31 December 2004: 11; 1 January 2005 to 31 December 2005: 2; chi(2) test P<0.05) in this age group. A permanent visual deficit was seen in 11 (18.3%) patients. Of these, one (9%) was aged 18 years or under, and this injury was sustained before the new regulations. CONCLUSION: New rules rendering the use of protective eye wear compulsory for players aged 18 years or under have resulted in a significant reduction in the incidence and severity of hurling-related eye injuries in this age group.

Adult↗

The aetiology and prevention of peri-operative corneal abrasions.

Corneal abrasion is the most frequent ocular complication to occur during the peri-operative period. This review describes the aetiology of corneal abrasions and evaluates the current methods of prevention. Most abrasions are caused by lagophthalmos (failure of the eyelids to close fully) during general anaesthesia, resulting in corneal drying. General anaesthesia reduces both the production and the stability of tears and therefore increases the incidence of this painful condition. Taping the eyelids closed, soft contact lenses, the instillation of aqueous gels or paraffin-based ointments are all effective in preventing corneal abrasions, but ointments are associated with significant morbidity.

Anesthesia, General↗

Sunbeds in current use in Scotland: a survey of their output and patterns of use.

Spectral irradiances of 100 commercially available sunbeds in current use have been measured. Ultraviolet (UV) A and UVB doses from sunbed use have been calculated and compared with doses likely to be received from solar radiation. The majority of sunbeds use UVA fluorescent tubes for irradiating the body and filtered metal halide lamps, which have a higher proportion of UVA1, for the face. The average minimum erythemal dose per session is 0.80, but irradiances for particular models varied by a factor of two to three primarily because of decline in lamp output with age. The UVA dose from a session on a sunbed is similar to that which might be received from 20 to 30 min sunbathing at a Mediterranean resort or 1 h on a sunny day in Glasgow, while UVB doses are 20-25% of this level. Responses from 200 current users of the sunbeds indicate that 38% had skin types 1 and 2, that 17% had more than 100 annual sunbed sessions and that 35% rarely or never used the goggles provided.

Adult↗

Congenital porphyria with necrotizing scleritis in a 9-year-old child.

Porphyria is a rare metabolic disorder that is characterized by the accumulation of photosensitive, toxic intermediates of the heme metabolic pathway in various organs of the body including the skin, eye and neural tissue. Porphyria as a potential cause for bilateral necrotizing scleritis in children is very infrequently emphasized in literature, probably due to the relatively rare occurrence and lack of well-documented cases. A case of a 9-year-old child with congenital porphyria who had developed necrotizing scleral ulceration in both eyes in addition to severe cutaneous hypersensitivity and facial disfigurement is herein presented.

Atropine↗

Video-resection does not stop corneal contamination during transurethral resection of the prostate.

OBJECTIVES: To determine the efficacy of video-resection systems in reducing the risk of corneal contamination during transurethral resection of the prostate (TURP) and thus in decreasing the possibility of transmission of blood-borne diseases from the patient. MATERIALS AND METHODS: After performing a TURP using a video camera system in 30 patients, the number of potential corneal droplets was measured for one operator wearing a pair of spectacles and, for a second operator, over an identically sized area of a standard disposable plastic eyeshield. RESULTS: In 20 (67%) of cases, droplets were observed on the eye protection, correlating with potential corneal contamination. Splashes were also seen on the face-mask of the eyeshield. CONCLUSION: Urologists should use eye and face protection when performing TURP using a video system.

Blood-Borne Pathogens↗

Assessment of fogging resistance of anti-fog personal eye protection.

The propensity for occupational eye protectors to fog in warm and moist conditions is often offered as a reason by workers not to wear occupational eye protection even where mandatory eye protection areas have been specified. A study of eye protection practices in the New South Wales coal mining industry identified the number one issue in underground coal mine conditions as being fogging of eye safety wear. Conventional anti-fog treatments and cleaners were considered by the miners as completely inadequate in these conditions. At the time of the study claims were being made for a new generation of lens treatments. These merited evaluation. Spectacles and goggles claimed to be fog resistant were obtained from manufacturers and suppliers and subjected to the test set out in BS EN 168 and the compliance criterion of BS EN 166. Some lenses claimed to be fog resistant failed the requirement, some new technology lenses showed arguably superior performance but failed the criterion of the standard. Modifications to the test procedure of BS EN 168 and acceptance criteria of BS EN 166 are proposed.

Coal Mining↗