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Community needlestick accident data and trends in environmental quality.

New health-based indicators of environmental quality are being sought. In this search a retrospective analysis was undertaken for all persons in England and Wales who, during 1988-91, were given Hepatitis B Immune Globulin (HBIG) in prophylaxis against Hepatitis B infection after accidental percutaneous or permucosal exposure, and for whom a surveillance form was returned to the Public Health Laboratory Service Communicable Disease Surveillance Centre, England and Wales (PHLS CDSC). Although the number of adult HBIG doses issued during 1988-90 increased annually from 1,907 to 2,850, the percentage for which completed forms were returned fell during this time from 55% (1,043/1,907) to 31% (894/2,850). In 1991, 2,049 doses were issued and completed forms returned for 32% (653/2,049). From data on the completed and returned forms for 1988-91, 51% (1,805/3,535) of accidental exposures occurred in the community and 45% (1,604/3,535) in hospitals. Of the community exposures, 958 (53%) were needlestick accidents; 16% of them occurred 'in the street', 12% from 'contact with rubbish', 6% 'in the park', and 4% 'on the beach'. The findings confirm that discarded hypodermic syringe needles in the general environment are causing new public health problems. As the percentage of completed and returned forms has declined, and because HBIG is not recommended for needlestick accidents in the community where the source of the needle is unknown, HBIG surveillance forms are thought not to be a suitable source of data for continued monitoring of environmental quality.

Adult↗

Practical application of infection control in endodontics.

The transmission of infections in an endodontic practice is a significant concern for both patients and dental health care providers. This article offers a review and practical application of infection control methods in the practice of endodontics.

Disinfectants↗

Galactorrhoea and hyperprolactinaemia associated with protease-inhibitors.

We describe four patients with galactorrhoea as an isolated endocrine abnormality after use of protease inhibitors (PIs) as part of both highly active antiretroviral therapy (HAART) and postexposure prophylaxis (PEP). This reaction may be a direct effect of PIs or may be indirectly mediated by the effect of PIs on the cytochrome P450 system, thus potentiating the dopamine antagonist effects of other drugs.

Anti-HIV Agents↗

Avoiding the point.

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Allied Health Personnel↗