Accidents with biological material in a Dental School: profile, reporting and underreporting

Background: Accidents caused by exposure to biological material (BM) are common in dentistry as a result of working with sharp objects in a restricted field of view and because of the patient, thus it is essential to report the cases and then implement actions.

Objective: To identify the occurrence of accidents involving BM among academics and professionals, evaluate the occurrence of sub-reports and their causes, characterize the profile of accidents, identify protective measures adopted by professional and academic casualties.

Methods: Cross-sectional study of accidents with BM developed at the Dental School, Federal University of Goiás (FUG) that was approved by the Ethics Committee of the FUG (protocol 058/2006). Data were obtained by evaluation of 71 registration forms for accidents with BM in the 2001 to 2008, and by applying a questionnaire to all students registered in that period, technicians and teachers, totaling 566 subjects eligible. For this, we developed a software: Evaluation and Management Distance System (EMDS), which allowed the circulation of the questionnaire electronically. Data were tabulated and analyzed by SPSS 16.0 and descriptive statistical analysis performed by the measures of frequency and inferential, through chi-square and logistic regression.

Results: Of the 71 reports, only 41 (57.7%)  had complete data. Of the subjects eligible for the questionnaire (EMDS), 266 (47.0%) participated: technicians (100.0%), teachers (85.4%), academics (69.4%) and former students (21.0%). The complete vaccination against hepatitis B was reported by 81.9%, and five (1.9%) reported not having been vaccinated. The result of antiHBs was known for 151 (69.3%) who claimed to be responders. Ninety-one (34.2%) claimed to have suffered accidents with BM, and there was no difference in this occurrence among academics, technicians and teachers (p=0.496). Only 24 (26.4%) reported formally the accident, the rate of underreporting was 73.6%. The reasons cited for not reporting were: not considered serious (52.2%), considered the low risk (32.4%), did not know they should notify (22.0%). The exposures were percutaneous (76.9%), splash on intact skin (25.3%) and into mucous membranes (24.2%). The most affected parts were: fingers of the nondominant hand (42.8%). The BM involved, were: saliva (68.1%) and blood (48.3%). Seventy-five subjects (82.4%) reported using all protective equipment, and have been neglected gloves (13.2%), face (11.0%) and goggles (7.7%). The accident percutaneous (p=0.016) with involvement of blood (p=0.013) presented significant for the notification.

Conclusions: The lack of data in records of notifications, the high rates of accidents with BM, as well as under-reporting signal the need to restructure the notification service, and the importance of disclosure of official protocol of the institution of post-exposure and preventive measures to be adopted by the academic community.