Oral Health Program: Bloodborne Disease Transmission
Hepatitis B and HIV are two of the most important bloodborne diseases. Although the potential for HBV transmission in the workplace setting is greater than for HIV, the modes of transmission for these two viruses are similar. Both have been transmitted in occupational settings. Blood is the single most important source of HIV and HBV in the workplace setting. Protection measures against HIV and HBV for workers should focus primarily on preventing these types of exposures to blood as well as receiving the HBV vaccination.
The risk of hepatitis B infection following a parenteral (i.e., needlestick or cut) exposure to blood is directly proportional to the probability that the blood contains hepatitis B surface antigen, the immunity status of the recipient, and on the efficiency of transmission. The probability of the source of the blood being positive for hepatitis B varies from l to 3 per thousand in the general population to 5% - 15% in groups at high risk for HBV infection, such as:
Of persons who have not had prior hepatitis B vaccination or postexposure prophylaxis, 6% - 30% of persons who receive a needlestick exposure from an individual who is hepatitis B-positive will become infected.
The risk of infection with HIV following one needle-stick exposure to blood from a patient known to be infected with HIV is approximately 0.3%. This rate of transmission is considerably lower than that for HBV, probably as a result of the significantly lower concentrations of virus in the blood of HIV- infected persons.
An effective hepatitis B vaccine has been developed and is recommended for any health care provider, including all dental personnel. Also, hepatitis B immune globulin is available as a treatment in postexposure situations. However, the most important part of preventing disease transmission is correct use of barrier protection and disinfection and sterilization practices.
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