This Information Sheet provides an overview of the steps to take when an exposure incident occurs.
Dental practitioners face occupational exposure to blood-borne pathogens such as Human Immunodeficiency Virus (HIV), Hepatitis B (HBV), and Hepatitis C (HCV). Exposures are not limited to needlestick or other sharps injuries; they also include contact of blood, salvia or bodily fluids with skin, eyes and mucosa.
1. First Aid
Follow the First Aid emergency steps below if you sustain a blood and body fluid exposure (BBFE).
Stop work as soon as it is safe and reasonable to do so, even if in the middle of a procedure. Safety of the patient and all personnel should take priority.
Clean the affected site/s immediately.
- SKIN CUTS: Allow the wound to bleed and clean it thoroughly with soap and plenty of cold running water. There is no benefit in squeezing the wound. Do not apply disinfectants as some are irritants and retard healing.
- EYES: Flush mucous membranes/ conjunctiva with normal saline or cold water. If contact lenses are worn, remove after flushing eye and clean as usual.
- MOUTH: Spit out the fluid. Rinse the mouth with water several times, spitting the water out each time.
- CLOTHING: Change clothing and wash off or shower and clean off blood or body fluids that have come in contact with the skin.
2. Risk Assessment and Record Keeping
Risk assessment must be undertaken to determine the appropriate management of the exposure incident. All exposures to blood and bodily fluids should be documented.
To assess the severity of the exposure and to determine whether post-exposure prophylaxis (PEP) is required (assuming the source is HIV, HBC, HCV positive or of unknown status) – refer to this BBFE-self-assessment-flow-chart.
For further advice and support, a trusted medical practitioner or hospital emergency department can be contacted or visited immediately following occupational exposure. Referral for assessment and management of the risk of blood borne virus transmission can be arranged when necessary.
Use the Australian Dental Association (ada.org.au) Guidelines for Infection Prevention and Control (Fifth Edition) Resources | Australian Dental Association  – Appendix: Blood and body fluid exposure (BBFE) protocol for information that should be recorded in the incident register in your practice
3. Follow up testing, management and counselling
These will be managed by the qualified medical personnel.
Further Information
The Albion Centre Blood and Body Fluid Exposure Hotline has ceased operating, however online resources are still available such as The Albion Centre Procedure for the management of occupational blood and body fluid exposures (2019) thealbioncentre.org.au
ACT Members
ACT Health advise any practitioner who has had an exposure incident in the ACT to contact the nearest hospital (emergency department) or Medical Practitioner.
Exposures Incident Poster
A work place information poster on what to do when an exposure incident occurs can be ordered from Mi-tec.
NHMRC Guidelines (excerpt):
4.2.3 Managing exposures to occupational hazards:
Each healthcare facility requires a policy on the management, and on providing immediate post-exposure advice for sharps injuries and other blood or body substance incidents involving healthcare workers. This is because generic policies may not be relevant to individual settings (e.g. access to care, especially after hours).
The healthcare worker should receive immediate care and treatment at the site of exposure. A risk assessment of the exposure should be taken—including the type of exposure, type and amount of fluid involved, infectious status of the source, and susceptibility of the exposed healthcare worker. If the source of exposure can be identified, they should be tested for HBV surface antigen, HCV antibody and HIV antibody. The healthcare worker should have baseline testing, as required. Counselling and follow-up should be provided to the healthcare worker.
Disclaimer:Â This is one of a series of Advisory Services information sheets created by ADA NSW. They are intended as general guides that highlight key pieces of information frequently requested. They do not set out to provide comprehensive information about a topic and they are not legal advice. Please be mindful that information provided in these resources can change after the publication date.
