The Dynamic Dental Safety Compliance Blog

Dental office cell phone safety

2010-06-21T10:58:00.004-05:00

Cell phones in the office are the expected and not the unusual... that said, it should be the policy of ALL dental offices to have them shut off while in the patient treatment areas.

There are many reasons for this not the least of which is that they can certainly present a significant distraction and may in fact interfere with the delivery of optimum dental care.

Additionally, most of these devices are able to take photos and some will also take videos. This has the potential to have some impact of a negative nature if some of the photos are misrepresentations. Please use caution with allowing electronic device usage by patients or visitors in the office.

Please call us at Dynamic Dental Safety ... (888) 669-8846 with any questions as well as complimentary phone consultation... visit us at our site www.dynamicdentalsafety.com for additional information regarding on-site services and continuing education with ADA/CERP credits.

Dental Safety Meeting

2010-06-13T12:20:00.002-05:00

Dr. Howard Pactovis has just returned from the OSAP meeting in Tampa, FL. OSAP is the premier safety organization for all things dental. He will be happy to share any valuable compliance and safety updates.

Visit our website and you are invited to request complimentary materials and access to ADA/CERP courses. We have just launched the "industry standard" of live interactive CEU for the dental community.

Toll free contact us at 888-669-8846 or link to our site at http://www.dynamicdentalsafety.com and our online partner at http://www.dentallearning.org

World TB Day --- March 24, 2009

2009-03-22T16:19:00.005-05:00

World TB Day is observed each year on March 24 to commemorate the datein 1882 when Dr. Robert Koch announced the discovery of Mycobacterium tuberculosis, the bacterium that causes tuberculosis (TB). Worldwide,TB remains one of the leading causes of death from infectious disease. An estimated 2 billion persons are infected with M. tuberculosis (1).

In 2006, approximately 9.2 million persons became ill from TB, and 1.7 million died from the disease (1). World TB Day provides anopportunity for TB programs, nongovernmental organizations, and other partners to describe problems and solutions related to the TB pandemic and to support worldwide TB control efforts. The U.S. theme for this year's observance is Partnerships for TB Elimination.

Additional information about World TB Day and CDC TB- elimination activities is available at http://www.cdc.gov/tb/worldtbday.

ref. MMWR March 20, 2009 / 58(10);249

OSHA Resources - Pandemic Influenza

2009-03-07T18:08:00.002-05:00

A new Safety and Health Topics Web page on pandemic influenza has been posted to OSHA's Web site. The page is a central repository for OSHA information and resources on helping workplaces prepare for a pandemic. One of the newest resources is a link to a Web page featuring answers to the most frequently asked questions about OSHA's Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers.

Put You Hands Together - Handwashing Video

2009-02-28T19:37:00.006-05:00

Scientists estimate that people are not washing their hands often or well enough and may transmit up to 80% of all infections by their hands. From doorknobs to animals to food, harmful germs can live on almost everything. Handwashing may be your single most important act to help stop the spread of infection and stay healthy.

Check out this great Video from the CDC-
Put Your Hands Together

www.cdc.gov/CDCTV/HandsTogether/

Source: National Center for Preparedness, Detection, and Control of Infectious Diseases (NCPDCID) and National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED) Running Time: (3:38)

Hepatitis B Vaccination Declination Form

2009-02-20T19:02:00.002-05:00

Q. If an employee who handles blood as part of their job is offered the hepatitis B vaccine, but refuses it... what paper work is required?

A. Below is an example of a declination statement which should be signed/dated by the employee and kept on file in the office.

“ I understand that due to my occupational exposure to blood and/or other potentially infectious body fluids, I may be at risk of acquiring hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated with hepatitis B vaccine at no cost to myself. However, I decline the hepatitis B vaccine at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B which is a serious disease. If in the future I continue to have occupational exposure to blood and/or other potentially infectious body fluids and I want to be vaccinated with the hepatitis B vaccine, I can receive the vaccination at no cost to me.”

2009-02-08T18:33:00.003-05:00

safetyDRs is pleased to announce new online continuing education courses for dental professionals administered by the Academy of Dental Learning, an ADA CERP Recognized Provider. A certificate of completion (including CE Credits earned) may be downloaded online.

These online courses offer busy dentists and other dental professionals the opportunity to stay current in their practice and obtain required CE Credits. Featured courses include:

- OSHA/Bloodborne Pathogens Standard Required Annual Review for Dental Office

- OSHA: Hazard Communication Standard

- Medical Emergencies in the Dental Office

The complete catalog of continuing education courses may be viewed at: http://www.safetydrs.com/catalog.php

HHS Issues Action Plan To Prevent Health Care-Associated Infections

2009-01-13T10:27:00.005-05:00

"The U.S. Department of Health and Human Services (HHS) unveiled a plan that establishes a set of five-year national prevention targets to reduce and possibly eliminate health care-associated infections (HAIs). Health care-associated infections are infections that patients acquire while undergoing medical treatment or surgical procedures. These infections are largely preventable.

In addition to the tremendous toll on human life, the financial burden attributed to these infections is staggering. HHS' Centers for Disease Control and Prevention (CDC) estimates that approximately 1.7 million HAIs occurred in U.S. hospitals in 2002 and were associated with 99,000 deaths. CDC also estimates that HAIs add as much as $20 billion to health care costs each year.

HHS intends to update the plan in response to public input and new recommendations for infection prevention. The plan, and instructions for submitting comments on the plan, can be found online at http://www.hhs.gov/ophs"

Ref. Medical News Today (http://www.medicalnewstoday.com)

2009 Adult Immunization Schedule

2009-01-11T13:15:00.004-05:00

The Advisory Committee on Immunization Practices (ACIP) annually reviews the recommended Adult Immunization Schedule to ensure that the schedule reflects current recommendations for the licensed vaccines. In October 2008, ACIP approved the Adult Immunization Schedule for 2009. No new vaccines were added to the schedule; however, several indications were added to the pneumococcal polysaccharide vaccine footnote, clarifications were made to the footnotes for human papillomavirus, varicella, and meningococcal vaccines, and schedule information was added to the hepatitis A and hepatitis B vaccine footnotes.

Additional information is available as follows: schedule (in English and Spanish) at http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm; adult vaccination at http://www.cdc.gov/vaccines/default.htm; ACIP statements for specific vaccines at http://www.cdc.gov/vaccine/pubs/acip-list.htm; and reporting adverse events at http://www.vaers.hhs.gov or by telephone, 800-822-7967.

Ref. Centers for Disease Control and Prevention. Recommended adult immunization schedule---United States, 2009. MMWR 2008;57(53).

Evidence-Based Strategies to Fight Infection

2008-10-12T10:37:00.003-05:00

The AHA and four other health care organizations today released on Oct. 8 a compedium of strategies to help prevent the most dangerous infections that hospitals face. Distilled from the latest guidelines and scientific evidence, the compendium identifies what hospitals should be doing, and how, to prevent staph and C. difficile infections, ventilator-associated pneumonia, bloodstream infections caused by central-line catheters, and urinary tract and surgical site infections.

“As of today, the nation’s infection control team has a common ‘play book’ − one that harnesses the latest authoritative information in a clear and concise manner for everyone’s benefit …especially the patient,” said AHA President and CEO Rich Umbdenstock at a Washington, DC, press event. In addition to the AHA, the partnership includes the Society for Healthcare Epidemiology of America, Infectious Diseases Society of America, Association for Professionals in Infection Control and Epidemiology, and The Joint Commission.

The full text of The Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals is available here.

ref. AHANews.com

Nashua, NH Dental Office Faces $75k OSHA fine

2008-09-27T09:55:00.005-05:00

"Whopper of a fine!

OSHA cites Allcare Dental Nashua office for allegedly violating occupational health standards after an employee suffered a needlestick injury. The office faces $76,500 in proposed fines.
The OSHA inspection, conducted by OSHA's Concord area office, found that the Allcare office did not provide the injured employee with no-cost, post-exposure medical evaluation and follow-up and did not have the blood of the source individual tested, as required under OSHA's bloodborne pathogens standard.

Although the alleged needle stick incident took place back in November 2007, OSHA did not become aware of it until about 31 1/2 months later when they received a complaint. [So, where do you think that OSHA received a complaint from? It is important to follow guidelines to protect your healthcare workers for their sake and for the sake of your business!]

Allcare was cited with one willful citation, with a proposed $63,000 fine because the source individual's blood was not tested, although required. In addition six serious citations, with $13,500 in proposed fines, were issued for not providing the post-exposure evaluation and follow-up; not annually reviewing and updating the exposure control program; training deficiencies; and not using sharps with engineered sharps protection."

ref. International Sharps Injury Prevention Society Newsletter, Sept. 26, 2008

It is incredible that there are about 1 million needlestick and other sharps injuries that continue to occur each year among healthcare workers in the United States. This is unacceptable! Healthcare employers are obligated to provide a safe workplace for their employees and provide annual bloodborne pathogens training and implemention of sharps safety devices.

For information on how to comply with OSHA Standards and compliance to sharps safety, please contact safetyDRs, tel. (888) 669 - 8846, x703

Recommendations for 'Flu Control & Prevention

2008-08-11T11:08:00.001-05:00

MMWR
Recommendations and Reports
Volume 57, No. RR-7 August 08, 2008

PDF of this issue: http://www.cdc.gov/mmwr/PDF/rr/rr5707.pdf http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5707a1.htm?s_cid=rr5707a1_e

Prevention and Control of Influenza Recommendations of the AdvisoryCommittee on Immunization Practices (ACIP), 2008. This report updates the 2007 recommendations by CDC's AdvisoryCommittee on Immunization Practices (ACIP) regarding the use of influenza vaccine and antiviral agents (CDC. Prevention and control ofinfluenza: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2007;56[No. RR-6]). The 2008 recommendations include new and updated information.

Principal updates and changes include 1) a new recommendation that annual vaccination be administered to all children aged 5--18 years, beginning in the2008--09 influenza season, if feasible, but no later than the 2009--10 influenza season; 2) a recommendation that annual vaccination of all children aged 6 months through 4 years (59 months) continue to be aprimary focus of vaccination efforts because these children are athigher risk for influenza complications compared with older children;3) a new recommendation that either trivalent inactivated influenzavaccine or live, attenuated influenza vaccine (LAIV) be used when vaccinating healthy persons aged 2 through 49 years (the previous recommendation was to administer LAIV to person aged 5--49 years); 4) a recommendation that vaccines containing the 2008--09 trivalentvaccine virus strains A/Brisbane/59/2007 (H1N1)-like, A/Brisbane/10/2007 (H3N2)-like, and B/Florida/4/2006-like antigens be used; and, 5) new information on antiviral resistance among influenza viruses in the United States. Persons for whom vaccination is recommended are listed in boxes 1 and 2.

These recommendations also include a summary of safety data for U.S. licensed influenza vaccines.This report and other information are available at CDC's influenza website (http://www.cdc.gov/flu), including any updates or supplementsto these recommendations that might be required during the 2008--09influenza season. Vaccination and health-care providers should be alert to announcements of recommendation updates and should check the CDC influenza website periodically for additional information.

Emerging Infectious Disease (EID) Journal

2008-08-05T09:08:00.001-05:00

Emerging Infectious Diseases (EID) journal provides recognition of new and re-emerging infections and understanding of factors involved in disease emergence, prevention, and elimination. It also represents the scientific communications component of CDC's efforts against the threat of emerging infections.

See the August 2008 issue of the EID journal at the following link: http://www.cdc.gov/ncidod/EID/index.htm

Mass Casualty Events

2008-08-05T09:02:00.003-05:00

Mass Casualty EventsRecommendations for Postexposure Interventions to Prevent Infection with Hepatitis B Virus, Hepatitis C Virus, or Human Immunodeficiency Virus, and Tetanus in Persons Wounded During Bombings and Other Mass-Casualty Events - CDC - MMWR Recommendations and Reports - Aug 1

This report outlines recommendations for postexposure interventions to prevent infection with hepatitis B virus, hepatitis C virus, human immunodeficiency virus, or tetanus in persons wounded during bombings or other events resulting in mass casualties. Persons wounded during such events or in conjunction with the resulting emergency response might be exposed to blood, body fluids, or tissue from other injured persons and thus be at risk for bloodborne infections.

This report adapts existing general recommendations on the use of immunization and postexposure prophylaxis for tetanus and for occupational and nonoccupational exposures to bloodborne pathogens to the specific situation of a mass-casualty event. The recommendations contained in this report represent the consensus of U.S. federal public health officials and reflect the experience and input of public health officials at all levels of government and the acute injury response community. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5706a1.htm <http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5706a1.htm?s_cid=rr5706a1_e>

ref. CDC Updates for Clinicians: July 28-August 4, 2008

2008 Study of Nurses' Views on Workplace and Needlestick Injuries

2008-07-09T09:40:00.003-05:00

The 2008 Study of Nurses' Views on Workplace Safety and Needlestick Injuries, an independent survey of more than 700 U.S. nurses, sponsored by the American Nurses Association (ANA) and Inviro Medical Devices revealed that needlestick injuries and bloodborne infections remain concerns for nearly two-thirds (64%) of nurses. The research also highlights that safety concerns influence the decisions made by the vast majority of nurses (87%) about the type of nursing they do, and that nearly two-thirds of nurses (64%) have been accidentally stuck by a needle while working.

The study is sponsored by the American Nurses Association. Research results can be downloaded at: www.nursingworld.org.

OSHA Offers Guide to Stockpiling Masks, Respirators

2008-05-15T05:58:00.004-05:00

US Department of Labor (DOL) yesterday released proposed guidance on stockpiling respirators and facemasks in the workplace, which encourages employers to stockpile the items because of the likelihood that they will run short during an influenza pandemic.

The proposed guidance lists stockpiling estimates for individual employees in a range of medium- to very high-risk jobs, listing numbers of masks or respirators by work shift and a theoretical pandemic duration (about 120 work days). For example, a retail-store employee might need two masks per shift and 240 for the duration of a pandemic, whereas a nurse in a medical office or clinic classified has high risk might need four N95 respirators per shift and 480 to cover the whole pandemic. Dental professionals are classified as high risk due to performing aerosol generating procedures and recommended to have 960 masks available per employee .

It is important to note that healthcare workers must be first fit-tested for N95 respirators for proper sizing and use.

See: Proposed Guidance on Workplace Stockpiling of Respirators and Facemasks for Pandemic Influenza: http://www.osha.gov/dsg/guidance/stockpiling-facemasks-respirators.html

Ref. Center for Infectious Disease Research & Policy --

Please contact safetyDRs at (888) 669 - 8846 x 701 for low cost, on-site, N95 respirator fit-testing.

Employers Must Post OSHA Illness/Injury Summaries Beginning Feb. 1, 2008

2008-01-27T13:03:00.000-05:00

SafetyDRs would like to reminded employers that beginning Feb. 1, they must post a summary of the total number of job-related injuries and illnesses that occurred during 2007. Employers are only required to post OSHA Form 300A (summary), not the OSHA 300 log.

The summary must be posted from Feb. 1 to April 30, 2008. The summary must list the total number of job-related injuries and illnesses that occurred in 2007 and were logged on the OSHA 300 form. Information about the annual average number of employees and total hours worked during the calendar year is also required to assist in calculating incidence rates. Companies with no recordable injuries or illnesses in 2007 must post the form with zeroes on the total line. All summaries must be certified by a company executive.

The form is to be displayed in a common area wherever notices to employees are usually posted. Employers with ten or fewer employees and employers in certain industry groups are normally exempt from federal OSHA injury and illness recordkeeping and posting requirements.

Copies of the OSHA Forms 300 and 300A are available on the OSHA Recordkeeping Web page in either Adobe PDF or Microsoft Excel Spreadsheet format.

New Respirator Fit-Testing Protocol

2008-01-17T11:45:00.000-05:00

OSHA recently published a Notice of Proposed Rulemaking for a new respirator fit-testing protocol—the Abbreviated Bitrex® Qualitative Fit-Testing (ABQLFT) protocol. The proposed rule would add the ABQLFT protocol as an alternative to the current OSHA-approved qualitative fit-test procedures. The ABQLFT protocol for the seven exercises listed in the existing OSHA-approved Bitrex fit-test procedure in the Respiratory Protection standard would shorten the duration of each of the seven fit-test exercises from one minute to 15 seconds. Comments are being accepted until Feb. 25, 2008.

Do you have N95 respirators for your staff? N95 respirators should be used for contact with known or suspected patients with certain airborne infectious disesases (e.g. Tuberculosis, SARS, Pandemic Influenza). SafetyDRs can come to your office and fit-test applicable staff. It only takes about 10 minutes per employee and the required written OSHA Respiratory Protection Plan is included. Access to low cost N95 respirators are also available. Please contact safetyDRs at: (888) 669 - 8846, 701

Norovirus spreads via keyboard and mouse

2008-01-07T09:15:00.000-05:00

The CDC reports an outbreak of acute gastroenteritis in an elementary school associated with contaminated computer keyboards. Norovirus causes the majority of acute gastroenteritis outbreaks in the United States. Person-to-person spread through the fecal-oral route, contaminated food and water, and aerosolized vomitus are known to transmit norovirus; contact with contaminated environmental surfaces also has been implicated in transmission.

Laboratory studies have demonstrated that fingers contaminated with norovirus can transfer the virus to environmental surfaces, which can subsequently contaminate clean fingers with detectable amounts of norovirus. Because of shared computer use in health-care facilities, schools, and workplaces, certain researchers have suggested that computer equipment might be a route of bacterial disease transmission.

Proper washing with soap and water can eliminate norovirus from hands; alcohol-based sanitizers may also be effective. Potentially (but nonvisibly) soiled surfaces are best disinfected with a solution of 1:50 to 1:10 concentration of household bleach in water (1,000--5,000 ppm chlorine) by vigorous wiping for >10 seconds. Disposable towels used to clean visibly soiled surfaces should be discarded appropriately after use because they can transfer norovirus to fingers and other surfaces

Care should be taken when cleaning computer equipment. Washable keyboards and mice are available.

Ref. MMWR, January 4, 2008 / 56(51);1340-1343

New Year Safety Resolutions!

2008-01-01T10:34:00.000-05:00

Let 2008 be the year that you and your staff work towards a positive safety culture. OSHA has acknowledged that those facilities that have a total safety culture have less employee injuries and increased work productivity. Here are some tips to consider:

- Ensure that you accomplish required education and training (i.e. annual bloodborne pathogens training).

- Conduct a survey to identify where you are using sharps in your office. Identify potential sharps safety devices (engineering controls) and have your staff evaluate them and implement as applicable.

- Get everyone involved. Share the responsibility to check eyewash stations, fire extinguishers, maintain material safety data sheets, labelling secondary chemical containers, etc.

Let safetyDRs (formally Dynamic Dental Safety) help you with all your office safety compliance and training. We provide a comprehensive and cost-effective solution of becoming your partner in maintaining safety and risk management in your facility. The program includes all required manuals, on-site safety surveys and assistance with ensuring your facility is in complete regulatory compliance and on-site training for your staff including continuing education credit and 24/7 telephone support. Contact safetyDRs at: (888) 669-8846 x703 or visit us at safetyDRs.com.

National Handwashing Week: Dec. 2 - 8

2007-12-03T08:59:00.000-05:00

December 2 – 8 is National Handwashing Awareness Week. Keeping hands clean is one of the most important ways to prevent the spread of infection and illness.

Wash Your Hands: The Right Way:

When washing hands with soap and water:

• Wet your hands with clean running water and apply soap. Use warm water if it is available.
• Rub hands together to make a lather and scrub all surfaces.
• Continue rubbing hands for 15-20 seconds. Need a timer? Imagine singing "Happy Birthday" twice through to a friend.
• Rinse hands well under running water.
• Dry your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet.
If soap and clean water are not available, use an alcohol-based hand rub to clean your hands. Alcohol-based hand rubs significantly reduce the number of germs on skin and are fast acting.

When using an alcohol-based hand sanitizer:

• Apply product to the palm of one hand.
• Rub hands together.
• Rub the product over all surfaces of hands and fingers until hands are dry.

World AIDS Day

2007-12-01T11:00:00.000-05:00

World AIDS Day --- December 1, 2007

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5647a1.htm?s_cid=mm5647a1_e%0A

December 1 marks the 20th observance of World AIDS Day, an annual worldwide event established to increase awareness and education regarding human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). In 2007, an estimated 33.2 million persons worldwide are living with HIV; the number of deaths from AIDSin 2007 is expected to total 2.1 million (1). In the United States, an estimated 1 million persons were living with HIV in 2003 (2); of these, approximately 25% were unaware of their infection and thus were at high risk for infecting others.

HIV testing remains a crucial component of HIV prevention strategies. Persons who know they are infected with HIV can seek health care and protect their partners from becoming infected. In 2006, CDC issued newguidelines recommending routine HIV testing of adults, adolescents,and pregnant women in health-care settings in the United States (3). In addition, CDC recently provided funding to increase testing among populations disproportionately affected by HIV/AIDS. Additional information regarding World AIDS Day and HIV prevention measures isavailable at
http://www.cdc.gov/features/worldaidsday and http://www.cdc.gov/hiv.

New NIOSH Blog

2007-11-07T07:22:00.000-05:00

The National Institute for Occupational Safety and Health (NIOSH) introduced a new NIOSH Science Blog on Nov. 5, 2007, to further communicate the scientific issues related to NIOSH's research and recommendations, and to stimulate discussion on those issues.

The blog or web log at http://www.cdc.gov/niosh/blog/ is intended as a new way to help NIOSH fulfill its mission of translating research into practice for preventing work-related injuries, illnesses, and deaths. It is designed to provide an expeditious system for partners and stakeholders to present ideas to NIOSH scientists and each other, while engaging in robust scientific discussion with the goal of protecting workers.

MRSA in the Workplace

2007-10-28T09:51:00.000-05:00

NIOSH has posted a new web page with information and recommendationsto help employers and workers address workplace concerns associated with MRSA.

http://www.cdc.gov/niosh/topics/mrsa/

Posted as a resource for employers and workers who may be looking forinformation that can be applied to workplaces other than health-carefacilities, which are already included under general CDC infection-control guidelines.

Needlestick Brochure

2007-09-14T19:41:00.000-05:00

The Premier Safety Institute developed a brochure to educate healthcare and public health and safety workers in any setting across the continuum of care about the serious risks of occupational needlestick injuries and strategies and devices to reduce risks. The settings where needlestick injuries may occur include ambulatory settings, physicians' offices, ambulances, nursing homes, skilled nursing facilities, home health care, assisted living, or hospitals.

Download copy of brochure
Needlestick prevention brochure (.pdf) (925 KB)

The 12-page, easy-to-read brochure has information about:
How needlesticks happen
Why needlesticks are stressful to you and your family
What work practices can protect you
What the laws are for using safety devices
How to evaluate safety devices
How to dispose of sharps safely
What to do if you are injured

Labor Day Message

2007-09-03T11:00:00.000-05:00

As the President said today, "On Labor Day, we honor the hard work and dedication of the men and women of our workforce. Their efforts contribute to the prosperity of our great Nation". We at Dynamic Dental Safety would like to echo those sediments and especially thank dental and all other healthcare professionals for their hard work, dedication and compassion to their patients.

Need a Flu Shot Reminder?

2007-08-28T07:37:00.000-05:00

Flu season is just around the corner… The Centers for Disease Control has determined that vaccinations are the single most effective way to prevent flu and strongly encourages high-risk individuals (including health care providers) to get vaccinated. From a public health prospective, it is recommended that you encourage your office staff and high-risk patients to get an annual Flu shot.

This includes individuals who are:

-- Anyone who wants to reduce the likelihood of becoming ill or spreading influenza to others

-- All persons over 50 years old

-- Children and adolescents who are receiving long-term aspirin therapy

-- Women who will be pregnant during the influenza season

-- Adults and children who have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological or metabolic disorders (including diabetes mellitus)

-- Adults and children who have a weakened immune system (due to: HIV/AIDS, long term treatment with drugs such as steroids, cancer treatments)

-- Adults and children who have certain muscle or nerve disorders (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders) that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration; and

-- Residents of nursing homes and other chronic-care facilities

- Anyone who lives or cares for people at high risk for influenza related complications

-- Health care providers

-- Household contacts and caregivers of children from birth to 5 years of age and adults age 50 and older.

-- All children aged 6-59 months

See http://www.FindaFluShot.com to schedule a reminder to insure you are alerted to find a convenient location to obtain your immunization this coming flu season.

North American Pandemic Influenza Plan

2007-08-24T06:30:00.000-05:00

Leaders of Canada, Mexico, and the United States who met at a security summit in Montebello, Quebec, on Aug 21 unveiled a North American pandemic influenza plan designed to share expertise, coordinate public health messages, and overcome anticipated obstacles at national borders.

The North American Plan will enhance collaboration in order to: detect, contain and control an avian influenza outbreak and prevent transmission to humans; prevent or slow the entry of a novel strain of human influenza to North America; minimize illness and deaths; and sustain infrastructure and mitigate the impact to the economy and the functioning of society.

Maintaining critical infrastructure and services will be essential during a pandemic. While influenza cannot physically damage critical infrastructure, a pandemic could weaken it by diverting essential resources or removing essential personnel from the workplace. This Plan, therefore, extends beyond the health sector to include a coordinated approach to critical infrastructure protection, including the importance of business continuity planning and recognition of interdependencies among sectors.

The full Plan is available at http://www.state.gov/g/avianflu/91246.htm

Please contact Dynamic Dental Safety (888-669-8846 x701) for assistance in developing your own business continuity plan for all emergencies.

Hepatitis B Vaccination Declination Form

2007-08-22T19:12:00.000-05:00

Q. If an employee who handles blood as part of their job is offered the hepatitis B vaccine, but refuses it... what paper work is required?

A. Below is an example of a declination statement which should be signed/dated by the employee and kept on file in the office.

“ I understand that due to my occupational exposure to blood and/or other potentially infectious body fluids, I may be at risk of acquiring hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated with hepatitis B vaccine at no cost to myself. However, I decline the hepatitis B vaccine at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B which is a serious disease. If in the future I continue to have occupational exposure to blood and/or other potentially infectious body fluids and I want to be vaccinated with the hepatitis B vaccine, I can receive the vaccination at no cost to me.”

OSHA Offers New Health Care Compliance Assistance Module

2007-08-17T07:27:00.000-05:00

OSHA added a Health Care module to its Compliance Assistance Quick Start tool-the online guide to free compliance assistance resources on OSHA's Web site. The module is designed to help employers understand OSHA regulations applicable to the healthcare industry, including recordkeeping, reporting and posting requirements. It also contains information on developing a comprehensive safety and health program and on training employees.

Please contact Dynamic Dental Safety (888-669-8846, x701) for cost-effective assistance in developing your office safety program, including on-site training for your staff with continuing education credits.

Blood Exposures with Unknown Source

2007-08-13T08:57:00.000-05:00

Q. How are exposures to blood from a patient whose infection status is unknown handled?

A. If the source patient cannot be identified (e.g. exposure when disinfecting equipment) or refused to be tested (does not give informed consent), decisions regarding follow-up should be based on exposure risk and whether the source is likely to be infected with a bloodborne pathogen. Follow-up testing should be available to all personnel who are concerned about possible infection through occupational exposure.

Dynamic Dental Safety is available for blood exposure consultations, please call (888) 669-8846, x 701

MSDS

2007-08-09T15:49:00.000-05:00

Q. How long do I need to keep a MSDS after we discontinue use of the product?

A. Employee exposure records, which include MSDS or an inventory of the MSDS that an employee may have been exposed to, must be kept for 30 years after an employee leaves the organization.

As this can lead to a very thick MSDS manual, dds recommends that MSDSs of discontinued products in the office be placed in a separate archive file.

Eye Protection

2007-08-03T11:30:00.000-05:00

Ocular injuries may have serious and long term effects. Symptoms of direct mechanical trauma often relate to the degree and type of trauma, and include pain, lacrimation, and blurring of vision. Penetrating ocular trauma often causes visual damage and may require extensive surgery. Bacterial, viral and chemical exposures can result in long term visual impairment and discomfort, which may limit a practitioner's future clinical practice.

Operators and close support clinical staff must protect their eyes against foreign bodies, splatter and aerosols that may arise during operative dentistry:

During scaling, (manual and ultrasonic)
Using rotary instruments
Cutting and use of wires
Cleaning instruments.

Ideally protective glasses should have side protection. Patients' eyes must always be protected against possible injury; tinted glasses may also protect against glare from the operating light.

Reference: Infection control in dentistry. BDA Advice Sheet A12. Feb 2003

Construction Issues

2007-07-30T20:11:00.000-05:00

An office exhibiting the picture to the right during operational hours is not in compliance with the electrical standards of not only OSHA........ but those of most localities as well. In addition this condition shown above may pose a serious threat to not only employees, but patients and visitors as well.

We know that our contractors ideally should take care of these situations as part of their completion of the project. However, we at Dynamic Dental Safety are seeing an increasing number of these situations in existing operational dental facilities. Please note that "ignorance is not a defense" in an office ........ and the liabilities are enormous.

It is imperative that each and every "team member" be empowered with bringing any and all safety issues to the correct person in the dental office. Additionally, a third party evaluation of the facility is almost always a benefit to the office.

Dynamic Dental Safety performs this service and all other compliance issues for the dental office. Please contact us at (888) 669-8846 ext. 701 for information on our comprehensive services for your dental office.

Dental Records

2007-07-27T19:39:00.000-05:00

The dental record/chart is an official document. As such attention to detail is vital in all aspects of this document. Part of the "due diligence" for each and every dental office should be the monitoring and auditing of these documents. Of particular importance is the medical history of the patient. This should always be reviewed with the patient orally and signed by the reviewer.

Dynamic Dental Safety can assist the office with the "auditing form" that should be employed to ensure full compliance with your State Board of Registration as well as many of the insurers.
Please contact us at (888) 669-8846 ext. 701 for further information with regard to compliance issues in the dental office.

Ceiling Tiles

2007-07-23T16:14:00.000-05:00

As we can all see, the picture to the right is not a pretty one. With the inordinate amount of plumbing necessary to operate a dental office, there can be times when a pipe or connection fails. Either this or some weather event may cause damage to the dental office.

When ceiling tiles become saturated with water they pose serious issues on multiple levels. Firstly, due to the weight of the water, the tile or tiles can become quite heavy and eventually may break and injure either an employee or visitor to the dental office.

Past this, when the immediate problem is "contained", the issue then may become one of air quality. In the above picture, the recommendation to the dental office was to replace the affected tiles due to appearance and potential for mold growth. This potential additionally could pose long term liabilities for the owner of the dental office as welll as open the office up to the visitation by the regulatory agencies.

Dynamic Dental Safety addresses all forms of compliance issues for the dental office. Please contact us for information on our cost effective programs for your office at:

(888) 669-8846 ext. 701

What's in Your Biohazard Box?

2007-07-18T19:28:00.000-05:00

This is a biohazard box from a dental facility that was reviewed by Dynamic Dental Safety. Many of you may note that there are items in this double corrugated box that are at the very least unnecessary in most states. This only adds to the expense of the dental office and additionally needlessly overfills our landfills.

Please note that it is important to dispose of any and all "biohazardous" materials with appropriate care. It is also important to review your state and local regulations with respect to these items and their proper disposal and recordkeeping.

Dynamic Dental Safety assists dental offices with all compliance regualtions for state specific guidelines as well as OSHA and CDC standards. Please contact us for any compliance questions and solutions at: (888) 669-8846 ext. 701

Eyewash........ more information

2007-07-16T09:17:00.000-05:00

We at Dynamic Dental Safety have addressed the eyewash station in a number of blogs to date. Location, usage, and documentation of monitoring of this device are essential for all staff to exhibit their knowledge.

Now, a situation that has presented itself on numerous occasions, we feel is important to address for each and every dental office. Due to our labor and work situations, we in the dental field are sometimes confronted with the need to employ a "temp" in our office. This may seem like an innocuous situation, however, it may pose some serious liability for our dental office.

Take for example the "temp" who might accidentally have something affect his or her eye(s). If we at the dental office did not take the time to "show" this individual where the eyewash was located and how to operate it........ and further to document this ....... we might be assuming untold liability.

For assistance with this or any other compliance issue facing the dental office, please contact us a Dynamic Dental Safety for our cost effective solutions for your dental office at:

(888) 669-8846 ext. 701

Location of Emergency Eye Wash Stations

2007-07-13T16:07:00.000-05:00

Q. Where should the emergency eye wash station be located?

A. To be effective, the equipment has to be accessible. The American National Standards Institute (ANSI) recommends that a person be able to reach the equipment in no more than 10 seconds. In practical terms, consider that the person who needs the equipment will be injured, and may not have use of their vision. Recommendations for this distance in linear terms range from 15 to 30 meters (50 to 100 feet).

Other recommendations include that the eyewash station should:

- be located as close to the hazard as possible
- not be separated by a partition from the hazardous work area.
- be on an unobstructed path between the workstation and the hazard. (Workers should not - have to pass through doorways or weave through machinery or other obstacles to reach them.)
- be located where workers can easily see them - preferably in a normal traffic pattern.
- be on the same floor as the hazard (no stairs to travel between the workstation and the emergency equipment)
- not come into contact with any electrical equipment that may become a hazard when wet.

Reference: Canadian Centre for Occupational Health & Safety

Digital X-Rays and Lead Aprons

2007-07-11T19:25:00.000-05:00

Q. Our office has switched to digital x-rays... do we still need to place lead aprons and thyroid collars on our patients?

A. From a scientific standpoint, the answer is esstentially no. From a risk management standpoint, the anwer is yes.

Many years ago, dental x-ray equipment was a lot less sophisticated than it is today. Not only that, the type of film used was much slower than that in use now, and a LOT slower than the new digital x-rays. Depending on instrument settings, digital x-rays may have lower amounts of radiation emitted. Overall, the technological improvements in equipment, film types and data processing in use today have pretty much eliminated the need for leaded aprons.

However, patients often expect to have an apron placed over them during their procedures, just because they were used to seeing them in the past. In addition, it is conceivable that a patient could subsequently claim (perhaps many years after their treatment) that a medical issue they have is as a result of radiation exposure. So, from a risk management standpoint, it would be best to continue to use lead chest aprons and thyroid collars when using both traditional and digital x-ray systems.

Contaminated Toothpaste from China

2007-07-09T15:32:00.000-05:00

The US Food and Drug Administration (FDA) has found a poisonous chemical, diethylene glycol (DEG), in certain toothpastes imported from China. DEG is used in antifreeze and as a solvent. The agency increased its scrutiny and testing of imported toothpaste and dental products after receiving reports in late May 2007 of contaminated Chinese dental products found in several countries, including Panama.

The agency is warning consumers to avoid using tubes of toothpaste labeled as made in China and, through an import alert, is stopping all suspect toothpaste from entering the United States. FDA continues to investigate this problem and will take further action, as appropriate, to address this important public safety issue.

FDA is not aware of any U.S. reports of poisonings from toothpaste containing DEG. However, the agency is concerned about potential risks from chronic exposure to DEG and exposure to DEG in certain populations, such as children and individuals with kidney or liver disease. DEG in toothpaste has a low but meaningful risk of toxicity and injury to these populations. Toothpaste is not intended to be swallowed, but FDA is concerned about unintentional swallowing or ingestion of toothpaste containing DEG.

What to Avoid:
- Products labeled “made in China”
- Counterfeit toothpaste falsely packaged as "Colgate," manufactured in South Africa
- Packages labeled in a language other than English

Frequently Asked Questions About the Contaminated Toothpaste from China. (En Español)

HIPAA Tips

2007-07-06T17:30:00.000-05:00

Q. Will sending appointment reminder postcards violate HIPAA?

A. It is A-OK to send an appointment reminder card which simply states the date/time of the appointment. However, confidentiality would be violated if you provide both the patient's name and reason for the visit (e.g. Mr. Jones, this is a reminder of your July 17, 2007 appointment for your crown).

Storage and Dispensing of Hand Care Products

2007-07-04T12:05:00.000-05:00

Handwashing products, including plain (i.e., nonantimicrobial) soap and antiseptic products, can become contaminated or support the growth of microorganisms. Liquid products should be stored in closed containers and dispensed from either disposable containers or containers that are washed and dried thoroughly before refilling. Soap should not be added to a partially empty dispenser, because this practice of topping off might lead to bacterial contamination. Store and dispense products according to manufacturers’ directions.

Ref. CDC Guidelines for Infection Control in Dental Health-Care Settings — 2003

Stress at Work

2007-07-02T22:22:00.000-05:00

Working conditions play a primary role in causing job stress. However, the role of individual factors is not ignored. According to the NIOSH view, exposure to stressful working conditions (called job stressors) can have a direct influence on worker safety and health. Examples of individual and situational factors that can help to reduce the effects of stressful working conditions include the following:

- Balance between work and family or personal life
- A support network of friends and coworkers
- A relaxed and positive outlook

Ref. Stress at Work - NIOSH Publication No. 99-101:

Dental Ergonomic Risk Factors and Control Measures

2007-06-29T17:44:00.000-05:00

Significant ergonomic risk factors for dentists are static loading of the neck (prolonged focus on small areas inside the patient’s oral cavity) and static loading and awkward postures of the hands (anesthetic injection and drilling of patient’s teeth).

Sigificant ergonomic risk factors for dental assistants are twisting and turning of the back, and extended reaches of the arms to access dental instruments, prolonged static postures, forceful exertions of the hands while using dental instruments, and carving fillings.

Control measures include, but are not limited to:

- Replace older rear delivery equipment with more modern “continental-style” over-the-patient equipment. Utilize patient chairs that are as thin as possible.

- Ensure that existing equipment is functioning properly and that all chairs are able to be raised and lowered within the range for which they were designed.

-Design operatories so that the assistant or dentist does not have to get up or twist to use an amalgamator or curing light.

- Practice good posture while treating dental patients.

- Utilize slow set amalgams when doing large fillings.

Ref. NIOSH: HETA 98-0032-2795, Indian Health Service Dental Clinics, Arizona

Controll Exposures to Nitrous Oxide during Anesthetic Administration

2007-06-27T10:48:00.000-05:00

Nitrous oxide may cause decreases in mental preformance, audiovisual ability and manual dexterity and adverse reproductive effects. Prevent leakage from the anesthetic delivery system through proper maintenance and inspection of equipment.

Eliminate or replace the following:
- Loose-fitting connections
- loosely assembled or deformed slip joints and threaded connections
- Defective or worn seals, gaskets, breathing bags, and hoses

Control waste nitrous oxide with a well- designed scavenging system that includes the following:
- Securely fitting masks
- Sufficient flow rates for the exhaust
- Properly vented vacuum pumps

Ref. National Institute for Occupational Safety and Health (NIOSH)

Remove Those Rings

2007-06-25T07:51:00.000-05:00

Q. Must I remove rings before putting on exam gloves?

A. Whether wearing rings increases the likelihood of transmitting a pathogen is unknown; further studies are needed to establish whether rings result in higher transmission of pathogens in health-care settings. However, rings and decorative nail jewelry can make donning gloves more difficult and cause gloves to tear more readily. Thus, our recommendation is to remove jewelry so that it does not interfere with glove use (e.g., impair ability to wear the correct-sized glove or alter glove integrity).

Ref. CDC Guidelines for Infection Control in Dental Health-Care Settings — 2003

Autoclaves........ and more

2007-06-22T09:30:00.000-05:00

Please do not be put off by the sign at the left ... it may seem insulting, however, many of us are on such a tight schedule and under heavy pressure to produce that we try to "push the limits" of not only ourselves..... but our trusted machinery.

One of the items that we so often take for granted is our sterilizer. In many of the dental offices that we visit, the primary sterilizer is an autoclave. Most of the dental offices use these machines in the proper way. Some, due to scheduling issues, growth in the practice and for a variety of other reasons, abuse the machine and this can cause a multitude of problems for the office. A not so pretty picture of this occured at an office that we at Dynamic Dental Safety visited some time ago.

The picture that we see below is not very attractive......... in fact it did lead to a subsequent failure in the process. In short .... it created havoc in the office.

We cannot emphasize enough that proper training, accountability and documentation of compliance procedures can be implemented to avoid issues like this.

Please contact us at Dynamic Dental Safety for questions and answers to this or any other compliance issue that you may have in your dental office. We can be reached at (888) 669-8846 ext. 701

Burs......... What to do?

2007-06-20T12:18:00.000-05:00

Upon entering the operatory as a patient I might see the image at the right. A number of questions might enter my thoughts as I see this scenario...........

What are all of those things on the table?

Should the instrument (pliers) be just left out as they are?

Those little drills ........ are they going to go into my mouth?......... and more important.. are they sterile?

In fact, patients might think all of these things and more!!!!!!! In today's world, many of the patients will be confident enough to ask us their questions. However, there are some who might in fact not volunteer the questions and might take these to the next level.

The level that the patients most often go is their state dental board. We at Dynamic Dental Safety have seen an alarming increase in reports of Infection Control lapses coming to state dental boards. It is therefore imperative to both view your facility from the eyes of the patient and ensure that all of your compliance mandates are in place.

For help with this or any compliance questions please contact Dynamic Dental Safety at (888) 669-8846 ext. 701

Sterilization Packaging

2007-06-18T09:25:00.000-05:00

After we run our sterilizer through its cycle, and we remove the packaged instruments from the interior....... we should notice that there is a color change evident somewhere on the packaging material. It is either a word or an arrow or some indication. What exactly does this mean??? In many of the dental offices that we visit, the impression from the employees is that they think that this means that the instruments in the packet are sterile.

In fact, the color change is only measuring one of the necessary parameters for sterilization. In most cases this is only measuring that the heat or temperature has reached the desired level for the appropriate amount of time. For dental and medical procedures we need both the temperature and a sufficient pressure for a period of time to effect a proper sterilization.

This can only be measure by some form of spore testing. Please note that there are specific federal and state guidelines for the documetation and frequency of spore testing.

Please contact us at Dynamic Dental Safety for some of the specifics in the requirements for compliance for your area at (888) 669-8846 ext. 701

Watch Your Skin!

2007-06-15T08:01:00.000-05:00

Percutaneous injuries (e.g. needlesticks and other “sharps” injuries) are among the most efficient modes of transmission of bloodborne pathogens (hepatitis B, hepatitis C, HIV). However, direct or indirect blood or body fluid exposures that inoculated bloodborne pathogens into cutaneous scratches, abrasions, burns, other lesions, or on mucosal surfaces likely account for a significant proportion of occupational infections.

Dental personnel are reminded to take care of their primary defense system…their skin. A medical professional should treat skin conditions. Any cuts or lesions should be covered (e.g. plastic bandage), even though gloves are worn. Gloves and eye/face protection must be worn properly and consistently. Remember that good hand washing is the single most important procedure to prevent infection!

Hand Washing Posting Advisory

2007-06-13T21:11:00.001-05:00

Have you received a “Hand Washing Posting Advisory” from a “Healthcare Compliance Center”?

CDC has received reports from healthcare facilities (including dental offices) in several states that the healthcare facilities have been receiving “Hand Washing Posting Advisory” advertisements from state “Healthcare Compliance Centers” concerning hand washing signage. Please be advised that this is not a CDC activity. The CDC Guideline for Hand Hygiene in Healthcare Settings and accompanying educational materials are available at the Hand hygiene home page (http://www.cdc.gov/handhygiene).

Please note that the Guideline as well as all educational materials developed by CDC are in the public domain and may be downloaded, copied (without alteration), and distributed free of charge. CDC is encouraging healthcare facilities who have additional questions about this advertisement to contact their state/local health department.

Ref. Centers for Disease Control (CDC): Hand Hygiene in Healthcare Settings

What's In Your First-Aid Kit?

2007-06-11T16:06:00.001-05:00

Workplaces vary widely in their degree of hazard, location, size, amount of staff training and availability of professional medical service. Because of these significant variables, OSHA standards (1910.151 and 1926.50) do not require specific first aid kit contents. However, because some employers may find it useful to refer to a list of basic first aid supplies, federal OSHA provided a reference to this type of information by adding nonmandatory Appendix A to the standard. Appendix A references ANSI Z308.1-1978, “Minimum Requirements for Industrial Unit- Type First-aid Kits.” This ANSI standard was revised in 1998 and retitled: “Minimum Requirements for Workplace First Aid Kits.” First aid kits in compliance with this standard will provide a basic range of products to deal with most types of injuries encountered in the workplace.

The assortment of required items was developed based on treatment for the following potential injuries: major wounds, minor wounds (cuts and abrasions), minor burns and eye injuries. ANSI Z308.1-1998 includes the following recommended basic contents of a first aid kit.

ANSI Z308.1-1998 – Minimum requirements for workplace first aid kits: Basic kit – minimum contents
Item	Minimum Quantity
Absorbent compress, 32 sq. in. (81.3 sq. cm.) with no side smaller than 4 in. (10 cm)	1
Adhesive bandages, 1 in. x 3 in. (2.5 cm x 7.5 cm)	16
Adhesive tape, 5 yd. (457.2 cm) total	1
Antiseptic, 0.5g (0.14 fl oz.) applications	10
Burn treatment, 0.5 g (0.14 fl. oz.) applications	6
Medical exam gloves	2 pair
Sterile pads, 3 in. x 3 in. (7.5 x 7.5 cm)	4
Triangular bandage, 40 in. x 40 in. x 56 in. (101 cm x 101 cm x 142 cm)	1

Spore Testing of Sterilizers (Autoclaves)

2007-06-08T16:49:00.000-05:00

Q. How often should dental offices test their autoclave with spore strips?

A. According the Centers for Disease Control (CDC) Guidelines for Infection Control in Dental Health-Care Settings, biological indicators (BIs) (i.e., spore tests) are the most accepted method for monitoring the sterilization process because they assess it directly by killing known highly resistant microorganisms (e.g., Geobacillus or Bacillus species), rather than merely testing the physical and chemical conditions necessary for sterilization. Because spores used in BIs are more resistant and present in greater numbers than the common microbial contaminants found on patient-care equipment, an inactivated BI indicates other potential pathogens in the load have been killed.

Correct functioning of sterilization cycles should be verified for each sterilizer by the periodic use (at least weekly) of BIs. Every load containing implantable devices should be monitored with such indicators, and the items quarantined until BI results are known.

Family Emergency Preparedness

2007-06-06T20:31:00.000-05:00

Being prepared for an emergency, whether it be for a natural disaster, bioterriosm or infectious disease outbreak is important not only for our dental practices, but for our families. Having basic supplies available for our families is just good comment sense. A great resource is the Red Cross. See the following link on how to "Prepare for Disasters Before they Strike: Build A Disaster Supplies Kit" at: http://www.redcross.org/services/prepare/0,1082,0_91_,00.html

Breaking the Chain of Infection

2007-06-04T15:28:00.000-05:00

A popular model used to understand the infection process is the chain of infection, a circle of links, each representing a component in the cycle. Each link must be present and in sequential order for an infection to occur. The links are: infectious agent, reservoir, portal of exit from the reservoir, mode of transmission, and portal of entry into a susceptible host.

Understanding the characteristics of each link provides the dental professional with methods to support vulnerable patients and to prevent the spread of infection. An awareness of this cycle also provides the worker with knowledge of methods of self-protection.

For example, by focusing on the transmission chain, direct or indirect contact may be interrupted by proper hand washing and strict attention to disinfection and sterilization techniques.

Ref. City Colleges of Chicago, Infection Control for Nursing Students

XDR TB: CDC Letter to Heatlhcare Providers

2007-06-01T06:09:00.000-05:00

Dear Healthcare Professional,

A person with recently diagnosed culture-confirmed, extensively drug-resistant pulmonary tuberculosis (XDR TB) traveled on the following two extended flights (more than 8 hours in duration) in May 2007:

Date From To Airline / Flight#
May 12/13 Atlanta, Georgia Paris, France Air France #385/Delta #8517
May 24 Prague, Czech Rep. Montreal, Canada Czech Air #104

XDR TB is defined as a subtype of multidrug resistant TB (MDR TB) (i.e., an isolate resistant to at least isoniazid and rifampin), with additional resistance to at least two of the most important second-line antibiotics (i.e., a fluoroquinolone and an injectable agent [amikacin, kanamycin, or capreomycin]).

The patient is currently in respiratory isolation in a hospital in the United States, and is receiving medical therapy for XDR TB. He has remained relatively asymptomatic, and his sputum smear results were negative for acid fast bacilli (AFB), both before and after his travel; however, his sputum culture results are positive for XDR TB.

This is the first investigation of a case of XDR TB during air travel. Due to the serious nature of this strain of TB disease, CDC is recommending that all U.S. residents and citizens on these two flights receive evaluation, testing, and follow-up for TB infection.

We are requesting your assistance to perform TB evaluation and testing on any person identified as a contact on one of these flights. The XDR TB Contact Investigation Form is enclosed. Please keep a copy of this completed form for your records, give a copy to the person tested, and also please contact your State or Local TB control office via: http://www.cdc.gov/tb/pubs/tboffices.htm .

For inquiries related to this investigation, please call your State or Local Health Department. For more information about XDR TB, please see this link: http://www.cdc.gov/tb/XDRTB/default.htm.

We greatly appreciate your assistance on this important international XDR TB contact investigation.

Disposal of Dental X-Ray Fixer and Developer

2007-05-30T15:18:00.000-05:00

Q. Is it safe to dispose dental X-Ray fixer and developer down the sink?

A. Silver-bearing wastes, including X-Ray fixer, should not be discharged to the sewer unless they are first treated in a properly sized, designed, installed, operated, maintained, and serviced standard silver recovery system. Otherwise, fixer should be taken off-site for treatment and disposal. Developer solutions should not be mixed with fixer solutions, and may only be discharged to the sewer if they have not mixed with fixer. If you are not connected to a sewer system, you should have your developer disposed of by a hazardous waste company. So, the short answer is if you are connected to a sewer, developer can be poured down the sink and if you have a silver recovery system, fixer can also be poured down a sink.

HIPAA Privacy Rules in Dentistry

2007-05-28T06:25:00.000-05:00

Q. May a physician send out appointment-reminder postcards?

A. Yes, The HIPAA Privacy Rules allow a physician to communicate with patients, including communications to the patient's home. However, privacy and confidentiality must be maintained. For example, it is A-OK to send a postcard reminder with the date and time of the next appointment. It is not acceptable to send a postcard with specific treatment information such as "Mr. Smith, your dentures are ready".

OSHA Influenza Preparedness Guidance

2007-05-25T22:20:00.000-05:00

As reported in the newly released, Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers, OSHA strongly urges healthcare institutions (including dental offices) to stockpile N-95 respirators and other protective equipment, warning that the items will be scarce once a pandemic strikes. "Employers and employees should not count on obtaining any additional protective equipment not already purchased and stockpiled," the report said. "Therefore, it is important for healthcare facilities to consider respiratory protection for essential personnel to assure that employees are ready, willing, and able to care for the general population."

http://www.osha.gov/Publications/OSHA_pandemic_health.pdf

Pandemic Flu Leadership Blog

2007-05-23T14:27:00.000-05:00

On June 13, Michael O. Leavitt, Secretary, U.S. Department of Health and Human Services, is convening a leadership forum on pandemic preparedness, which brings together highly influential leaders from the business, faith, civic and health care sectors to discuss how best to help Americans become more prepared for a possible influenza pandemic. The Department is hosting this five-week blog summit to expand this conversation as part of an ongoing effort by the Department to help Americans become more prepared.

See: http://blog.pandemicflu.gov

Free Handwashing Poster

2007-05-21T07:33:00.000-05:00

Here is a free high quality poster from the CDC for placing throughout your facility. Shows bugs that can lead to infection and may be found on unclean healthcare worker's hands.

Download English Version PDF (1 page/44KB)

Download Spanish Version PDF (1 page/158KB)

First Bird Flu Vaccine

2007-05-18T17:42:00.000-05:00

The FDA is announced the licensure of the first vaccine in the United States for humans against the H5N1 influenza virus, commonly referred to as avian influenza or "bird flu." This inactivated influenza virus vaccine is indicated for immunization of persons 18 through 64 years of age who are at increased risk of exposure to the H5N1 influenza virus subtype contained in the vaccine. This vaccine is derived from the A/Vietnam/1203/2004 influenza virus. The vaccine is manufactured by Sanofi Pasteur Inc. of Swiftwater, PA and has been purchased by the federal government for inclusion within the Nation's National Stockpile.

Should such a bird flu pandemic emerge, the vaccine may provide early limited protection in the months before a vaccine tailored to the pandemic strain of the virus could be developed and produced. "The threat of an influenza pandemic is, at present, one of the most significant public health issues our nation and world faces," said Andrew C. von Eschenbach, M.D., Commissioner of Food and Drugs. "The approval of this vaccine is an important step forward in our protection against a pandemic."

Should a Dental Office Stockpile Antivirals?

2007-05-16T11:15:00.001-05:00

According to a report published by the Center for Infectious Disease Research & Policy (CIDRAP), “At least 5 to 6 months into a pandemic, until a vaccine can be made and distributed, antiviral drugs for influenza (ie, antivirals) will be the only pharmacologic option for potentially preventing, shortening, or reducing the severity of illness among employees. Given grim estimates of 30% absentee rates, offering employees antivirals as part of a prevention or treatment strategy could appear to be a cost-effective way of both reducing worker absenteeism and bolstering employees' confidence in their company.

In a recent poll of 120 preparedness professionals attending the CIDRAP summit on business preparedness for pandemic influenza in February, 37% of the participants (many from Fortune 500 companies), said their firms had purchased or were planning to purchase antivirals for distribution to employees during a pandemic.” (May 11, 2007: CIDRAP News: http://www.cidrap.umn.edu/cidrap/content/influenza/biz-plan/news/051107antivirals.html)

Should dental offices consider stockpiling and potentially distribute antivirals (e.g. Tamiflu) to their employees? Although it is a difficult decision based on issues such as supply, distribution and timing, Dynamic Dental Safety recommends that dental offices should at least explore this option as part of a comprehensive emergency preparedness plan.

Lead Aprons in Dentistry

2007-05-14T10:15:00.000-05:00

On the right is a depiction of a lead apron and thyroid collar that is typically used in the dental office. This is directed to be worn by the patient in the act of taking dental x-rays.

Many dental offices are now converting to and installing digital radiographic equipment. The amount of radiation delivered to the patient during this digital type of exposure is significantly less than the traditional x-ray equipment.

Taking this into account, we often get asked the question regarding the necessity for the patient to wear this protective lead apron with the usage of digital x-rays. The answer that we give is that the dental office should always consider the "worst possible scenario" in that if something were to happen to the patient at that moment or in the future......... the rememberance of not having the protective apron will be etched in the mind of the patient. The patient then might decide to take things to the next level.

The advice that we at Dynamic Dental Safety give to all of our clients is to practice "risk prevention", and in this case to always have the patient wear the lead apron during times of x-ray exposure.

For this or any other compliance issue or question, call us at Dynamic Dental Safety (888) 669-8846 ext. 701

Don't Block Your Fire Sprinklers!

2007-05-11T07:21:00.000-05:00

Fire sprinklers are an essential and effective means of fire protection for people and buildings. Often, however, dental supplies and other stacked items are placed near or around sprinkler heads, blocking the range of the sprinkler and greatly reducing its effectiveness. Nothing should ever be placed any higher than 18 inches below a sprinkler or positioned in such a way as to block a sprinkler’s full range of coverage.

Hige storage of items can also create unstable loads and create a fall hazard. Pay attention to the organization of your storage closets. Minimize the storage of non-essential items and keep the area tidy.

Dental sharps container safety

2007-05-09T06:00:00.000-05:00

Let's look at the opening at the top of the typical sharps container found in the dental office. We notice that there are multiple holes on the circumference. Most of the dental office does not even take note of these, however they are an important part of the safety solutions for the dental office.

The four holes that are similar are for the securing of the cover for the sharps container when it is deemed to be full. This is in most cases when the container is 2/3 to 3/4 full so as not to make it difficult to place something in the sharps container without undue force.

The two holes that we see on the extreme right and left of the picture are for the purpose of safely removing the needle from the syringe. This is done by inserting the needle into the opening and sliding it so as to engage the ribs on the hub of the needle. Next the needle can be disengaged by rotating the hub of the syringe and the needle will fall directly into the sharps container.

This method can be used with or without the needle being capped. We have demonstrated that the dental office has implemented "safer medical/dental devices" with the proper usage of pre-existing materials.

For compliance advice for the dental office please contact Dynamic Dental Safety at (888) 669-8846 ext. 701

Electrical Surge Protector/Power Strip Safety

2007-05-07T08:34:00.000-05:00

Do NOT plug a surge protector or power strip into an existing surge protector or power strip. This practice is called "daisy-chaining" or "piggy-backing" and can create a serious hazard. There should only be one surge protector or power strip plugged into a single duplex electrical outlet.

- Power strips should not be overloaded. Most are rated for 15A. This equates to approximately 1500 watts of power connected to the device.

- Surge protectors, power strips, and/or extension cords are NOT a substitute for permanent wiring.

- Do NOT locate a surge protector or power strip in any area where the unit would be covered with carpet, furniture, or any other item that will limit or prevent air circulation.

- Do NOT staple, tack, or tape a surge protector or power strip.

Gas Cylinder Safety in Dental Offices

2007-05-04T21:07:00.000-05:00

Safety is all important in the dental office. To this end it is essential that each and every employee in the dental office participate ... by observing and either correcting the issue or bringing it to the attention of an individual who has the ability to correct the offending issue.

Additionally, certain items should be checked on a regular basis. This is necessary in the documentation to "prove" that we not only say that we check items, but that in truth we do .. and place this in writing. Creating this "performance based" program in the dental office is one of the items that Dynamic Dental Safety helps to "walk the staff through" in providing our OSHA/Risk Prevention services.

One of the items to check on a regular basis are the compressed gas cylinders. These should be checked in the following way:

Compressed Gas Tanks should be visually checked to ensure:

The area of storage is clearly marked
The tanks are secured
There is no obstruction present
The regulators for the tanks are in place and functional

For further information regarding this or any compliance issue in the dental office, please contact Dynamic Dental Safety at (888) 669-8846 ext. 701

Hepatitis B Declination Statement

2007-05-03T08:14:00.000-05:00

The following statement of declination of hepatitis B vaccination must be signed by an employee who chooses not to accept the vaccine. The statement can only be signed by the employee following appropriate training regarding hepatitis B, hepatitis B vaccination, the efficacy, safety, method of administration, and benefits of vaccination, and that the vaccine and vaccination are provided free of charge to the employee. The statement is not a waiver; employees can request and receive the hepatitis B vaccination at a later date if they remain occupationally at risk for hepatitis B.

Declination Statement: I understand that due to my occupational exposure to blood or other potentially infectious materials I may be at risk of acquiring hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated with hepatitis B vaccine, at no charge to me; however, I decline hepatitis B vaccination at this time. I understand that by declining this vaccine I continue to be at risk of acquiring hepatitis B, a serious disease. If, in the future I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with hepatitis B vaccine, I can receive the vaccination series at no charge to me.

Employee Signature:_____________________________ Date:____________________

Adapted from OSHA etools

Safer Medical Device Implementation in Dental Offices

2007-05-01T15:15:00.000-05:00

Since the passage of the Needlestick Safety and Prevention Act in 2000 and the subsequent revision of the OSHA Bloodbornes Pathogen Standard, all health care facilities, including dental offices are required to use safer medical devices. To assist facilities that are working through this process, The National Institute for Occupational Safety and Health (NIOSH) has asked a small number of facilities to share their experiences on how they implemented safer medical devices in their settings. These facilities have agreed to describe how each step was accomplished, and also to discuss the barriers they encountered and how they were resolved, and most importantly, lessons learned.

Click on the following link and scroll down to “Dental Facilities Results” to learn about the experiences of two different dental facilities: http://www.cdc.gov/niosh/topics/bbp/safer/Step1b.html

Alcohol-Based Hand Rinses in Dental Offices

2007-04-30T19:48:00.000-05:00

Q. Is it acceptable to use alcohol-based hand rinses in dental offices?

A. Yes, in fact, using waterless alcohol-based agents is now considered by the CDC to be the preferred method of skin asepsis. Most formulations contain emollients to soften skin and prevent dryness. Other benefits include rapid and effective antimicrobial action and increased hand asepsis compliance, as these products provide enhanced accessibility and convenience.

However, there are several limitations such as they can not be used if hands are visibly soiled and they should be stored away from high temperatures or flames. In addition, since hand softeners and glove powders may “build-up” on one’s hands, handwashing with soap and water may be needed after every 3-5 applications.

Work-Related Injuries

2007-04-27T07:40:00.000-05:00

"Data collected through a National Electronic Injury Surveillance System occupational supplement (NEISS-Work) provide information on persons treated for nonfatal work-related injuries and illnesses in U.S. hospital emergency departments (EDs). CDC's National Institute for Occupational Safety and Health uses these data to monitor injury trends and aid prevention activities. This report summarizes 2004 NEISS-Work injury and illness surveillance data. In 2004, an estimated 3.4 million nonfatal ED-treated injuries and illnesses occurred among workers of all ages, with a rate of 2.5 cases per 100 full-time equivalent (FTE) workers aged >15 years.

More than three fourths of all nonfatal workplace injuries/illnesses were attributed to contact with objects or equipment (e.g., being struck by a falling tool or caught in machinery), bodily reaction or exertion (e.g., a sprain or strain), and falls. No substantial reduction was observed in the overall number and rate of ED-treated occupational injuries/illnesses during 1996—2004."

Ref. MMWR: April 27, 2007 / 56(16);393-397 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5616a3.htm?s_cid=mm5616a3_e%0A

Comment: Injuries (e.g. sharps injuries, work related musculoskeletal disorders, etc.) in dental personnel continue to occur at unacceptable rates. Your employees are your most valuable asset. Please contact Dynamic Dental Safety (888-669-8846, ext. 701) for information on our on-site training programs designed to help prevent dental work-related injuries and illnesses.

Safety issue........ hazardous materials

2007-04-26T08:01:00.000-05:00

Note the picture at the left taken in a dental office a short while ago. There are multiple issues that can be seen as safety/OSHA or risk to dental professionals in the office.

The first of the issues that is noted is that the label on the container is not appropriate. Either a manufacturer's original label or an appropriate secondary container label (Dynamic Dental Safety can provide a customized specific label) should be evident on the container.

Next, and a slight bit less obvious is the fact that this bottle is resting on the floor. Should this item tip over, spill or leak in any way - the contamination of the underlying floor surface and cleanup would be extensive. A simple solution to this would be to place the container in a "boot tray" or other containment item. This would simplify the process of cleaning, thus saving time and expense for the dental office.

For solutions to this or other safety and risk areas relating to compliance in the dental office, please call Dynamic Dental Safety at (888) 669-8846 ext. 701

It's Not Too Late!!!!!!!!....the NPI time is here for dentists

2007-04-25T06:11:00.000-05:00

The time is coming close for the implementation of the third part of the HIPAA regulation applicable to dental offices. The American Dental Association states the following:

Any health care provider who uses standard electronic transactions, like electronic claims, eligibility verifications, claims status inquiries, and claim attachments, will be required by federal law to start including NPIs on electronic transactions not later than May 23, 2007. In addition, those dentists who use only paper, voice and fax to transmit these communications may find NPIs useful or necessary for other reasons. Many dental plans will require dentists to include NPIs on paper claim submissions, so even paper based dentists may find it a necessity to have NPIs.

Thus, our recommendation is to apply for and implement this as soon as possible. Following this link to the ADA article will allow each and every dental professional and dental office to make application either online or via mail:

http://www.ada.org/prof/resources/topics/npi.asp

For assistance with this or any other compliance issue for the dental office, please contact us at Dynamic Dental Safety at (888) 669-8846 ext. 701

Show Your Infection Control Practices to Your Patients

2007-04-24T09:05:00.000-05:00

The general public is becoming increasingly aware of infection control and other safety practices in healthcare. Newspapers, television and radio news carry daily stories on emerging pathogens, antibiotic resistant bacteria, foodborne poisoning, avian influenza, medical errors, etc. Your patients expect that your office is following "state-of-the-art" safety practices and are watching that you implement them consistently.

For example, we have heard about dental offices where a patient calls OSHA with a complaint that they observed their dentist not changing gloves and/or washing their hands before starting their procedure. When we investigate these complaints, we usually find that the dentist changed gloves and washed their hands in another operatory or sink area (i.e. not viewed by the patient). We recommend that you try to change gloves and wash your hands in front of your patient. By demonstrating good infection control practice, your patients will acknowledge that you consider their safety as number one!

How Do You Clean Utility Gloves?

2007-04-23T10:17:00.000-05:00

Since utility gloves (i.e. heavy rubber gloves used when handling chemicals) are reusable, they may be decontaminated with 1:10 bleach or an EPA approved disinfectant. However, utility gloves should be inspected before and after use and discarded if they are cracked, peeling, torn, punctured, or exhibit other signs of deterioration or when their ability to function as a barrier is compromised.

Safe Usage of Dental Products

2007-04-20T07:29:00.000-05:00

Just by viewing the container of Clorox wipes to the left in the dental office does not tell us the whole story. Exactly what do we mean by this?... well we must look for certain statements either on the container label or on the MSDS sheet if we have that available in the dental office.

First, in order to utilize an item for disinfection of countertops in the dental office (or cleaning any surface in the dental office that may be contaminated with bodily fluids) - that product must have the classification of being "tuberculocidal". In simple terms, it has been tested and is at the level required to disinfect the dental countertop and other non-porous materials at the appropriate level.

Additionally, we should be aware of the proper methods of addressing any injury from the chemicals within the product. One of the important items that we should be aware of and train our staff on is the use of the eyewash. An often overlooked item is placed right on the label of most products and that is the time of use to rinse our eyes if we are exposed to the chemical in the dental office.

As we can see the time listed on the right... the back of the label of the product.. tells us that we should rinse our eyes for 15-20 minutes. The importance of training our staff and additionally any "temporary" employees in both this as well as the location of the eyewash is essential in our dental office.

For help or clarification with this or any other dental compliance questions please contact us at Dynamic Dental Safety at (888) 669-8846 ext. 701

HIPAA Privacy Rules

2007-04-18T09:44:00.000-05:00

Q. Can I still call out patients' names in the waiting room?

A. Yes, it is OK to call out the patient’s full name. For example… it is fine for the receptionist to announce in the waiting room, "Mary Jones, we are ready for your now". However…"John Smith, your dentures are ready is inappropriate". Thus, under HIPAA Privacy Rules, it is acceptable to call out a patients name, but not combined with particulars such as the reason for their visit. In addition, please be careful about the vollume of your voice when discussing a patient in the office, whether it be on the phone, in an operatory or corridor.

Exit Signage

2007-04-17T08:00:00.000-05:00

One of the items that often goes overlooked in the dental facility at the expense of items like the MSDS, infection control, and other much more difficult issues to comply with is the signage issue for exits. We typically see either the wrong size of signage at the dental office just due to the fact that we do not pay this item much attention.

Note that the sign at the right is illuminated... this is not a requirement if there is enough ambient lighting along the exit route in the dental office. However, the size of the lettering is strictly regulated by OSHA. Our guidance to the dental office is to research and implement all applicable standards to ensure the optimum compliance with OSHA.

The link for the signage size standard is:

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=19456

For additional information on this topic or any compliance questions please call Dynamic Dental Safety at (888) 669-8846 ext. 701

OSHA Hazard Communication and Chemical Labels

2007-04-16T06:27:00.000-05:00

Q. What do the numbers and symbols on an NFPA fire diamond mean?

A. Under the OSHA Hazard Communication Standard, chemical containers are required “to communicate” the specific hazards of the chemical to the employee. Interpretation of the National Fire Protection Association (NFPA) diamonds: Blue = Health Hazard; Red = Flammability; Yellow = Instability; White = Special Hazards. Numbers in the three colored sections range from 0 (least severe hazard) to 4 (most severe hazard). The fourth (white) section is left blank and is used only to denote special fire fighting measures/hazards. For example, the “3” in the blue diamond communicates that short exposure of the chemical could cause serious temporary or residual injury even though prompt medical attention was given. For a specific chemical, one should consult the Material Safety Data Sheet (MSDS) to determine the appropriate hazard ratings which go into each of the diamonds.

The OSHA Hazard Communication Standard requires dental offices to: have a written plan (e.g. comprehensive manual); properly labeled chemicals; Material Safety Data Sheets readily available; and training provided to all employees who handle hazardous chemicals in the office.

Please contact Dynamic Dental Safety for all of your Hazard Communication needs: (888) 669 – 8846 ext. 701.

Do Not Over-Fill Sharps Containers

2007-04-13T16:23:00.000-05:00

Sharps containers are specially designed containers into which used needles and other dental-waste sharps are discarded. In recent years, models have been introduced which are intended to prevent users from overfilling the container. However, most containers we presently see in dental offices simply have a visible “do not fill over line” which is usually set at ¾ of the container's volume. It is imperative that dental personnel do not overfill containers.

Sharps injuries associated with disposal containers are among the most serious kind, as you are not able to identify the source patient. This means that as part of the medical evaluation, the conservative approach is to consider that you have been exposed to all of the most common bloodborne pathogens – HIV, hepatitis B and hepatitis C.

Ergonomic Risk Factors in Dental Offices

2007-04-12T16:28:00.000-05:00

Q. What factors contribute to Work-Related Musculoskeletal Disorders (WMSDs) in the dental office?

A. WMSDs in dental personnel is a significant issue, that does not get enough attention in terms of prevention efforts. Ergonomic stressors include, but are not limited to:

Repetitive motions (e.g., scaling, polishing)
Awkward and static neck, back and shoulder postures
Poor or improper adjustment of equipment
Infrequent breaks

The April issue of The Dental Safety Compliance Newsletter will feature an article on dental ergonomics by a leading expert, Bethany Valachi, MS, PT, CEAS. She is president of Posturedontics, a company that provides research-based dental ergonomic education (www.posturedontics.com). You can sign up for our complimentary Newsletter in the Web Form in the right column of this Blog Page.

Dental Emergency Plan…………. Why????

2007-04-11T06:48:00.000-05:00

In our visits and consultation with dental offices throughout the country, it is amazing how few have planned for that ultimate contingency… an emergency of any sort. Certainly, we counsel the dental office in forms of preparedness with respect to the HIPAA Security dictates. Additionally we prepare the dental office with respect to how to evacuate the premises and a gathering location for that limited emergency. These are not only important, they are requirements under OSHA.

Our Department of Homeland Security has produced an excellent document addressing many if not all of the issues of “protecting our business” as well as our employees and patients. This can be found by following this link:

http://www.ready.gov/business/_downloads/readybusiness-brochure.pdf

We encourage each and every dental office to implement and drill on emergency preparedness to ensure the safety of all.

For any further information or help with this or any other compliance issue please contact Dynamic Dental Safety at (888) 669-8846 ext. 701

Use the Right Glove for the Appropriate Task

2007-04-10T06:05:00.000-05:00

A common mistake found in dental offices is when staff use latex or vinyl exam gloves for virtually all tasks. Heavy rubber gloves, also known as utility gloves should be used when cleaning and disinfecting instruments, surrounding surfaces and operatories. In general utility gloves made of nitrile, butyl, or neoprene are protective for most chemicals used in the dental office. However, it is good practice to check the MSDS of the specific chemical you are handling for specifications on the type of gloves that would be protective. A utility glove should be worn if the MSDS states a waterproof or protective glove is required.

Orthodontic Wires

2007-04-09T07:05:00.000-05:00

Should the orthodontic wire used in a dental office be disposed of as regulated medical waste? This is a question that is posed to us in virtually every orthodontic office. The answer to this question is delivered by OSHA in a response that dates back to 1990........ and the answer is yes as seen in this link:

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=19998

Further, as a means of risk prevention in the office, it is advised to all of our clients that any and all orthodontic wires should be disposed of in a certified sharps container.

For any questions regarding this or any other compliance questions please contact Dynamic Dental Safety at (888) 669-8846 ext. 701

Where can you get a Material Safety Data Sheet?

2007-04-08T09:37:00.000-05:00

Under the Hazard Communication Standard, OSHA requires you to have an accessible MSDS Sheet for all hazardous chemicals in your dental office. When you buy a chemical, the manufacturer is required to provide a copy of the MSDS. If it is not included in the same package with the chemical, you can contact the manufacturer and ask them to fax or mail the MSDS to you. In addition, some companies have MSDS’s for their products on-line and you can easily access them and print them out.

Dynamic Dental Safety’s OSHA/Risk Management CD Rom includes over 1,000 MSDSs on commonly used dental chemicals and products. For additional information, please contact Dynamic Dental Safety at: ( 888) 69-8846 ext. 701.

Glutaraldehyde Use in the Dental Office

2007-04-07T08:04:00.000-05:00

Glutaraldehyde is a toxic chemical that is used as a cold sterilant to disinfect and clean heat-sensitive medical, surgical and dental equipment. Health effects of glutaraldeyde exposure include:

Short term (acute) effects: skin and eye, nose, throat and respiratory track irritation.
Long-term (chronic) effects: Glutaraldehyde is a sensitizer. Workers may get sudden asthma attacks with difficult breathing, wheezing, coughing, and tightness in the chest. Prolonged exposure can cause a skin allergy and chronic eczema, and afterwards, exposure to small amounts produces severe itching and skin rashes. It has been implicated as a possible cause of occupational asthma.

Although you can limit exposure to glutaraldehyde through work practice, engineering controls and personal protective equipment, the best consideration is changing to safer product substitutes. Please contact Dynamic Dental Safety (tel. 888-669-8846 x701) for manufacturer contact information.

References: 1) Best Practices for the Safe Use of Glutaraldehyde in Health Care. OSHA Publication 3258, (2006), 48 pages. 2) OSHA Hospital eTool: Healthcare Wide Hazards Module: Glutaraldehyde

Dental Safety Glasses

2007-04-06T11:53:00.000-05:00

Dental personnel are occupationally exposed to ocular hazards when using rotary instruments and handling chemicals. Eye protection is essential to reduce exposure to bloodborne pathogens, chemicals, particulates and radiation. Dental safety glasses and shields must fulfill a wide range of functional and ergonomic aspects. In addition, they must comply with OSHA and ANSI Standards.

Most dental professionals want safety glasses that not only give good eye protection, but provide good vision and are easy to wear and use. For a complimentary form that may be used to help you evaluate safety glasses, please contact Dynamic Dental Safety at: (888) 669 – 8846 ext. 701.

Confidentiality of Printed Patient Schedules

2007-04-05T10:33:00.000-05:00

Q: Does HIPAA regulate where printed patient schedules are placed in the dental office?

A: Yes. Some offices may print out the patient schedule for the day and post it for professional staff. Often the schedule is posted where it can be seen by a patient - either in the examining room, or in a corridor, or on a door. Where it is placed may result in an unauthorized disclosure of patient information. Offices must make an effort to protect identifiable personal health information on a schedule of appointments, but this does not mean that the use of patient schedules is prohibited. If a schedule is placed in an operatory, with the patient’s back to the wall where it is hung, this would likely be considered sufficient protection of patient information.

Another approach is to place the printed side of the schedule facing the wall. Then one has to simply turn the bottom of the page up to reveal the schedule. An office that shows it has made a conscious effort to protect such information by placing it in a location accessible to professional staff, but with minimum access by patients in the office, will not be in violation of the HIPAA privacy rule to use printed patient schedules.

Ref. California Dental Association

No Eating or Drinking in Dental Clinical Areas

2007-04-04T13:27:00.000-05:00

According to the OSHA Bloodborne Pathogen Standard 1910.1030(d)(2)(ix), eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in work areas where there is a reasonable likelihood of occupational exposure. During our on-site safety surveys, we have noted that staff often drink beverages in clinical areas such as the operatories or lab. Although it may be difficult, drinking and eating should be limited to such areas as the break room, offices or other non-clinical areas.

Is this sterile??????

2007-04-03T12:42:00.000-05:00

In many of our trainings and talks with dental offices, the assumption is that when the dental assistant, dental hygienist, or the dentist sees the packet at the left......... it is sterile. This is quite common since the color has darkened at the arrows. Unfortunately, this is not a correct assumption!!!!

With virtually all of our sterilizers in the dental office that utilize a combination of steam and pressure to effect the sterilization of our instruments...... only one of those parameters is measured with the color change on the packet or the tape. This most often is that the chemical changes color when the temperature has risen to the correct level and stayed at that heat level for the proper amount of time.

The true measure of the correct operation of the sterilizer is that of a spore test. There are multiple ways to measure this both in the dental office and outsourced to a separate testing facility. According the the CDC, they state the following under the recommendations for Sterilization:
6. Monitor sterilizers at least weekly by using a biological indicator with a matching control (i.e., biological indicator and control from same lot number) (IB)

Feel free to contact us at (888) 669-8846 ext 701 for any further information regarding this or other compliance issues.

Boodborne Pathogen Training

2007-04-02T12:40:00.001-05:00

Q. Does OSHA require annual bloodborne pathogen training for dental personnel?

A. Yes, annual training is required for all personnel who have occupational exposure to blood or other potentially infectious materials (OPIM). Training should include an explanation or description of the following elements:

An explanation of 29 CFR 1910.1030, Occupational Exposure to Bloodborne Pathogens.

The activity's exposure control plan and instructions for how to obtain a written copy of the plan.

The basic epidemiology, modes of transmission, and symptoms of bloodborne diseases.

The criteria for the recognition of tasks and other activities in which occupational exposure may occur.

The methods that prevent or minimize occupational exposure [i.e., engineering controls, work practice controls, personal protective equipment (PPE)] and their limitations.

The selection criteria for PPE and the criteria for equipment availability, use, handling, decontamination, and disposal.

The hepatitis B vaccine to include its benefits, efficiency, safety, administration, and availability.

The procedures for reporting exposure incidents and the availability of medical treatment and follow-up examinations.

The procedures for reporting and cleaning up spills.

An explanation of the warning signs, labels, and color-coding systems used.

Dynamic Dental Safety offers on-site training with approved contact hours. For additional information, please call: (888) 669-8846 ext 701.

What's underneath your Operatory Sink?

2007-04-01T12:32:00.000-05:00

As storage in many dental offices is at a premium, staff store items anywhere they can…underneath the sink is a favorite spot. Since water from pipe condensation or leaks can contaminate supplies, clean and sterile patient care items should not be stored underneath sinks. Dark and damp areas are a favorite place for insects and vermin. Consider this… would you want exam gloves, tooth brushes, mouthwash and other dental supplies which have been stored under the sink used in your mouth? Note that it is acceptable to store a few chemicals such as cleaners and disinfectants underneath the sink, but not a fire extinguisher as shown in the picture.

Dental Office Environmental Issues

2007-03-31T09:06:00.000-05:00

Buildings with poor indoor air quality (IAQ) or chronic leaks frequently have areas with surface fungal contamination. Studies have demonstrated that certain fungi grow on building materials such as wallpaper, drywall, and ceiling tiles, particularly after water damage has occurred. In some people, excessive mold can trigger allergic reactions. In addition, brown or black stained ceiling tiles does not give the proper message to your patients or staff about the overall sanitation in your dental office.

If you discover stained ceiling tiles, first identify and fix the source of the leak. Problems with the heating, ventilation and air conditioning system (HVAC), leaky pipes or roof are the likely culprits. Cleaning porous ceiling tiles is difficult and replacement is generally necessary. Note that you should conduct these maintenance and cleanup activities when the occupancy of the building is at its lowest.

Decontamination of Computer Keyboards and Mice in the Dental Office

2007-03-30T16:46:00.000-05:00

Photo Courtesy of Seal Shield Corp.

Cleaning and/or disinfecting irregular surfaces in dental operatories is difficult at best. Decontamination of keyboards and computer mice have particularly been an issue, as the electronics are susceptible to water and disinfectant solutions. Low cost - washable computer devices have recently become available. Several models are even dishwasher safe. We recommend that you reexamine your cleaning protocols and consider washable computer input devices in an effort to reduce cross-contamination. For further information please contact Dynamic Dental Safety at: (888) 669-8846 ext 701.

Safety in Your Dental Waiting Room

2007-03-29T19:44:00.000-05:00

Have you ever considered that your Dental Waiting Room could be dangerous to young children? Outlet Plugs help prevent children from putting sharp objects and fingers into electrical outlets. Small children are very curious and are tempted to play with anything within their reach. By protecting your outlets you decrease the possibility of electrical shock. Simply insert Outlet Plus (available in hardware and home stores) into unused sockets. Outlets Plugs will fit firmly in place. This product is only a deterrent. It is not a substitute for proper adult supervision. So, don’t assume that parents are paying attention to their children in the waiting room…Front desk staff should “keep an eye out”.

Disposables

2007-03-28T15:44:00.000-05:00

The device shown at the right is a disposable prophy angle. In a few of the offices that we have visited it has been noted that some of these "wound up" in the ultrasonic cleaner. Looking at that from a potential OSHA or Board of Registration in Dentistry inspector's viewpoint............. the dental office will most certainly be reusing this item.

This then becomes a huge issue and one that likely will result in a citation at the very least. The lesson to be learned here for the dentist and the dental office is that items that are classified as disposable, must be disposed of after a single use. Under no circumstances should it be justified to reuse a disposable dental treatment related item in the dental office.

For any further clarification of this or other safety or infection control related issues in the dental office please do not hesitate to contact us at (888) 669-8846 ext. 701

State and Federal Labor Law Posters

2007-03-27T06:41:00.000-05:00

All employers (including dental offices) are required to post several Federal and State specific labor notices. The Federal Posting Requirements include:

Equal Employment Opportunity is the Law
Federal Minimum Wage
Employee Polygraph Notice
Federal OSHA Poster
IRS Witholding Notice
Payday Notice
USERRA - Your Rights Under USERRA
Family and Medical Leave Act (if 50 or more employees).

Many Federal and State posters are available free on-line and/or by mail. Searching for all the correct posters can be time consuming. There are several companies that sell combined Federal/State Posters that are laminated. For further information please contact Dynamic Dental Safety at: 888) 669-8846 ext 701.

Needlestick Post-Exposure Evaluation

2007-03-26T19:32:00.000-05:00

Do you know EXACTLY what is required when one of your employees sustains a needlestick or other dental sharps injury (e.g. bur, wire, tooth)?

The March issue of our complimentary monthly electronic Newsletter - The Dental Safety Compliance Monitor reviews OSHA's Post - Exposure Evaluation and Follow-up Requirements - A Guide to Dental Employer Obligations. To get a copy of this issue and a complimentary monthly subscription, simply sign-up in the Web Form on this site.