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After an exposure incident (needlestick) occurs in the dental office, the following procedures should be followed, according to OSHA regulations:¹

Information the employer (dental office) must provide for the healthcare professional treating the injured employee:

• A copy of OSHA’s Bloodborne Pathogens Standard (BPS)
  

• A description of the employee’s duties as they relate to the exposure incident
  

• Documentation of the routes and circumstances of the exposure
  

• The results of the source individual’s blood testing, if available
  

• All medical records relevant to the appropriate treatment of the employee—including vaccination status. (Note: These records are the employer’s responsibility to maintain.)
  
  

Information the healthcare professional providing treatment must give to the employer:

• A written opinion for hepatitis B, limited to whether Hepatitis B vaccination is indicated, and whether the employee received the vaccination.
  

• A written opinion for post-exposure evaluation that must document that the employee has been informed of the results of the evaluation and told about any medical conditions resulting from exposure that may further require evaluation and treatment.

• Note: All other findings or diagnoses must be kept confidiential and not included in the healthcare professional’s written report to the employer. Also, the employer must obtain and provide the injured employee with a copy of the healthcare professional’s written opinion within 15 days of the evaluation’s completion.

Counseling and the type of counseling required for an injured employee, following an exposure incident:

The BPS requires that post-exposure counseling be given to employees following an exposure incident. Counseling should include United States Public Health Service (USPHS) recommendations for transmission and prevention of HIV. These recommendations include:

• Refraining from blood, semen, or organ donation
  

• Abstaining from sexual intercourse or using measures to prevent HIV transmission during sexual intercourse
  

• Refraining from breastfeeding infants during the follow-up period.

• Note: Counseling for the employee must be made available, regardless of whether the employee decides to accept serological testing.

Factors for evaluating an exposure incident after it occurs should include examination of the following:

• The engineering controls and the work practice in place
  

• The protective equipment or clothing used/worn at the time of the exposure incident

• Note: Also be sure to evaluate any policies in place and “failures of controls” that occured at the time of the exposure incident.

Source: Adapted from Miller, CH. Minding OSHA’s Ps and Qs, Dental Products Report 2007;41(7):68.