dental infection prevention and control update

Question 1

airborne precautions

Answer 1

respiratory pathway (FFP3 masks, gowns, fallow times)

Question 2

droplet precaution

Answer 2

non-respiratory pathway (FRSM, PPE)

Question 3

aersols

Answer 3

particles that remain suspended due to size and/or environmental conditions

Question 4

droplet

Answer 4

particles that fall to the ground/surface under the influence of gravity and/or the momentum of an infected person’s exhaled air

Question 5

10 reasons supporting SARS-Cov2 (COVID) transmission as airborn

Answer 5

1. Superspreading events account for substantial SARS-CoV-2 transmission
2. Long-range transmission of SARS-CoV-2 between people in adjacent rooms but never in each other’s presence has been documented in quarantine hotels.
3. Asymptomatic or presymptomatic transmission of SARS-CoV-2 from people who are not coughing or sneezing is likely to account for at least a third, and perhaps up to 59%, of all transmission globally
4. Transmission of SARS-CoV-2 is higher indoors than outdoors and is substantially reduced by indoor ventilation
5. Nosocomial infections documented in health-care, with strict contact-and-droplet precautions & use of PPE designed to protect against droplet but not aerosol exposure
6. viable SARS-CoV-2 has been detected in the air. In laboratory experiments, SARS-CoV-2 stayed infectious in the air for up to 3 h with a half-life of 1·1 h
7. SARS-CoV-2 has been identified in air filters and building ducts in hospitals with COVID-19 patients; such locations could be reached only by aerosols
8. Infected caged animals connected to separately caged uninfected animals via an air duct = transmission of SARS-CoV-2 that can be adequately explained only by aerosols.
9. no study to our knowledge has provided strong or consistent evidence to refute the hypothesis of airborne SARS-CoV-2 transmission
10. there is limited evidence to support other dominant routes of transmission—ie, respiratory droplet or fomite.

https://www.nature.com/articles/d41586-021-00460-x

Question 6

transmission of respiratory viruses more likely when 3 Cs present

which are

Answer 6

Closed setting with poor ventilation (defined as 1-3l/s/person)

Close contact

Crowding

Question 7

good ventilation is associated with

Answer 7

• Improved health
• Better concentration
• Environmental satisfaction
• Less work absence
• Sleep quality
• Reduced air pollutants

Question 8

how to manage a risk of a hazardous environment?

controlling hazardous environments

Answer 8

hierarchy of controls

Elimination
* Physically remove the hazard

Substitution
* Replace the hazard

Engineering controls
* Isolate people from the hazard

Administration controls
* Change the way people work

PPE
* Protect the worker with PPE and vaccines (last defence)

Question 9

hierarchy of controls

controllong a hazardous enviroment

Answer 9

Created to show that that design, elimination and engineering controls should be used and/or exhausted first, as they are the MOST EFFECTIVE when available
* Linked to processes such as Prevention through design or Safety by design

Elimination
* Physically remove the hazard

Substitution
* Replace the hazard

Engineering controls
* Isolate people from the hazard

Administration controls
* Change the way people work

PPE
* Protect the worker with PPE and vaccines (last defence)

Question 10

4 examples of dental engineering controls for hierarchy of controls for hazardous environments

Answer 10

rubber dam
high vol aspiration
isolate people from hazard
effective surgery ventilation

Question 11

dental PPE for hierarchy of controls for hazardous environmens

Answer 11

You and your staff are a last line defence

• Use appropriate PPE for the task
• Vaccinations