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NIOSH and OSAP Survey Finds Private Dental Practices Lacking OSHA Bloodborne Pathogens Exposure Control Plans

June 7, 2017
NIOSH Update:
Press Contact: Nura Sadeghpour (202) 245-0673

Findings from a web-based survey conducted by the National Institute for Occupational Safety and Health (NIOSH) and the Organization for Safety, Asepsis and Prevention (OSAP) showed that over a quarter of private dental practices who participated in the survey did not have a written site-specific bloodborne pathogens exposure control plan (ECP). This study is published in the June issue of the Compendium of Continuing Education in Dentistry and is available online.

The paper presents information on whether private dental practices were aware of OSHA’s requirement for an ECP, had a written ECP addressing all requisite elements, and could identify barriers to implementation of an ECP. The OSHA bloodborne pathogen (BBP) standard covers all dental healthcare settings where dental healthcare personnel could be exposed to blood or certain body fluids during the performance of their job, and describes precautionary practices to protect healthcare workers from pathogens such as hepatitis B virus (HBV), hepatitis C virus (HBV) and human immunodeficiency virus (HIV). These pathogens can be transmitted from patient to dental healthcare provider or patient to patient via contact with blood or certain body fluids.

Overall, 1,059 respondents representing private, non-franchised dental practices across the U.S. completed the online survey. They primarily included dentists who owned the practice (63%) and others in the practice including non-owner dentists, dental hygienists, and other staff.

“Having an effective exposure control plan that everyone in the dental office is aware of will better protect dental healthcare personnel and their patients from exposure to bloodborne pathogens” said NIOSH Director John Howard, M.D. “Identifying any barriers to the implementation of an exposure control plan is a critically important step to making the exposure control plan as effective as it can be.”

Survey findings showed that participating private dental practices were either unaware of the requirement to have an ECP or did not adhere to all key elements of the ECP if they had one. Salient findings, expressed as percent of dental practices that participated in the survey, show that:

  • 28% did not have a written site-specific ECP, including 4% who didn’t know whether or not they had one;
  • 50% without an ECP had no plans to implement one in the next 12 months;
  • 20% with a plan had not implemented all of the elements; the primary reasons for not having all elements was “not aware it was needed” (50%), “lack of expertise” (47%) and “lack of time” (36%);
  • 24% with a plan had not reviewed it within the past year;
  • 65% did not use needles with sharps injury prevention features; and
  • 15% did not offer HBV vaccine to its employees and another 8% did not know if they did or not.

We found that survey respondents from dental practices were either unaware of or not fully complying with the OSHA BBP standard. A relatively low response rate precludes generalization of the findings to all private dental practices. Nevertheless, the findings should prompt all dental practices to evaluate if they have an appropriate ECP containing all of the key elements and develop an ECP if they do not have one. Periodic review of the ECP and training and education of staff with potential exposure to BBPs on current infection control policies and practices is necessary to avoid complacency and ensure compliance.

This study is one of the first to examine extent of awareness of and compliance with OSHA’s bloodborne pathogens standard in private dental practices, particularly with respect to having an exposure control plan. This information supports the need for increased continuing education and training on methods to prevent occupational exposure to bloodborne pathogens in dental settings. To access the paper online, visit:, or

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