HAZCOM

The Federal Hazard Communication Standard (HAZCOM, or HCS) is a regulation enforced by the Occupational Safety and Health Administration (OSHA) of the United States Department of Labor. HAZCOM is based on employees’ rights and their “need to know” the identities of hazardous substances to which they may be exposed in the work environment. OSHA requires employers to provide workers with preventive safety equipment and ensure that they wear it during dental procedures. To comply with the HAZCOM requirements, employers must also submit a written hazard communication program.

Safety Requirements for Veterinary Dentistry

For the veterinary dentistry practice, OSHA requires that the employer provide safety glasses, masks, and gloves for all employees who perform dental procedures (Figure 4-1). The employee is responsible for wearing the safety equipment during all procedures. After all, it is the employee’s health that is at stake, and flying debris or other substances can easily cause infections if the employee neglects to wear the safety protection provided. Employees must always be careful to take responsibility for their own safety by wearing the necessary safety equipment and should not expect their employers to remind them before each potentially hazardous procedure.

FIGURE 4-1 Mask, eye protection, and gloves should be used for every procedure.

Types of Hazards

Veterinary staff risk exposure to several different hazards. Hazards are classified as follows: Chemical, physical, biologic, and ergonomic. Chemical hazards are formulations that can act on the skin, eyes, respiratory tract, alimentary system, and other organs and organ systems. Physical hazards are those that can physically harm. Ergonomic hazards are due to workplace interactions.

Eye Protection

The importance of eye protection cannot be overstated. Infections from a number of sources can cause permanent visual impairment. Unprotected operators are sometimes struck in the eye by pumice while polishing or by a flying piece of tooth during high-speed drilling. Scaling can also send bacteria-laden calculus into the dental technician’s eyes or mouth. The calculus almost always scratches the eye and thereby deposits bacteria directly into the wound. Splatter from rinsing acid etch or sodium hypochlorite is potentially devastating to the eyes and can also cause small lesions on the face.

Mouth and Lung Protection

Use of high-speed equipment, such as ultrasonic scalers and high-speed drills, creates a vapor that contains bacteria, blood, saliva, and tooth dust. This vapor extends up to 3 feet from the source and can irritate and infect the respiratory system of people who are not wearing protective masks. The risk extends to nonemployees, such as clients visiting the dental area while a procedure is in progress.

Hand and Skin Protection

Gloves protect the patient from cross-contamination and protect the veterinary staff from the toxic materials used in dentistry. Toxins in resins, such as methyl methacrylate, formaldehyde, chloroform, x-ray chemicals, and cold sterilization chemicals, are all absorbed through the skin. Some are carcinogenic and accumulate in the body with repeated exposure. Most affect the liver and kidneys. Because of the critical importance of these organs, all staff members should wear proper safety protection when handling these materials.

Hand Washing

Proper hand washing is important for disease control. If employees do not wear gloves and are accidentally stabbed by an instrument or bitten by a patient, they may become infected by the organisms on their own skin. Employees should always wash their hands before putting on gloves in case a glove is torn or otherwise penetrated during the course of a procedure.

Glove Concerns

Some people develop allergies to latex gloves with time. Three types of hypersensitivity reactions to latex exist. The most common is a contact dermatitis, which is a delayed, type IV allergy. It causes a localized rash and develops 24 to 72 hours after exposure. Next frequent is a contact urticaria, which is an immediate, type I allergic reaction that occurs immediately after exposure. Contact urticaria manifests itself as hives, nasal inflammation, general itching, and wheezing. The worst but rarest type is a systemic reaction, also known as a type I reaction, and results in conjunctivitis, asthma, and systemic anaphylaxis. The fact that latex powder remains in the air for a long time if gloves are snapped on complicates the reaction. Because many conditions mimic these hypersensitivities, employees should consult an allergist if they experience problems.

Proper fit in gloves is also important for preventing hand fatigue that can lead to tendonitis in the wrist. Gloves should be loose through the palm of the hand. If they are too tight, the muscles of the palm will cramp with the effort to maintain a relaxed position.

Sharps

Needles are another source of potential infection. To keep from accidentally stabbing themselves, employees should never recap needles with both hands. The needle cover should be scooped up with one hand with the needle (Figure 4-2) or simply discarded in the sharps container. Sharps containers should be disposed of properly when they reach the full line. To prevent punctures when inserting needles, employees should never continue to pack additional needles in the containers after they are full.

FIGURE 4-2 If the cap is placed back on the needle, it should be replaced by scooping the syringe cap.

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