Abstract
Background: Dental practitioners are at high risk of occupational ocular incidents during their daily work practice. The aim of this study was to assess the prevalence, pattern and determinants of ocular incidents and to establish the use of eye protection by dental staff in southwestern Saudi Arabia. Methods: This multicentre cross-sectional study was conducted among dental practitioners working in private, military and Ministry of Health dental clinics in southwestern Saudi Arabia. A predesigned self-report questionnaire was used to elicit information on demographics, splash or foreign body ocular incidents, postincident practices and use of eye protection. Results: Of the 233 dental practitioners examined, 29.6% and 51.1% reported ocular incidents as a result of foreign bodies and fluid splashing, respectively. The risk of ocular incidents as a result of fluid splashing was significantly higher in the absence of postgraduate qualification [odds ratio (OR) = 3.04, 95% confidence interval (95% CI): 1.70–5.43], poor compliance with wearing eye protection (OR = 2.52, 95% CI: 1.49–4.28) and long work hours (OR = 2.16, 95% CI: 1.17–3.96). The most frequent postexposure practice was to rinse eyes under running water (87.5%). Approximately 4.2% and 9.2% of dental practitioners reported incidents of ocular injury and infection, respectively, and 14% reported that they never wore any eye protection. Conclusion: Occupational ocular incidents as a result of splashing and foreign bodies are relatively common among dental practitioners in southwestern Saudi Arabia. The absence of postgraduate qualification, poor compliance with wearing eye protection and working long hours are predictors of ocular incidents. Awareness about eye safety is therefore considered mandatory for dental practitioners in southwestern Saudi Arabia. Also, dental clinic administrators should provide and promote the use of eye protection.
Key words: Dentists, occupational, ocular incidents, splash, foreign body, injury, infection
Introduction
Dental practice involves the use of rotating and sharp instruments. These create splashes of patient's bodily fluids, containing water, saliva, microorganisms and blood, as well as foreign bodies including tooth particles, lubricating oil and restorative materials. These materials and fluids can play a significant role in causing injuries to the unprotected eye1., 2.. Approximately 48% of dental practitioners have encountered eye trauma or infection during their working life. Most of these injuries were associated with inadequate eye protection3. Eye injuries and infections in dental clinics can have serious complications and long-lasting effects that may influence the performance and health of the dentist4.
Wearing eye protectors during patient-care procedures protects the eyes from splashes and foreign bodies that may be generated during such procedures. However, worldwide, most studies have revealed that compliance with wearing eye protection is poor among dental professionals, which increases the risk of developing ocular injuries3., 4., 5..
Eye exposure to splashes of patient's fluid, during dental and routine-care procedures, may be associated with a high risk of eye infections and occupational blood-borne infections, including hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV)6., 7., 8., 9..
Despite the increased risk of local and general health problems, the postexposure practice of dental practitioners following eye exposure through splashes and trauma is not adequate and not based on scientifically validated protocols2., 10..
To date, no data addressing the magnitude and determinants of occupationally related ocular eye injuries and infections in South Saudi Arabia have been collected. These data are important for developing guidelines and practices to improve work safety and minimise the risk of these work-related problems in both government and private dental clinics.
Methods
Study design and sampling
A multicentre cross-sectional study was conducted in dental clinics in the three large cities located in southwestern Saudi Arabia, namely Najran, Abha and Khamis Mushait.
Male and female dental practitioners affiliated with dental centres and clinics in these southwestern Saudi Arabian cities constituted the target population. At least 2 years of work experience was the only criterion for study eligibility.
The minimum sample size was calculated according to the World Health Organization (WHO) manual for sample size determination in a health study11; with an expected prevalence of ocular events among dental practitioners of 22%2 and with a level of absolute precision of 6% at 95% confidence, the appropriate sample size was at least 186. To avoid an insufficient sample size from non-responses, a total of 250 dental personnel were invited to participate in the study. Of these, 233 responded to the self-reported questionnaire, yielding a response rate of 93%. The causes of non-response were lack of time and interest.
Dental clinics affiliated with university and military hospitals, as well as five randomly selected private clinics in the previously mentioned cities, were included in this study. All dental practitioners in the selected clinics that agreed to participate were included in the study.
Dental practitioners included general dentists, dental surgeons, dental hygienists and dental technicians.
Study tools and data collection
Appointments with dental practitioners were arranged, and clinics were visited on separate days. All the participants were asked to complete an anonymous self-reported questionnaire. The questionnaire was constructed by the researchers and was based on the knowledge obtained from studies conducted in Saudi Arabia4, Nigeria2., 12. and the UK13. Validation of the questionnaire according to content validity was performed through rating each item by experts in epidemiology and ophthalmology. The questionnaire was pretested by 10 randomly selected dental professionals to ensure validation and improve question clarity. The final questionnaire was composed of the following sections. Sociodemographic questions, including age, sex, marital status, residence and smoking status. Occupational history questions, including qualification, specialty, workplace, duration of work and average number of cases per day. Eye protector questions, including types, attitude and compliance. Questions to assess ocular incidents, including history of exposure to a foreign body or body fluid splash during the past 6 months, work activity during the ocular event, type and frequency of work-related eye injuries or infections, causative procedures, use of eye protection during the event(s) and outcome of any eye injury or infection. Use of eye protection was sorted into adequate and inadequate, with adequate eye protection including prescription glasses with side shields, face shields and safety glasses, and inadequate eye protection including prescription glasses without side shields and without adequate frame diameter12. Questions to assess post-event practices, such as rinsing the eye with water, rubbing the eye with the back of the gloved hand, using a handkerchief or tissue to clean eye, using eye drops to prevent infection, visiting an eye clinic and testing for HBV, HCV and HIV infection.
Statistical analysis
Statistical Package for Social Sciences (SPSS) software version 22.0 (IBM, SPSS, Chicago, IL, USA) was used for data entry and analysis. Descriptive statistics were presented as number and percentage for categorical data and as mean and standard deviation for continuous data. Chi-square tests were used to determine associations between categorical variables. Possible predictors for ocular exposure to patient fluid splashing were examined by calculating the odds ratios (OR) and their 95% confidence interval (95% CI). A value of P <0.05 was considered to be statistically significant.
Ethical consideration
The study was approved by the Ethics Committee of King Khalid University (No. 02-04-2015, date 04/06/2015). After formal approval from the directors of the selected hospitals and private clinics, verbal informed consent was collected from participants after explaining the importance of the study. The verbal consent procedure was approved by the Ethics Committee of King Khalid University. Confidentiality and privacy were guaranteed for all participants. The research was conducted in full accordance with the World Medical Association Declaration of Helsinki.
Results
The study included 233 dental practitioners; Table 1 describes their sociodemographic and job characteristics. The age range of the study group was between 24 and 60 years with an average age of 35.64 ± 7.74 years. Most of the group were male (66.1%), married (75.5%), non-Saudi (83.2%), non-smokers (72.5%), possessed a Bachelor's degree (57.5%) and were from urban areas (75.9%). The majority were general dentists (90.2%) and worked in private clinics (64.4%). Their average working hours per week was 43.51 ± 11.88 and the average number of cases per day was 10.09 ± 6.16.
Table 1.
Sociodemographic and job characteristics among dental practitioners (n = 233)
| Characteristics | Value |
|---|---|
| Age (years) | 35.64 ± 7.74 (24–60) |
| Sex | |
| Male | 154 (66.1) |
| Female | 79 (33.9) |
| Marital status | |
| Married | 176 (75.5) |
| Single | 57 (24.5) |
| Nationality | |
| Saudi | 39 (16.7) |
| Non-Saudi | 140 (83.2) |
| Smoking | |
| Smoker | 49 (21) |
| Ex-smoker | 15 (6.4) |
| Non-smoker | 169 (72.5) |
| Qualification | |
| Bachelor | 134 (57.5) |
| MSc | 20 (8.6) |
| MD | 79 (33.9) |
| Specialty | |
| General dentist | 210 (90.2) |
| Dental surgeon | 16 (6.9) |
| Dental technician | 7 (3.0) |
| Residence | |
| Urban | 177 (75.9) |
| Rural | 56 (24.1) |
| Duration of work (years) | 9.96 ± 7.62 |
| Working hours/week | 43.51 ± 11.88 |
| Average no. of cases/day | 10.09 ± 6.16 |
| Workplace (clinics/hospitals) | |
| University | 45 (19.3) |
| Military | 6 (2.6) |
| Ministry of Health | 32 (13.7) |
| Private | 150 (64.4) |
Values are given as mean ± standard deviation (range), mean ± standard deviation or n (%).
Compliance with wearing eye protection is presented in Table 2. Approximately 14% of the dental practitioners included in this study never wore any eye protection, while half of them wore it most or all of the time and about one-third of participants wore it occasionally.
Table 2.
Compliance with wearing eye protection among dental practitioners in the study
| Compliance with eye protection | n (%) |
|---|---|
| Wearing eye protection (n = 233)* | |
| Never | 32 (13.7) |
| Part of the time | 85 (36.5) |
| Most of the time | 59 (25.3) |
| All the time | 57 (24.5) |
| Type of eye protection (n = 201) | |
| Personal glasses | 78 (38.8) |
| Safety glasses | 89 (44.3) |
| Visors | 34 (16.9) |
| Wearing eye protection according to the dental procedure (n = 167) | |
| Tooth preparation | 154 (66.1) |
| Polishing | 157 (67.4) |
| Forceps extraction | 103 (44.2) |
| Surgical extraction | 124 (53.2) |
| Amalgam removal | 159 (68.2) |
| Trimming of denture | 140 (60.1) |
| Cutting inter-dental wire | 111 (47.6) |
| Biopsy | 87 (37.3) |
| Oral examination | 62 (26.6) |
| Irrigation | 124 (53.2) |
| Cutting orthodontic wire | 101 (43.3) |
| Suturing | 87 (37.3) |
| Root planing/curettage | 124 (53.2) |
| Surgical procedure | 137 (58.8) |
| Agree eye protection could protect against eye injuries and infection (n = 233) | 212 (91.0) |
n = number of respondents to the question.
About one-third (38.8%) were satisfied with their personal glasses as eye protection, while specific eye protectors (such as safety glasses and visors) were worn by 44.3% and 16.9%, respectively. Wearing eye protection when performing dental procedures was found to be more frequent during amalgam removal (68.2%), polishing (67.4%), tooth preparation (66.1%) and trimming of dentures (60.1%), whereas it was less frequent during oral examination (26.6%). The majority of dental professionals included in this study (91.0%) agreed that eye protectors could protect wearers from eye injuries and infection.
As seen in Table 3, the prevalence, during a 6-month period, of ocular insult in dental practitioners as a result of foreign bodies or trauma and splashes of patient fluid was 29.6% and 51.1%, respectively. This yielded an overall prevalence of ocular incidents of approximately 80%.
Table 3.
Prevalence of occupational exposure to eye trauma and body fluid splashes among dental practitioners in a 6-month period (n = 233)
| Incidents | Value |
|---|---|
| Eye exposure to foreign body or trauma | 69 (29.6) |
| Types of foreign body (n = 69) | |
| Part of tooth | 25 (36.2) |
| Instrument | 4 (5.8) |
| Material wed | 40 (58.0) |
| Incidents in which adequate eye protection was worn (%) | 38.9 ± 34.1 |
| Eye exposure to the patient fluid through splashing | 119 (51.1) |
| Types of splash (n = 119) | |
| Blood | 4 (3.4) |
| Saliva | 58 (48.7) |
| Mix | 57 (47.9) |
| Incidents in which adequate eye protection was worn (%) | 44.9 ± 35.7 |
Values are given as n (%) or mean ± standard deviation.
The most common types of foreign bodies were material wed (58.0%) and tooth particles (36.2%), while the most common types of fluid splashes were saliva (48.7%) and mixed blood and saliva (47.9%). The average percentages of foreign body and fluid splash incidents when wearing adequate eye protection were 38.9% and 44.9%, respectively.
Univariate analysis for the factors potentially associated with eye exposure in dental practitioners as a result of the splashing of patient fluid revealed that the risk of exposure was significantly increased in the absence of postgraduate qualification (OR = 3.04; 95% CI: 1.70–5.43), poor compliance with wearing eye protection (OR = 2.52; 95% CI: 1.49–4.28) and average working hours per day of more than 8 hours (OR = 2.16; 95% CI: 1.17–3.96), as shown in Table 4. The independent significant predictors of eye exposure to splashes of patient fluid, as determined by multivariate logistic regression, were absence of postgraduate qualification (OR = 2.758; 95% CI: 1.51–5.05) and poor compliance with wearing eye protection (OR = 2.402; 95% CI: 1.38–4.17; data not tabulated).
Table 4.
Univariate analysis for predictors of dental practitioner eye exposure to splashes of patient fluid
| Factors | Total | Eye exposure (%) | OR (95% CI) | |
|---|---|---|---|---|
| Sex | Male | 154 | 76 (49.4) | Ref. |
| Female | 79 | 43 (54.4) | 1.23 (0.72–2.14) | |
| Age (years) | <30 | 55 | 33 (60.0) | 1.50 (0.61–3.61) |
| 30–45 | 145 | 70 (48.3) | 0.93 (0.43–2.01) | |
| 45–60 | 32 | 16 (50.0) | Ref | |
| Current smoking status | Non-smoker | 183 | 95 (51.9) | Ref |
| Smoker | 50 | 25 (50.0) | 0.93 (0.50–1.73) | |
| Duration of work (years) | <10 | 148 | 76 (51.4) | 1.06 (0.43–2.59) |
| 10–20 | 63 | 32 (50.8) | 1.03 ((0.39–2.73) | |
| >20 | 22 | 11 (50.0) | Ref | |
| Average number of patients per day | <10 | 143 | 70 (49.0) | Ref |
| 10–20 | 82 | 43 (52.4) | 1.15 (0.76–1.98) | |
| >20 | 8 | 6 (75.0) | 3.13 (0.61–16.03) | |
| Average working hours per day | ≤ 8 hours | 173 | 80 (46.2) | Ref |
| >8 hours | 60 | 39 (65.0) | 2.16 (1.17–3.96) | |
| Marital status | Married | 176 | 91 (51.7) | 1.11 (0.61–2.02) |
| Single | 67 | 28 (49.1) | Ref | |
| Nationality | Saudi | 39 | 22 (56.4) | 1.29 (0.65–2.59) |
| Non-Saudi | 194 | 97 (50.0) | Ref | |
| Qualification | Bachelor | 134 | 82 (61.2) | 3.04 (1.70–5.43) |
| MSc | 20 | 10 (50.0) | 1.93 (0.71–5.19) | |
| MD | 79 | 27 (34.2) | Ref | |
| Specialty | Dentist | 208 | 110 (52.9) | 1.4 (0.74–2.69) |
| Dental surgery assistant | 16 | 6 (37.5) | Ref | |
| Dental technician | 7 | 3 (42.9) | 1.25 (0.21–7.62) | |
| Dental hygienist | 2 | 0 (0.0) | – | |
| Workplace | University hospital | 45 | 18 (40.0) | Ref |
| Military Hospital | 6 | 3 (50.0) | 1.5 (0.27–8.28) | |
| Ministry of Health hospital | 32 | 17 (53.1) | 1.70 (0.68–4.25) | |
| Private clinics | 150 | 81 (54.0) | 1.76 (0.89–3.47) | |
| Compliance with eye protection | Never/part of the time | 117 | 73 (62.4) | 2.52 (1.49–4.28) |
| Most/all of the time | 116 | 46 (39.7) | Ref | |
| Type of eye protection | Personal glasses | 78 | 39 (50.0) | 1.27 (0.56–2.85) |
| Safety glasses | 89 | 47 (52.8) | 1.42 (0.64–3.14) | |
| Visors | 34 | 15 (44.1) | Ref | |
| Attitude towards eye protection | Strongly disagree/disagree | 21 | 7 (33.3) | Ref |
| Agree/strongly agree | 212 | 112 (52.8) | 1.58 (0.87–5.77) | |
OR (95% CI), odds ratio (95% confidence interval); Ref, Reference group.
Table 5 presents the frequency of postexposure practices of dental practitioners after eye exposure to splashes of patient fluid or trauma from foreign bodies. The most frequent postexposure practices included rinsing eyes under running water (87.5%), using eye drops to prevent eye infection (50%), visiting the eye clinic (49.4%) and using a handkerchief or tissue to clean the eye (48.5%). On the other hand, the least frequent practices were rubbing the eye with the back of a gloved hand (20.8%) and testing for blood-borne infections (15.3%), and none of the dental practitioners reported the eye incident to Occupational Health and Safety Unit.
Table 5.
Frequency of post-exposure practices by dental practitioners after eye exposure to splashes of patient fluid or foreign bodies
| Practices | Total respondents | n (%) |
|---|---|---|
| Rinsed eyes under running water | 184 | 161 (87.5) |
| Rubbed the eye with the back of a gloved hand | 178 | 37 (20.8) |
| Used a handkerchief or tissue to clean eye | 173 | 84 (48.5) |
| Used eye drops to prevent infection | 174 | 87 (50.0) |
| Visited the eye clinic | 174 | 86 (49.4) |
| HBV, HCV and HIV testing | 169 | 26 (15.3) |
| Reported the incident to occupational health and safety unit | 169 | 0 (0.0) |
HBV, hepatitis B virus; HCV, hepatitis C virus; HIV, human immunodeficiency virus.
According to Table 6, the prevalence, in a 6-month period, of occupational eye injury and infection were 14.2% and 9.4%, respectively. The prevalence of severe eye injury (requiring emergency department care) and severe eye infection (requiring treatment of longer than 4 weeks) were 0.8% and 1.8%, respectively. Eye protection was not worn during more than half of the incidents causing eye injury and eye infections (63.6% and 54.4%, respectively).
Table 6.
Prevalence of occupational eye injury and infection and eye protection status in a 6-month period (n = 233)
| Incident | Type of care | n (%) | Eye protection [n (%) per event] | ||
|---|---|---|---|---|---|
| Not worn | Not adequate | Adequate | |||
| Eye injuries | Care by ophthalmologist | 9 (3.9) | 5 (55.6) | 3 (33.3) | 1 (11.1) |
| Emergency department care | 2 (0.8) | 2 (100) | 0 (0.0) | 0 (0.0) | |
| Self-treatment | 22 (9.4) | 14 (57.7) | 5 (26.9) | 3 (12.2) | |
| Total | 33 (14.2) | 21 (63.6) | 8 (24.2) | 4 (12.1) | |
| Eye infections | <1 week of treatment | 14 (6.0) | 8 (57.1) | 2 (14.3) | 4 (28.6) |
| 1–4 weeks of treatment | 4 (1.8) | 2 (50.0) | 2 (50.0) | 0 (0.0) | |
| >4 weeks of treatment | 4 (1.8) | 2 (50.0) | 2 (50.0) | 0 (0.0) | |
| Total | 22 (9.4) | 12 (54.4) | 6 (27.3) | 4 (18.2) | |
Discussion
The results of this study give insight into compliance with wearing eye protection among dental practitioners. It confirms that most (91%), but not all, dental practitioners are aware of the need for eye protection to prevent eye injuries and infection. Additionally, a considerable proportion of dental practitioners studied never wear any eye protection during their work, only one-quarter wear eye protection during all procedures, while about one-third wear it occasionally. These data confirm the results of previous studies, which found that the total compliance of eye protection use among dental practitioners ranges from 36.2% to 64.3%, depending on the type of procedure2., 4., 13.. Additionally, according to our study, about one-third of the dental practitioners were satisfied with their personal glasses as eye protection. However, modern prescription glasses are becoming increasingly small and narrow, making them unsuitable for use as eye protection. It is therefore questionable whether dental practitioners' personal glasses will offer adequate protection13.
Our results revealed that the routine use of eye protection by dental personnel in the current study was dependent, to some extent, on the dental procedures being performed. Eye protection use was more frequent during amalgam removal, polishing, tooth preparation and trimming of dentures and was less frequent during oral examination. The best compliance occurred during procedures considered as hazardous to an unprotected eye, such as removal of amalgam, polishing and tooth and denture preparation3., 6..
Dental professionals are burdened by many occupational health problems, including occupational eye injuries. In this respect, the results of the current study revealed an overall prevalence of ocular incidents of approximately 80%. This was higher than the values reported among Greek endodontists (73.0%)14, Nigerian dental practitioners2 and Pakistani dental practitioners (60.0%)6, but lower than the 1 month prevalence reported in a previous Saudi study (86.8%)4. The high prevalence of ocular incidents in our study shows that dental practitioners in southwestern Saudi Arabia are at high risk of an avoidable harm, which could be prevented by adequate compliance with appropriate eye protection, as supported by a Canadian study15.
In the current study, the prevalence of ocular incidents within a 6-month period was 29.6% for foreign bodies and trauma and 51.1% for eye splashes with patient fluid. The prevalence of ocular foreign body incidents was lower than the values reported previously in Saudi Arabia (51.0%)4, the UK (48.0%)3 and Nigeria (37.8%)2. On the other hand, about half of the dental practitioners were exposed to ocular splashes with fluid from a patient, which is remarkably high in comparison with the Nigerian study (12.2%)2. A Brazilian study reported that mucocutaneous exposures to patient blood and saliva in dentistry are high, with an annual prevalence of 29.0%, half of which affect the eyes16. Furthermore, another study reported that 11% of the occupational incidents involving exposure to blood and other potentially infectious materials were mucosal, involving a splash to the eye of dental care workers17. Worse still, our results reported that in more than half of the incidents, adequate eye protection was lacking. These findings indicate the high risk of blood-borne infection, as well as eye infection, among dental practitioners and act as an indicator of poor adherence to infection-control measures and safe work practices.
Our results revealed that the risk of eye exposure to patient blood and fluids is significantly enhanced by the absence of postgraduate qualification, poor compliance with eye protection and work overload.
The lower risk of eye exposure among dental practitioners with postgraduate qualifications might be explained by increased adherence to safe work practice guidelines as a result of more work experience14. The correlation between increased risk of eye exposure and poor compliance with eye protection was in line with studies in Saudi Arabia,4 Nigeria2 and the UK3. These studies highlight the importance of wearing protective eyewear during different dental procedures to shield the eyes from splatter or debris that is generated. Unfortunately, compliance with protective eyewear among dental professionals in the current study and worldwide is poor2., 3., 4.. This warrants the need for regular use of eye goggles among dental personnel. The higher risk of eye exposure with work overload in the current study was in accordance with other studies, which reported higher prevalence of different occupational hazards, including eye accidents, among dental practitioners with longer working hours14., 18..
In the current study, the most frequent postexposure practices were rinsing eyes under running water, self-medicating with eye drops to prevent eye infection and visiting an eye clinic, as well as using a handkerchief or tissue to clean the eye. On the other hand, none of the dental professionals reported the eye incident to the Occupational Health and Safety Unit and a minority tested blood for blood-borne infections. This may indicate the minimal awareness of possible occupational hazards (including eye infection and blood-borne infections) following exposure of eyes to splashes of patient fluid. These findings are in line with a previous Saudi study, which reported insufficient attitude and awareness of subjects towards infection control in a prosthodontic practice19.
The results of the present study revealed that the prevalence of occupational eye injury and infection in a 6-month period were 14.2% and 9.2%, respectively, whereas the prevalence of severe eye injury requiring emergency department care and severe eye infection requiring more than 4 weeks of treatment were 0.8% and 1.8%, respectively. Eye protection was not worn at the time of more than half of these incidents (63.6% and 54.4%, respectively). These values were lower than in a previous Saudi study, which reported 42.0% and 50.0% for monthly eye injury and conjunctivitis, respectively4. Additionally, 43.0% of orthodontists in the UK have reported incidents of ocular injury in their practices20. Previous studies confirm the findings of our study, showing that most incidents of ocular injury were associated with inadequate eye protection2., 3., 4., 14.. The low adherence to safety precautions observed in the current study is related not only to the dental practitioners but also to work and administrative aspects that constitute the climate of safety at work21. The role of administration in occupational safety in health institutions includes the obligatory existence of a safety committee with an education and training programme, immunisation, protective equipment and postexposure measures to the availability of resources and feedback about the commitment to the adoption of safety measures22.
The present study provides new information concerning the prevalence and associated risk factors of ocular incidents among dental practitioners in southwestern Saudi Arabia. The information obtained could be generalised to help reduce the risk of occupational eye incidents at dental clinics in different countries. Yet, the study has some limitations. The first limitation is recall bias. To compensate for this limitation, ocular incidents were assessed only in the 6-month period prior to the study. Another limitation is that the reliability of this study depends on the honesty of participant responses. Assurance for confidentiality was assured to increase the accuracy of responses.
Conclusion and Recommendations
Occupational ocular incidents of splashes and foreign bodies are relatively high among dental practitioners in southwestern Saudi Arabia. Absence of postgraduate qualification, poor compliance with wearing eye protection and working long hours are predictors of ocular incidents. Awareness about eye safety, safe work practices and infection-control measures are therefore considered mandatory for dental practitioners in southwestern Saudi Arabia. Hence, it is recommended that the significance of safe work practice and infection-control policies are emphasized to dental students in their early years of education. Also, continuous postgraduate education and training is considered essential for them to remain adherent to the safety guidelines in dental clinics. In addition, dental clinic administrators should provide and promote the use of eye protection.
Acknowledgements
The authors are very grateful to the dental professionals in southwestern Saudi Arabia for their participation in the study.
Conflict of interest
The authors declare no conflict of interest.
Funding
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Authors' contributions
All the authors made substantial contributions to the conception and design of the study and data collection over a wide study area. Additionally, they shared either in the analysis or the interpretation of data. All authors participated either in drafting the article or revising it and gave final approval of the version to be submitted.
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