Occupational Exposure to Blood-Borne Pathogens Among Dental Practitioners and Dental Students : A Systematic Review, Meta-Analysis, and Regression Analysis of Determinants

Sammanfattning

Background: Occupational exposure to blood-borne pathogens remains a significant public health concern in dentistry because of frequent contact with sharp instruments and blood-contaminated materials. This study evaluated differences in blood-borne exposure risk between dental practitioners and students and assessed the influence of study year, Gross Domestic Product per capita adjusted for Purchasing Power Parity (GDP PPP), and gender. Methods: A systematic review and quantitative analysis were conducted using studies identified from multiple databases. Random effects meta-analysis and mixed effects meta-regression were performed to compare occupational exposure risk between practitioners and students and to assess the influence of study year and GDP (PPP) per capita on between-study heterogeneity. Quasibinomial proportional logistic regression analyses using the full dataset of fifty-seven studies and a gender-specific dataset of fifteen studies evaluated the association of practitioners and students, study year, GDP (PPP) per capita, and gender with occupational exposure risk. Results: Meta-analysis of five studies showed no significant difference in occupational exposure risk between practitioners and students (RR = 0.96, 95% CI: 0.70–1.36, p = 0.82), with moderate heterogeneity (I² = 54.45%). GDP and study year did not significantly explain between-study heterogeneity. In the quasibinomial logistic regression analysis of fifty-seven studies, students had lower odds than practitioners (OR = 0.48, 95% CI: 0.25–0.92, p = 0.03), higher GDP was associated with lower exposure risk (OR =0.999986, 955 CI: 0.999974–0.999998, p = 0.03) while study year was not statistically significant. In the gender-specific dataset of fifteen studies students again demonstrated lower exposure odds (OR = 0.23, 95% CI: 0.09–0.54, p = 0.003), whereas increasing study year (OR = 0.92, 95% = 0.87–0.98, p = 0.01 and GDP ( OR = 0.99996, 95%CI = 0.999951, 0.999979, p <0.001) were associated with lower exposure risk; gender was not statistically significant. Conclusion: While meta-analysis showed no significant exposure difference between practitioners and students, broader proportional logistic regression analyses suggested higher cumulative exposure risk among practitioners and lower exposure risk in higher-GDP settings, highlighting the importance of infection prevention and occupational safety measures.