Avoiding exposure to blood and other potentially infectious materials (OPIM), as well as protection by immunization, remain primary stategies for reducing occupationally-acquired infections, but occupational exposures can still occur.

In addition to blood, the following are considered to be potentially infectious with HIV, HBV or HCV:

All body fluid where it is difficult or impossible to differentiate between body fluid and amniotic fluid.
Any body fluid visibly contaminated with blood.
Any fixed tissue or organ (other than intact skin) from human (living or dead) blood/ organs or other tissues from experimental animals infected with blood borne pathogens.
Cerebral spinal fluid.
Culture media or other solutions containing blood borne pathogens.
Pericardial fluid.
Peritoneaal fluid.
Saliva in dental procedures (whether or not there is visible blood).
Semen.
Synovial fluid.
Vaginal secretions.

An exposure requiring evaluation and medical attention occurs when blood or OPIM is involved in:

A puncture of the skin with a needle, lancet or other contaminated sharp item.
A splash or spray or other transmission into the eyes, mouth or nose.
Transmission into an open wound, an oozing lesion, or other area where there is significant breakdown of skin.

A strict protoocol of standard precautions, instrument/equipment design, workplace set-up, work practice and administrative controls is the best means to minimize occupational exposure.

Policies and procedures regarding prevetion of exposure, accidental exposure, post-exposure management and reporting of exposure should be adequately discussed to all dental healthcare personnel. Written policies and proceudres should likewise be made availabe to all persons who are at risk of exposure to blood or OPIM.

DHCP who have contact with patients can also be exposed to persons with infectous TB and should have a baseline tuberculin skin test (TST), preferably by using a two-step test, at the beginning of employment. Thus, if an unprotected occupational exposure occurs, TST conversions can be distinguished from positive TST results caused by previous exposures. The facility's level of TB risk will determine the need for routine follow-up TSTs (see indications for two-step TST).