Animal health professionals have inherently high risks of exposure to zoonotic diseases. They are likely to be amongst the first people to encounter animals infected with zoonotic pathogens and to engage in high-risk interactions with them. This study was conducted to determine the perceptions of zoonotic diseases risk among Australian veterinarians, the infection control practices they use to protect themselves from zoonotic diseases, and the drivers influencing these perceptions, attitudes and practices.
A questionnaire was designed and piloted prior to its administration to veterinarians at the Australian Veterinary Association Conference in May 2011. The questionnaire comprised 21 closed, semi-closed and open questions. Data from the questionnaire were analysed using ordinal logistic regression analyses to determine significant drivers for veterinarians' use of personal protective equipment (PPE).
A total of 344 veterinarians completed the questionnaire of which 63.7% were women, 63.2% worked in small/companion animal practice, and 80% worked in private veterinary practice. Of the respondents, 44.9% reported contracting a zoonosis in their careers with 19.7% reporting a suspected case and 25.2% reporting a confirmed case. Similarly high levels of zoonoses among veterinarians are reported in previous surveys conducted overseas. In a study in the USA, 28% of veterinarians surveyed (105/371) reported having been infected with a zoonotic disease in practice (Lipton et al 2008). In another study in the States, 42.7% of 833 veterinarians experiencing an accident and 32.4% of 349 accident-free veterinarians had suffered from zoonotic infections (Schnurrenberger et al 1978). Even higher levels of zoonotic infections were reported in a British survey conducted in the early eighties, in which 363 of the 563 veterinarians (64.5%) reported experiencing at least one zoonosis (Constable and Harrington 1982). Similarly, 63.6% of the 88 veterinarians surveyed in South Africa had suffered from a zoonotic disease (Gummow 2003).
Alarming levels of zoonotic infections among veterinarians are predictable due to poor uptake of infection control practices among veterinarians and veterinary practices. The use of PPE was less than adequate for most scenarios except for performing post-mortems, surgery or dental procedures. No PPE was used by 60-70% of vets for treating respiratory and neurological cases and by 40-50% when treating gastrointestinal and dermatological cases. Workplace conditions need improvement as 34% of workplaces did not have isolation units for infected animals, 21% did not have separate eating areas for staff, and 57% did not have complete PPE kits for use. This suggests that a substantial improvement is required in workplace conditions and personal uptake of infection control practices by veterinarians.
Veterinarians were more likely to use PPE if they had undertaken postgraduate education, perceived that zoonosis exposure from animals and procedures was likely, consciously considered PPE use for every case they dealt with and believed that liability issues and risks encouraged use of PPE. In contrast, those working in private practices, those who tended to 'just hope for the best' when trying to avoid zoonotic diseases, and those who were not aware of industry guidelines were less likely to use PPE. The results indicate that awareness and education are important factors influencing the use of PPE and should be considered by the AVA, veterinary schools and animal health authorities to improve adequate use of PPE.
Overall, the results suggest that veterinarians' perceptions and workplace policies and culture substantially influence their use of PPE. Efforts should be made to encourage veterinarians and their workplaces to use infection control practices to protect themselves and their staff from zoonotic diseases
This study successfully evaluated infection control practices used by veterinarians and identified some factors associated with the use of PPE. However, it was not possible in this study to obtain detailed information about each practice type and individual circumstances in which the veterinarians operate. Therefore, further qualitative studies should be conducted.
We are grateful to all the veterinarians participating in the study. Logistic support by the Australian Veterinary Association in conduct of the interviews and financial support by the Faculty of Veterinary Science, The University of Sydney is thankfully acknowledged.