Regulatory and Advisory Agencies Chapter 22 Copyright 2012

Regulatory and Advisory Agencies Chapter 22 Copyright © 2012, 2009, 2005, 2002, 1999, 1995, 1990, 1985, 1980, 1976 by Saunders, an imprint of Elsevier Inc. All rights reserved. 1

Introduction Infection control in dentistry has gained the attention of regulatory agencies only in the last two decades because of the AIDS pandemic before that individual dentists evaluated their own risks. n q because of varied precautions many dentists have contracted Hepatitis B n. Now we have agencies that issue recommendations and regulations, some have regulatory roles and others are advisory. n These agencies can serve as an excellent resource for information and educational materials. 2

Recommendations are made by individuals, groups, or agencies that are advisory and have no authority with regard to enforcement. n Regulations are made by groups or agencies that do have the authority to enforce compliance with the regulations. n – Enforcement penalties may include fines, imprisonment, or suspension or revocation of licenses. n Recommendations may be made by anyone, but regulations are made by governmental groups or licensing boards in towns, cities, counties, and states. Copyright © 2012, 2009, 2005, 2002, 1999, 1995, 1990, 1985, 1980, 1976 by Saunders, an imprint of Elsevier Inc. All rights reserved. 3

Advisory Agencies n Centers for Disease Control and Prevention (CDC) – Agency of the US dept. of Health and Human Services – 2003 Guidelines for Infection Control in Dental Healthcare Settings (recommendations) n Organization for Safety, Asepsis and Prevention (OSAP) n n n – Not for profit organization; great resource for infection control and safety American Dental Association (ADA) American Dental Assistants Association (ADAA) American Dental Hygienists’ Association (ADHA) National Institute for Occupational Safety and Health (NIOSH) 4 National Institute of Health (NIH)

Organization for Safety, Asepsis and Prevention n The Organization for Safety, Asepsis and Prevention (OSAP) is a not-for-profit organization composed of dentists, hygienists, dental assistants, government representatives, dental manufacturers, university professors, researchers, and dental consultants. They recommend many techniques to promote compliance with the CDC 2003 guidelines This organization is an excellent resource for information on infection control, injury prevention, and occupational-health issues. 5

State and Local Dental Societies n State and local dental societies can help you comply with regulatory issues in your specific area. n National, state, and local dental assisting societies can often answer questions and provide opportunities for continuing dental education. 6

Centers for Disease Control and Prevention The CDC is recognized as the lead federal agency for protecting the health and safety of people at home and abroad. n The CDC bases its public-health recommendations on the highest-quality scientific data. n The guidelines contain an Oral Health Services section that concerns oral diseases, fluoride application, and infection control in dentistry. n The CDC does not have the authority to make laws, but many local, state, and federal agencies use CDC recommendations to formulate laws. n 7

National Institutes of Health n n Part of the U. S. Department of Health and Human Services The primary federal agency for conducting and supporting medical research. Many important health and medical discoveries of the last century resulted from research supported by the NIH. The NIH translates research results into practice and communicates research findings to patients and their families, healthcare providers, and the general public. 8

National Institute for Occupational Safety and Health n NIOSH does not have regulatory authority. n It is responsible for conducting research and making recommendations for the prevention of work-related disease and injury. n NIOSH makes recommendations and disseminates information on preventing workplace disease, injury, and disability. n It provides training to professionals in the field of occupational safety and health. 9

Regulatory Agencies n Occupational Safety and Health Administration (OSHA) – Division of the department of labor Food and Drug Administration (FDA) n Environmental Protection Agency (EPA) n – Department of environmental protection- state level (DEP) State and county health departments (DOH) n State and regional licensing agencies (BOD) n 10

Food and Drug Administration The FDA, a regulatory agency, is part of the U. S. Department of Health and Human Services. n The FDA regulates the manufacture and labeling of medical devices (e. g. , sterilizers, biologic and chemical indicators, ultrasonic cleaners and cleaning solutions, liquid sterilants, gloves, masks, protective eyewear, dental handpieces and instruments, dental chairs, and dental-unit lights). n It also regulates antimicrobial hand-washing products and mouthrinses. n Copyright © 2012, 2009, 2005, 2002, 1999, 1995, 1990, 1985, 1980, 1976 by Saunders, an imprint of Elsevier Inc. All rights reserved. 11

Fig. 22 -2 Overview of a dental operatory showing items (arrows) regulated by the U. S. Food and Drug Administration (FDA). Copyright © 2012, 2009, 2005, 2002, 1999, 1995, 1990, 1985, 1980, 1976 by Saunders, an imprint of Elsevier Inc. All rights reserved. 12

Environmental Protection Agency (EPA) Mission is to protect human health and the environment n Responsibilities include: n – – – Drinking water, hazardous and household waste Pollution prevention Wetlands, watershed and endangered species Radiation Pesticides among many other It ensures the safety and effectiveness of disinfectants. n The EPA regulates discharge and final treatment of waste materials (e. g. , chemicals), as well as medical waste after it leaves the dental office. n 13

Occupational Safety and Health Administration Its mission is to assure the safety and health of America’s workers by setting and enforcing standards; providing training, outreach and education n It protects workers against physical, chemical, and infectious hazards in the workplace. n In states that administer their own OSHA programs, the state standards must be equivalent to or more stringent than those of the federal agency. n OSHA standards of importance in dentistry are: – Bloodborne Pathogens and Hazard Communication n 14