Objective: There is increasing concern about the ability to control infectious diseases especially newly-evolving strains of influenza. We conducted a national survey of dental hygienists including investigation of immunizations.

Methods: The instrument was developed and tested using focus groups, test-retests and a pilot study. Questionnaires were mailed to a random sample of dental hygienists licensed by the Provincial/Territorial Colleges in Canada (n=5,900) and stratified by province. A modification of Dillman's guidelines for administration of mailed surveys was used with two additional mailings to non-respondents. Descriptive statistics were obtained using SPSS/PC+.

Results: The response rate was 56%. HBV immunization was reported by 98.5% of respondents (of these, 70% reported post-immunization serology); 59% of respondents reported anti-HBs titers of >10 mIU (3% <10 mIU) and 0.2% reported naturally-acquired immunity.

Hygienists reporting immunity (in %)were as follows:

Infectious Disease	Hygienists Reporting Immunity (%)
Hepatitis A virus	22
Measles	91
Mumps	83
Rubella	88
Influenza	38
Varicella	79
Diphtheria	81
Tetanus	91
Polio	87
BCG	40

Conclusions: It is clear that many hygienists are vulnerable to infectious diseases that can be prevented by immunization, and that dentists can play an important role in improving compliance. Although rates of HBV immunization are very high, only 60% reported knowing that they had adequate anti-HBs titers, raising concerns about a false sense of security for many. The low rates of immunization to influenza are worrying because of the threat of an influenza pandemic and this problem needs to be emphasized. Better awareness and implementation of comprehensive immunization of dental professionals are essential to reduce transmission risks.

This study was funded by the Canadian Institutes of Health Research.

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