Assessing the exposure of occupational injuries and zoonotic disease among small animal veterinarians in Klang Valley : A sequential mixed method

Abstract

The long-standing issue of occupational injuries and zoonotic disease while handling animals has not captured the attention of the public health circle as much as it should in the Malaysian setting. Around 75% of emerging diseases are zoonotic in nature, thus animal handlers are more likely exposed to the disease. Due to the unpredictable behaviour of animals, this may cause injuries like animal bite and scratch as well as from sharp instrument. This in turn could escalate the likelihood of infection to take place. Small animal veterinarians are among the high-risk group. Despite of this, their health and safety matter are being unnoticed. The aim of this study was to come out with occupational injuries and zoonotic disease exploratory models for small animal veterinarians in Klang Valley from both the quantitative and qualitative study. This study also determines the prevalence of occupational injuries and zoonotic disease transmitted through direct contact among this population. Small animal veterinarians’ perception on universal precaution, safe work practice, the likelihood of being injured and contracting zoonotic disease as well as knowing the causes that may have contributed to the current situation was also explored. A sequential mixed method study was conducted. Phase I comprises of a quantitative study applying a cross sectional method, utilising self-administered occupational zoonotic disease questionnaire. Questionnaires were manually handed to 95 small animal private practices around Klang Valley and the animal companion clinic (in a public veterinary hospital). Analysis was done using IBM SPSS and WarpPLS software. Phase II comprises of a qualitative study, applying the phenomenology method by employing in-depth interview and job observation. Thematic analysis was performed. Response rate of 70% was achieved for phase I. Approximately 76% (n=105) have been infected with zoonotic disease via direct contact. About 96% (n=133) of respondents have suffered animal bite or scratch, while 78% (n=108) had suffered sharp instrument injury, predominantly from needlestick. The measurement model for this study was acceptable, yet from the structural model, not all the relationships between the six constructs were significant. The significant relationships were knowledge on zoonotic disease towards perception on contracting zoonotic disease (β=0.165, p=0.023), attitude on PPE usage towards safe work practice (β=0.231, p=0.002), attitude towards perception on contracting zoonotic disease (β=0.221, p=0.003), perception towards safe work practice (β=0.336, p<0.0001) and occupational injuries towards history of being infected with zoonotic disease (β=0.152, p=0.033). Six respondents underwent in-depth interview and nine respondents underwent job observation. Majority of the respondents did not understand the importance of universal precaution, thus do not practice it. In some way, the respondents understood safe work practices, yet PPE was not applied consistently when needed. This may be due to the lack of formal training during undergraduate study. In conclusion, small animal veterinarians are considered as a vulnerable population on being exposed with occupational injuries and zoonotic diseases. With ongoing injuries occurring, this escalates the likelihood of infection to occur. The findings from this study may suggest appropriate preventive plan such as undergraduate curriculum improvement, continuous seminars on the importance of safe work practices, proper health surveillance system and written policies in order to protect this unique group of population. They are predicted be the inlet for potential emerging diseases. With this, we will be one step ahead on the prevention of zoonotic disease spread to the community, starting by protecting veterinarians and their families.