Zoonotic disease risk perceptions in the British veterinary profession

Abstract

In human and veterinary medicine, reducing the risk of occupationally-acquired infections relies on effective infection prevention and control practices (IPCs). In veterinary medicine, zoonoses present a risk to practitioners, yet little is known about how these risks are understood and how this translates into health protective behaviour. This study aimed to explore risk perceptions within the British veterinary profession and identify motivators and barriers to compliance with IPCs. A cross-sectional study was conducted using veterinary practices registered with the Royal College of Veterinary Surgeons. Here we demonstrate that compliance with IPCs is influenced by more than just knowledge and experience, and understanding of risk is complex and multifactorial. Out of 252 respondents, the majority were not concerned about the risk of zoonoses (57.5%); however, a considerable proportion (34.9%) was. Overall, 44.0% of respondents reported contracting a confirmed or suspected zoonoses, most frequently dermatophytosis (58.6%). In veterinary professionals who had previous experience of managing zoonotic cases, time or financial constraints and a concern for adverse animal reactions were not perceived as barriers to use of personal protective equipment (PPE). For those working in large animal practice, the most significant motivator for using PPE was concerns over liability. When assessing responses to a range of different "infection control attitudes", veterinary nurses tended to have a more positive perspective, compared with veterinary surgeons. Our results demonstrate that IPCs are not always adhered to, and factors influencing motivators and barriers to compliance are not simply based on knowledge and experience. Educating veterinary professionals may help improve compliance to a certain extent, however increased knowledge does not necessarily equate to an increase in risk-mitigating behaviour. This highlights that the construction of risk is complex and circumstance-specific and to get a real grasp on compliance with IPCs, this construction needs to be explored in more depth.

Keywords: Infection control practices; Personal protective equipment; Public health; Risk perceptions; Veterinary profession; Zoonoses.

Fig. 1

Relative frequency of reported zoonotic infections in a sample of 111 veterinary professionals from a cross-sectional survey of the British veterinary profession conducted in 2014, who reported a confirmed or suspected episode of occupationally-acquired zoonotic infection during their career, comparing those who had qualified or practiced outside GB (n = 19) with those who had qualified or practiced exclusively within GB (n = 92).

Fig. 2

Perceptions of risk from eight different clinical scenarios in a sample of 252 veterinary professionals from a cross-sectional survey of the British veterinary profession conducted in 2014. The clinical scenarios respondents were asked to assess the risk from included contact with animal faeces/urine; contact with animal blood; contact with animal saliva or other bodily fluid; performing post mortem examinations, assisting conception and parturition for animals, contact with healthy animals; contact with clinically sick animals and accidental injury. * Post mortem examination.

Fig. 3

Triplots showing reported use of personal protective equipment (PPE) in five different clinical scenarios in a sample of 221 veterinary professionals from a cross-sectional survey of the British veterinary profession conducted in 2014. Angles between variables reflect their correlations. Solid green lines represent the normalised PPE scores; dashed lines represent the explanatory variables. PPE use was scored in comparison with the National Association of State Public Health Veterinarians in the United States (NASPHV) guidelines. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)

Fig. 4

Triplots showing a) barriers and b) motivators to the use of personal protective equipment (PPE) in a sample of 240 veterinary professionals from a cross-sectional survey of the British veterinary profession conducted in 2014. Angles between variables reflect their correlations. Solid green lines represent the barriers/motivators; dashed lines represent the explanatory variables. Options for barriers for PPE use included time constraints; financial constraints; safety concerns; negative client perceptions; adverse animal reactions to PPE; availability of equipment. Options for motivators for PPE use included perceived risk to self, previous experience, practice guidelines, practices of competing veterinary practices, liability concerns, positive client perceptions and a recent disease outbreak. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)

Fig. 5

Principal component analysis of attitudes and perceptions related to zoonotic disease risk, from a sample of 244 veterinary professionals from a cross-sectional survey of the British veterinary profession conducted in 2014, based on the responses to 10 statements about attitudes towards risk of zoonotic infection and infection control practices.