1. The Etiology and Consequences of Injuries to Certified Veterinary Technicians (CVTs)
Leslie Nordgren, MPH
Susan Gerberich, PhD
Bruce Alexander, PhD
Andrew Ryan, MS
Timothy Church, PhD
Jeff Bender, DVM, MS

2. Background Greatest number of injuries to veterinarians due to:
- Animal bites and other animal-induced
trauma
- Needle sticks
- Ergonomic injuries
2004 study of 147 Veterinary Technicians:
Bites and scratches
Needle sticks
Chronic neck and back pain
This is the first population based study surveying CVTs from a given state.

3. Methods – Phase 1 Phase 1 - Determined: - Frequency - Rates
- Consequences
- Potential risk factors
Identified injury events in past 12 months
Collected exposure data on the 4 most severe injuries in past 12 months
Up to 3 follow-up surveys
Bullet 1 - For injuries in all CVTs certified in Minnesota.

4. Methods – Phase 2
Case-control study to determine risk and protective factors for bite injuries
Cases - exposures during the month prior to the incident.
Controls - exposures during the month prior to a randomly selected month from the study period.

5. Phase 1 Data Analyses
Determined injury rates by various characteristics using Poisson models
Multivariate regression – to determine potential risk factors

6. Injury definition An acute traumatic event
Occurring as a result of veterinary practice
- In the Clinic
- On the client’s or employer’s premises
- During work-related driving activities to or
from the client’s location

7. Injury definition
Restriction of normal activities for any length of time
Loss of consciousness, loss of awareness or amnesia for any length of time
The use of medical assistance
Bruising and/or break in the skin from a bite injury

8. Phase I Response rate 1427 - Surveys mailed to valid addresses
Responded
73.7% - Response rate
873 - Eligible
Those not eligible did not work in the 12 months prior to the survey

9. Population 97% - Female 73% - 25 to 44 Years of age
53% - Worked from 3 to 11 years as a CVT

10. Facility characteristics
58% - small animal private clinical practice
66% - clinics with 3 or more doctors
72% - clinics with 3 or more CVTs
42% - clinics with less than 11 total staff
< 11 employees – not regulated by OSHA standards
4 separate questions about where they worked

11. Primary animals handled
96% - Dogs
91% - Cats
74% - Pocket pets (rabbits, rodents, chinchillas,
etc.)
48% - Ferrets
46% - Birds
28% - Exotics (snakes, turtles, lizards, etc.)

12. Injury experience 51% - Injuries in past 12 months
36% - 3 or more injuries
1,827 - Total injuries
Injuries per 100 full-time CVTs per year
Bullet 3 – among 873 CVTs

13. Injury experience 12.7 - Lost time injuries per 100 full-time CVTs
per year
600 - Total bites in past 12 months
Bite rate per 100 full-time CVTs per year
Bullet 1 – 98 lost time injuries for 75 CVTs
Rate for loosing 1 or more days = 5.3 per 100 full-time CVTs per year (41 lost time > 1 day for 28 CVTs
Bullet 3 – This is the basis for the case-control phase.

14. For the 4 reported most severe injuries (N = 777):
Body location:
85% - Hands and arms
Most Frequent Sources:
47% - Cats
35% - Dogs
3.5% - Pocket Pets
3.5% - Needle/scalpel
Type:
52% - Bite injuries
We collected descriptive information about the 4 most severe injuries during the past 12 months, and for these injuries, 85%
Bullet 2 – 5 – in order of frequency

15. Treatment of the most severe injuries
77% of injuries - received treatment
Sources of treatment:
47% - Treated themselves
19% - Physician
10% - Urgent care
5% - Chiropractor

16. Consequences of the most severe injuries

17. Higher injury rates per 100 full-time CVTs

18. Higher injury rates per 100 full-time CVTs
Worked less than 4 years as CVT –
rate = (C.I. = 70.5 to 424.1)
Worked in a mixed, mostly small,
animal clinic - Rate = 593.8
(C.I. = 40.5 to 652.4)
Believed work-related injuries a
problem - Rate = (C.I. = 95.3 to 330.0)

19. Factors associated with CVT injuries- Multivariate analyses
Bullet 1 – includes type of facility
Bullet 2 – includes age

20. Factors associated with CVT injuries- Multivariate analyses
Bullet 1 – includes type of facility
Bullet 2 – includes age

21. Phase 2 - Case-Control Study
Identify risk factors associated with animal bites, based on relevant exposures

22. Phase 2 - Response rate
Questionnaires mailed to all CVT’s who returned Phase 1 questionnaires
534 - Responded – 61.9%
489 - Eligible

23. Phase II – Bite Cases and Controls
Cases – bite injury
- 176
Controls – no bite injury
- 313

24. Risks for bite injury - Multivariate analyses
Bullet 1 – includes type of facility
Bullet 2 – includes age

25. Risks for bite injury - Multivariate analyses
Bullet 1 – includes type of facility
Bullet 2 – includes age

26. Risks for bite injury - Multivariate analyses
Bullet 1 – includes type of facility
Bullet 2 – includes age

27. Risk of bite injury associated with using muzzles
Compared with those reporting no use of muzzles during the selected month:
Over 4 times the risk of bite injury with use of muzzles
Only 6 of the 176 cases who reported that they used muzzles during the indicated month made any mention of using a muzzle during the injury event description.
We may need to ask the exposure questions within a time-frame closer to the event. This would involve a change to study design to better study the effects of bite prevention methods.

28. Conclusions Opportunities for future research on injury exposures:
Clinical and animal handling experience
Handling multiple types of animals
Exposures in emergency and small animal clinics
Working long hours
Effects of owners presence during procedures
Perception of injury risk
Clinic staffing levels
Protective equipment and best work practices for injury risk reduction

29. Acknowledgments
Support for this effort was provided, in part, by the: National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention, Department of Health and Human Services, National Occupational Research Agenda Program and the Occupational Injury Prevention Research Training Program Midwest Center for Occupational Health and Safety (T42 OH008434); and the Regional Injury Prevention Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, U.S.A. The contents of this effort are solely the responsibility of the authors and do not necessarily represent the official view of the Centers for Disease Control and Prevention or other associated entities.